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What are the treatment available for multiple lumbar discs and nerve root compression?

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General & Family Physician
Practicing since : 2001
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Hi ,MR image for My aunt(52y) suggests multiple lumbar discs at L3-L4,L4-L5,L5-LS1 casing thecal SAC and back pain,Thanking you-XXXXXXX
Posted Sat, 9 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Michelle Gibson James 2 hours later
Hi, thanks for using healthcare magic

Problems related to the lumbar disc are a common reason for back pain. The disc are present between the vertebra and act as shock absorbers. They are composed of two parts; a central part and an outer ring.
The thecal sac is the membrane that surrounds the spinal cord and the nerves. Problems related to the disc can result in compression of the thecal sac and therefore possibly affect the spinal cord.

The MRI report does state that there is evidence of compression at the level of L3-L3 secondary to bulging of the disc.

Treatment can be divided into medical therapy and surgical. All persons are started first on medical therapy.

Your aunt would first be advised bed rest for a short amount of time (1 to 2 weeks), no longer than this because inactivity for a long period of time actually causes decreased muscle strength , stiffness and a decrease in bone density.

She should be given a course of pain medication and possibly muscle relaxants. Some people find that the muscle relaxants help them but others do not.

After the period of bed rest, physical therapy under the guidance of a physical therapist, should be started.The therapist would perform a number of techniques including (1) manual therapeutic technique which involves massaging, moving and stretching exercises to increase the range of motion of the spine
(2)therapeutic exercise which would involve stretching and strengthening exercises of the back and abdomen, by strengthening the abdomen it would decrease the stress on the back
(3)neuromuscular reduction- this restores her posture and teaches proper sitting and lying positions
(4) the use of ultrasound and other stimulation techniques
(5) they would also teach the exercises that are to be done at home

An occupational therapist can also be useful for some persons. They assist in modifying the home and showing how to get about with normal activities of daily living.

At present your aunt should take it easy, consider using an ice pack which would decrease any spasm of the muscle. It would be best not to do any exercise till she has been seen and assessed by a physical therapist. With physical therapy and pain medication, persons may have improvement of symptoms in months.

As stated there are surgical options but these are done only if there the symptoms do not improve with a course of physical therapy or there are worsening neurological symptoms such as weakness, numbness in the anal or genital region.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: What are the treatment available for multiple lumbar discs and nerve root compression? 2 days later
Hi Doctor,I am happy with your quick and useful advice for my aunt health issue.i conveyed the same and got few more inputs from her about the issue.They are as follows:
-Her back pain is very severe that she is unable to do any routine home tasks except standing,sitting and slow walking (in the home).
-She consulted local orthopedic doctor and is using medicine for pain relief etc and taking rest to cure from the decease.And not interested in surgery as it takes long recovery time.
- She also went through physical therapy for 10 days.
-She is getting pain at left foot.While taking bed rest she is getting opposite side body pain that is if she lying on the bed on left arm side ,she gets pain at right arm side body pains and vice verse.She is worrying about this inconvenience.
-She wants to wait and see few days by using local doctor's medicine prescription(Doctor advised) before surgery option.

Please review her/our views above and suggest on the same.

Thanking you,

Answered by Dr. Michelle Gibson James 7 hours later

There is no need to consider surgery at this point unless she is there is severe evidence of nerve compression.
It is good that physical therapy was started, it actually is suppose to continue for months unless the doctor and your aunt decide to go for surgery. If possible , she needs to start back the therapy, it is the main part of recovery function and strengthening the back.
She needs to continue the pain medication, if it is not working, ask the doctor for a stronger medication that may be more effective.

The symptoms that she is experiencing are all related to what was seen on the MRI.

Please feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: What are the treatment available for multiple lumbar discs and nerve root compression? 2 days later
Hi Doctor, Thanks for quick response again..

As mentioned above, she was using medication as prescribed from local doctor.
Now she was using pain killer medicines on daily basis..
Please let me know if she use these medicines on long-term, it may leeds to side effects. please confirm.

Note: from last 2-3 months onwars she was using pain-killers as prescribed by doctor.

Answered by Dr. Michelle Gibson James 8 hours later

It would depend on the type of pain killer used.
Pain killers that are in the NSAID family of drugs ( ibuprofen /cataflam /voltaren /celebrex) are associated with increased risk of gastritis and peptic ulcer disease which can result in bleeding from the stomach, this risk is decreased when taken on a full stomach.
There is also increased risk of kidney disease.

Overuse or excess use of paracetamol can potentially cause liver disease (if dose is very high)

Excess use of opiates can be associated with constipation, tolerance and dependence on the drug and possible addiction.

Please feel free to ask any other questions
Above answer was peer-reviewed by
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