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Back pain. MRI reveals disc bulge-herniation protrusion producing thecal sac indentation. Why?

MY MRI reveals disc bulge-herniation at L4-5 level(protrusion) producing thecal sac indentation and narrowing of bilateral neural foramina. I really need your help because i live in a poor country like afghanistan. I dont have pain too much. just when i bend i feel pain in my back and in all over the feet also when i walk i feel pain in my right knee
Asked On : Sun, 21 Apr 2013
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Spine Surgeon 's  Response
Not all disc bulges require surgery.
Avoid forward bending.
Sit supported.
Reduce weight if your are overweight.
Do back extension exercises. This should help.
There are Neurosurgeons/ Orthopedicians in your country ,you should consult them in addition.
Answered: Sun, 21 Apr 2013
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Orthopaedic Surgeon Dr. Sunil Kumar Srivastava's  Response
Wear some belt around (lower back). Avoid lifting weights and forward bending. Take anti-inflammatory(Ibuprofen400-600mg) twice a day after meals and apply hot packs to back.Also apply diclofenac sodium ointment to lower back and massage it with the cream.lie on hard bed and lie in posture which gives maximum relief.Injections of VITAMIN B1B6B12 (neurobion) once daily for 5 days in addition intramuscularly. Add muscle relaxant methacarbamol 750 mg tabs if there is too much stiffness in back , twice a day after meals for 3-5 days
Answered: Sun, 21 Apr 2013
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Spine Surgeon Dr. Rahul D Chaudhari's  Response
Welcome to HCM.
L4-5 disc herniation causes back pain and leg pain if there is nerve compression. Treatment usually decided on patient symptoms and severity of the disc herniation. Initially we always treat with anti-infflammatory with muscle relaxant with local gel application and if possible physiotherapy such as interferrential therapy. This treatment will resolve the pain in most patients.
If you pain is minimal then start doing back muscle and leg exercises. Thanks.
Answered: Sun, 21 Apr 2013
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Orthopaedic Surgeon Dr. Mukesh Tiwari's  Response

Welcome at HCM.

I have read your question completely.

It looks from your details that you are suffering prolapsed disc at L4-5 level.You are also having symptoms for that.At present you should do following to have relief in that-

-Take strict bed rest.

-Take a good analgesic like advil or aleeve.There are some other medicines like tramadol,pregabaline or gabapentin which should only be taken after consulting your doctor & in severe pain.

-Do warm fomentation over your back.This will help in reliving spasm.

-Take the help of a good physiotherapist who may help you in learning some exercises.

-After a period of bed rest ,when you are pain free,you may do following strengthening exercises-

Hope this all will help you.

With best wishes.
Answered: Sun, 21 Apr 2013
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