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Remedy for pain reduction due to back injury - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Back Pain
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Dear Dr.,I hurt my back a month ago when lifting 20 Lt of water bucket. I am in complete rest. (lying on a hard cot all the time). but the pain is not reduced. My MRI impression says.Transitional vertebra (lumbarisation of S1) at lumbo sacral junction.
Circumferential disc bulge evident at L4/L5 and L5/S1 levels with no significant thecal sac comprssions / nerve root impingement.A small and sharp postero central disc protrusion at D6/D7 level causing mild ventral thecal sac compression and anterior cord surface indentation.I have pain at my lower back. Please direct me what to do to reduce the pain. Thanks.
Doctor :   Hi
Doctor :   Let me read the query.
User :   sure Dr.
Doctor :   May I know your age and gender?
User :   i am 36 Male
Doctor :   Apart from the bed rest, may I know, what other treatment have been suggested by your doctors?
User :   initially for the first week muscle relaxant, pain killers and IFT physiotherapy.
Doctor :   Ok
User :   After that my Dr. told to stop the medicines and told me to continue physiotheraphy.
Doctor :   Has the pain reduced?
User :   it got reduced a little. but after that point the pain continues at the same level.
Doctor :   Ok
Doctor :   Do you feel the pain is radiating down to your lower limbs?
User :   no. it is stationed at the same place. junction of spine with pelvic bone region.
Doctor :   Do you feel any weakness of the lower limb?
User :   no. but my left knee hurts ( ecause of the damage caused by chikengunya in 2006)
Doctor :   Ok
Doctor :   Do you have any other medical problem such as diabetes/hypertension/kidney disease/Gastritis?
User :   no. by god's grace i am normal.
Doctor :   Ok
Doctor :   Let me brief you.
Doctor :   The exact treatment for a disc prolapse is a surgical treatment, however, since in your case the prolapse is mild
Doctor :   (indenting only the thecal sac, which is the outer most layer of the spinal cord),
User :   ok.
Doctor :   the need for immediate surgical treatment is not necessary.
Doctor :   The next form of treatment is by medical drugs, physiotherapy and rest.
Doctor :   Your doctors are right in treating you with the pain killers, physiotherapy and bed rest.
Doctor :   I shall however suggest you few more things which should help you in the recovery.
User :   will exercise help
Doctor :   1. If the pain is severe, you can continue with analgesics for few more days.
Doctor :   Simple analgesics are ibuprofen 400mg twice daily after food.
Doctor :   You can alternatively use the analgesics suggested by your doctor for a few more days.
Doctor :   2. Since analgesics can induce gastritis, use antacid syrups such as Syp Mucaine gel 2tsp twice daily before the meals as long as you use the analgesics.
Doctor :   3. Absolutely no exercises till the pain relieves completely.
User :   ok
Doctor :   4. You can use lumbar belts for back support.
Doctor :   They act by preventing the unintentional movements of the back which can lead to pain and thereby slowing the time of healing.
Doctor :   6. Continue with the physiotherapy - moist heat therapy or infrared radiations are one of the modalities of physiotherapy which can help.
Doctor :   Discuss with your physiotherapist regarding these.
User :   ok. i have few doubts. 1. what will happen to the bulge after some time. 2. when can i resume to normal routine work.
Doctor :   7. Watch out for symptoms such as weakness of limbs, pain radiating down the limbs, any difficulty while passing urine.
User :   ok
Doctor :   If you develop any of these symptoms, you need t to report to your doctors.
Doctor :   Unfortunately the disc which has bulged out will not go back to its normal positions.
User :   Will it hurt me forever.
Doctor :   It can either regress in size over a period of time, or
Doctor :   the worse instant it can increase the size leading to further indentation.
Doctor :   In such cases the treatment is surgical.
Doctor :   The symptoms mentioned to you are the symptoms and features of worsening of the prolapse.
Doctor :   So watch out for this.
User :   ok dr.
Doctor :   The chances of this happening is only if you continue straining such as heavy weight lifting, severe exercises.
Doctor :   So I would suggest you to avoid these acitivities as much as possible.
User :   For your information, i am newly married.
Doctor :   The present pain will gradually subside, if you follow the instructions strictly and you will be able to lead a normal life.
Doctor :   Follow these instructions strictly and you should be able to lead a normal life, you should not have any problems.
Doctor :   Have you followed what I have suggested?
User :   yes ofcourse.
User :   i am in COMPLETE REST.
Doctor :   Yes, and strictly avoid exercises and if possible you can get the lumbar belts too, (discuss with your orthopedicians)
Doctor :   Do you have any other query that I can assist you with?
User :   yes. you are saying that with complete rest, the pain can be reduced. normally how long it will take.
Doctor :   Since I haven't physically examined you, I will not be able to answer this question accurately. Nevertheless,
Doctor :   It may take another few weeks (2 to 4 weeks) for the symptoms to reduce.
Doctor :   It depends on the amount of inflammation that you sustained during the time of injury.
Doctor :   But it will reduce if you continue with the rest.
Doctor :   Have you followed what I have suggested?
Doctor :   Do you have any other query?
User :   yes Dr. what about the D6/D7 disc protrusion.
User :   i followed your suggestion and will continue to remain in rest.
Doctor :   I have discussed about this earlier, it would slowly regress or if there is further similar instances, it can worse.
User :   ok dr.
Doctor :   Do you have any other query?
User :   thanks dr. i will follow your insturctions.
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
User :   bye
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