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Having back pain. MRI showed disc bulge lateralisation at L4-5 level. Looking for suggestion

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Practicing since : 2006
Answered : 554 Questions
Hi below is my mri observation
I was having back pain
Pls. Provide ur suggestion . I have taken bed rest of 10 days. Feeling better
MRI lumbosacral spine findings revel disc bulge lateralisation towards left side at L4-5 level causing indentation of thecal sac and narrowing of bilateral lateral recess L>R with compromise of left neural foramina.
Posted Fri, 17 May 2013 in Back Pain
Answered by Dr. Satyadeo Choubey 2 hours later
Thanks for visiting XXXXXXX
One thing common between you and me is, I also suffered same situation during my MD.
Bulging of disc or prolapse of intervertebral disc (PIVD) as it is said, is a condition when the disc present between two vertebra, bulges posteriorly or laterally and presses on spinal cord and nerve roots causing pain and para-spinal muscle spasm leading to straightening of normal curvature of spine ( first line of your MRI report). In your case, your left nerve roots are being pressed more than right (left lateralisation).
Now regarding the treatment options:
1) Bed rest, which you have completed. Proper sitting postures and avoidance of prolonged sitting. Avoid spinal jerks as on bike. Avoid lifting weights with forward bending from hip as it increases the pressure on spine rather than legs.
2) Analgesics like ibuprofen, naproxen etc along with muscle relaxant.
3) Back extension exercises under supervision of physiotherapist. This is what you need the most and carry on even after subsidence of pain. Hot fomentation on the site also helps relieving acute pain.
4) If these conservative measures fail, and pain persists by 4-6 weeks you may go for epidural steroid injection.
5) Last resort is surgery like microdiskectomy or laminectomy to relieve pressure on thecal sac and neural faramina.
Usually the pain goes by physiotherapy and other conservative measures only and surgery is least needed.

Hopefully you have got what you wanted.....
Best wishes
Above answer was peer-reviewed by
Follow-up: Having back pain. MRI showed disc bulge lateralisation at L4-5 level. Looking for suggestion 6 hours later
Thanks a lot doctor
sometime pain is not there sometime it is like today it is there ,,.
Also I took mobizox, ultracet, dolonex for 7 days after that neorelax MR8 for 5 days. Not talking any medicine now. Also I started ultrasount physiotherapy 4 days back. Pls advice do I need more rest, n should I continue medicine till what time, also how much it takes to recover completely.
Thanks n looking forward for you suggestion.
Answered by Dr. Satyadeo Choubey 1 hour later
Thanks for follow up,
Both mobizox and neorelax are muscle relaxant. and ultracet and dolonex are analgesics (pain killer). You may continue the combination of analgesic and muscle relaxant for one more week but frankly speaking, it is the back extension exercises or physiotherapy which is going to help you and it may have to be continued for longer period. Please go for hard bed rest i.e avoid soft beddings during sleeping, avoid prolonged seating and seat with your back straight because seating with frontal bowing of lower spine will exacerbate the symptoms. Avoid jerks on bikes.
If by all means pain doesn't subsides by 4-6 weeks you may opt for steroid injection....

Best wishes
Above answer was peer-reviewed by
Follow-up: Having back pain. MRI showed disc bulge lateralisation at L4-5 level. Looking for suggestion 1 hour later
Thanks a lot definitely I will follow all your suggestions
I m still confused on waist belt suggested to me
Do I need to use it at home or ONLY going outside
Also specific therepy u reckon would u suggest based on your exp.
Thanks in advance
Answered by Dr. Satyadeo Choubey 7 minutes later
Again thanks,
There is no mentioning of waist belt in literature. The only thing is to any how you have to strengthen lower paraspinal muscles by back extension exercises and avoid forward bending of spine.
If belt suits you then can use it, better use it while going outside.
Nothing specific therapy, just honestly follow the advice and chill.....

I tried to make you understand how the disc bulge leads to symptom and what is the idea behind each treatment......Hopefully I succeeded....

Best wishes
Above answer was peer-reviewed by
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