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Suggest treatment for lumbar disc disease with radiculopathy

Jul 2013
User rating for this question
Very Good
Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Hello Doctor , While playing in ground i kept my right leg in depth place , and total body weight went in right leg and the back pain started , next day i feel nurve pulling pain in right leg and some time while walking the right leg toes become num . I Took MRI and it says : L1 – L2, L2 – L3 & L3 – L4 discs are normal. L4 – L5 disc shows minimal bulge indenting thecal sac. L5 – S1 disc shows diffuse bulge with small posterior right paracentral protrusion impinging on right S1 root. Please help me on this Regards, XXXX
Posted Wed, 12 Feb 2014 in General Health
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer: You have lumbar disc disease with radiculopathy. Detailed Answer: Hi, thanks for writing to XXXXXXX Due to the sudden strain imparted on your back, you have suffered a lumbar disc protrusion which causes pressure over the adjacent nerve root causing you the symptoms of pain, tingling and numbness in S1 dermatome (area of foot supplied by S1 nerve). There is nothing to panic about this condition as in most of the cases, the symptoms will get significantly reduced with conservative (non surgical) measures. The initial management of your problem will be as follows - - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. - Take rest breaks throughout the day, but avoid sitting for long periods of time. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction (under the supervision of a physiotherapist) might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements (methylcobalamine) & Pregabalin may be helpful in controlling the neuropathic pain. With all the above measures being followed strictly, there should be substantial symptom relief for you. If not, consult an orthopedic surgeon for further management. Hope this information is helpful. I welcome any more clarification Regards
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Follow-up: Suggest treatment for lumbar disc disease with radiculopathy 14 minutes later
Thanks for the answer doctor .iam an IT consultant used to sit for long time .how can i avoid that and is there any workaround. Is that advisable to drive bike for short distance. How long will it take to recover
Answered by Dr. K. Naga Ravi Prasad 8 hours later
Brief Answer: Use a Lumbo-sacral corset. Detailed Answer: Hi, Nice to hear from you. When prolonged sitting is unavoidable (owing to your job pattern), it is advisable either to wear a lumbo-sacral corset (simply stating -lumbar belt) or to use a spinal back support pillow on your chair (which are commercially available). Both of these measures are quite helpful in reducing your back pain. Generally, "JERKY" bike rides are to be avoided (as one single forward jerk may worsen your disc protrusion). Use the Lumbar belt while driving bike also, which will prevent forward bending of your spine. With conservative measures, significant symptom relief can be attained within 3-6 weeks. Hope I have justified your query. Good day
Above answer was peer-reviewed by
Follow-up: Suggest treatment for lumbar disc disease with radiculopathy 9 hours later
Thanks doctor , one more advice, can I use ice bag or heat bag to apply in my painfull area? Which one is better
Answered by Dr. K. Naga Ravi Prasad 30 minutes later
Brief Answer: Please find your answer below. Detailed Answer: Hi, Both Ice and Heat are effective in providing pain relief. But, Ice packing is advised for ACUTE pain (persisting for a shorter period) and Hot compresses for CHRONIC pain (pain present since longer periods). Ice will help calm the inflammatory response and stimulate blood flow to the area. Before any activity, gentle heating can help loosen the painful and stiff muscle. Apply a heat pack to the painful area prior to stretching or exercising. As a general rule of thumb, remember to heat the painful area before an activity and ice it afterwards. Happy to help further. Good luck
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