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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Diffuse Dice Bulge With Posterior Disc. Narrowing Pain Of Spinal Canal. Narrowing Bilateral Neural Foramina. Surgery?

I am 46yrs with l4_5 level and l5_s1 level there is diffuse dice bulge with posterior disc herniation measuring 13mutt+5mm so and 15mmtr+6mm so respectively severe narrowing of spinal canal with improvement of left l5 and s1 traversing nerve roots and mild narrowing of bilateral neural foramina. Is surgery the only way to stop the pain and numbness.
Fri, 4 Oct 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

Surgical decompression is the last option in the management of a lumbar disc disease with radiculopathy.

The conservative management is as follows -

* Avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Avoid lifting heavy weights as it imparts more strain on your back
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Judicious use of analgesics and muscle relaxants
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Epidural steroids are useful for patients with severe radicular pains in the limbs. Cortisone is a powerful anti-inflammatory preparation and so its injections in the "epidural space" can decrease swelling as well as pain.

If all the above measures fail to provide you symptom relief, then surgery is indicated.

Hope this information is helpful. Good day



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Have Diffuse Dice Bulge With Posterior Disc. Narrowing Pain Of Spinal Canal. Narrowing Bilateral Neural Foramina. Surgery?

Hi, thanks for writing to HCM. Surgical decompression is the last option in the management of a lumbar disc disease with radiculopathy. The conservative management is as follows - * Avoid forward bending activities as it will worsen the disc protrusion * Use a lumbosacral back support to augment your spinal muscles * Avoid lifting heavy weights as it imparts more strain on your back * Intermittent pelvic traction to cause a regression of disc * Maintain optimum body weight,if you are obese * Judicious use of analgesics and muscle relaxants * Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided. * Epidural steroids are useful for patients with severe radicular pains in the limbs. Cortisone is a powerful anti-inflammatory preparation and so its injections in the epidural space can decrease swelling as well as pain. If all the above measures fail to provide you symptom relief, then surgery is indicated. Hope this information is helpful. Good day