What causes severe lower back pain?

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Posted on Fri, 12 Jun 2015 in General Health
Question: Hi...
My father (58 years old) has been having pain in his back recently, he went to check an orthopedics, who ordered an MRI (report of MRI is attached.)
Pictures of the scan:
https://www.dropbox.com/sh/7ja3ma60uf6yo9q/AAAOwifn9RJmXkaFYFUT_dFBa?dl=0

the doctor indicated that two discs are formed in his spine... requesting him to undergo urgent surgery to fix that... I have the following questions:
1- according to the report and photos, is surgery necessary really ? and what are the expected complications if surgery is not done?

2-Is it a critical matter to perform the surgery right now? or can my father go about his business ?
3-what do they do in this kind of surgery? how long does it take? and what are the expected complications? recovery time? will he recover 100% if he undergoes the surgery?is there a probability the recovery doesn't go will? are there any steps to take now to avoid any more complications?
doctor
Answered by Dr. Adrian Rawlinson 23 minutes later
Brief Answer:
Low back pain

Detailed Answer:
Hello,

Thank you for contacting us. I will try to answer your question to the best of my ability.

On reviewing your case I can say that NO surgery is indicated at this time. Your MRI shows some non specific age related changes that are probably NOT causing the pain.

Please read this article written by a Physical Therapist colleague of mine - http://breakingmuscle.com/health-medicine/you-are-not-your-mri-results

The bottom line here is "treat the patient NOT the MRI scan". I would suggest using anti inflammatory medications, using good posture, applying heat and seeing a good physical therapist.

If that was my own MRI I would not seek out the help of a surgeon until I had done therapy for 3 months and exhausted all the non-surgical options.

I hope this helps. Best wishes.

Dr Rawlinson.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Adrian Rawlinson 50 minutes later
Thank you for your reply Dr. ;

* Shouldn't I be worried about (reduction of the spinal canal capacity at corresponding level A3-A4 ) and (diffuse posterior disc bulge indenting the ventral aspect of the thecal sac associated with bilateral facet joints hypertrophy obliterating both exit nerve foramina) mentioned in the MRI report?

* Do you have a more detailed treatment that I can follow?
doctor
Answered by Dr. Adrian Rawlinson 11 minutes later
Brief Answer:
Non specific low back pain -

Detailed Answer:
....The MRI findings are all very common in a 58 year old spine. Disc bulges, facet joint hypertrophy, spinal stenosis etc are all findings which describe 'wear and tear' - sometimes called arthritis or degeneration.

Even with MRI it is difficult to say where the pain is coming from. As detailed in that article just treat the symptoms and dont worrry too much about specific anatomical causes for the pain.

Treatment at this time would include;

Heat
Ibuprofen and/or tylenol.
PT - to include stretching and strengthening exercises
Sometimes a muscle relaxer medication if you have a lot of stiffness.
Massage can help
Some people try acupuncture for pain relief
Occasionally I will administer a steroid injection if the pain is persistent.

Dr R.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Adrian Rawlinson 3 days later
Thank you for the reply...

Assume we do go with the operation.... I would like to know all the information related to it as:
what do they do in this kind of surgery? how long does it take? and what are the expected complications? recovery time? will he recover 100% if he undergoes the surgery?is there a probability the recovery doesn't go will? are there any steps to take now to avoid any more complications?
doctor
Answered by Dr. Adrian Rawlinson 22 minutes later
Brief Answer:
Surgical option

Detailed Answer:
Hello,

If this were me or my dad I would NOT do surgery. I always tell patients who are thinking about surgery to get at least 2 or 3 surgical opinions - dont rely on the opinion of just one surgeon.

Surgery is NOT guaranteed to work - in my experience one third of patient get better, one third stay the same and one third get worse!

Your specific questions should be addressed to the surgeon as there are lots of different procedures and each has its own risks etc - from a simple diskectomy to a full spinal fusion.

Dr Rawlinson.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Answered by
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Dr. Adrian Rawlinson

Sports Medicine Specialist

Practicing since :1983

Answered : 77 Questions

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