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Suggest treatment for disc prolapse causing pinching nerves

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Posted on Sat, 7 May 2016
Question: Thank you for following up with me on this. I've since seen my PCP who just asked which ortho I wanted to see to have surgery to fix the discs. I said none. So he sent me to rehab. What is considered a normal time frame before I feel better. Right now we're at the adjustments and tens and massage phase which hurts. Would microdiscectomy just fix it and be done? This has been years and years of pain and the discs are getting worse. Obviously the RPT thinks he can fix it. I asked about pain management buy my Dr isn't a fan. (Said they'll do a ton of injections. U til insurance won't pay anymore, then turn me into an addict, even though I have no history of abuse) He gives me low doses of opiates for PT and has started me on 60mg of cymbalta and a muscle relaxer. We're working on anxiety issues too. Also if PT fails and I finally give into surgery I've heard neuros are better than orthos for nerve issues. Sorry that's a lot of information. With l5/s1 pinching the s1 nerve this is the first time I've considered surgery. I've just put up with it for 20 years.
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Answered by Dr. Neeraj Kumar (22 hours later)
Brief Answer:
Take treatment as advised and upload Mri images

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
For disc prolapse causing pinching nerves the treatment is as follows.
First pain killers with muscle relaxant along with pain modulator like pregabalin or amitryptiline or gabapentin are used in increasing doses.
Second physiotherapy remains an important part of management for strengthening the back muscles.
Surgical options are to be explored if the pain is not controlled adequately despite medication intake, or there is neurodeficit in form of weakness, sensory loss or bladder symptoms.
The best person for surgical procedure will be neurosurgeon for spine.
The procedure type depends upon the condition of disc, amount of prolapse, number of disc involvement, condition of foramina.
You can upload Mri images for better assessment regarding this.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Neeraj Kumar (44 minutes later)
I have the disk so if I can figure how to upload the actual images I will. I appreciate the advice. I do have some bladder issues I keep forgetting to talk to my dr about because we're focusing on the back and anxiety. I can't feel when I'm going or done. Also I have had 1 bout of incontinence. The RPT also said he could feel a vertibrae that was out of alignment he's working on.
doctor
Answered by Dr. Neeraj Kumar (13 hours later)
Brief Answer:
Upload Mri images

Detailed Answer:
Hello,
You can upload images in a compiled pdf format for review. If not possible then upload the report.
Actual situation can only be assessed by imaging.
You can also upload prescription of treating doctors.
Continue physiotherapy and medications as advised.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Neeraj Kumar

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Practicing since :2006

Answered : 2263 Questions

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Suggest treatment for disc prolapse causing pinching nerves

Brief Answer: Take treatment as advised and upload Mri images Detailed Answer: Hello, I have gone through your question and understand your concerns. For disc prolapse causing pinching nerves the treatment is as follows. First pain killers with muscle relaxant along with pain modulator like pregabalin or amitryptiline or gabapentin are used in increasing doses. Second physiotherapy remains an important part of management for strengthening the back muscles. Surgical options are to be explored if the pain is not controlled adequately despite medication intake, or there is neurodeficit in form of weakness, sensory loss or bladder symptoms. The best person for surgical procedure will be neurosurgeon for spine. The procedure type depends upon the condition of disc, amount of prolapse, number of disc involvement, condition of foramina. You can upload Mri images for better assessment regarding this. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr N Kumar Neurologist