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Herniated disc at L6-S1. Prescribed Ibuprofen. Best course of action?

Hi, My son is 17 and has a herniated disc at L6-S1. A chiropractor he d been seeing ordered some x-rays and then suggested he get an MRI . His doctor sent him to physical therapy and the therapist says he can t help him since he hasn t improved any over the last month and a half. He has been prescribed 2 different high dose ibuprofen medications that he can t take as they make him sick. He has trouble getting dressed (putting his pants and socks on). He is in the process of being referred to a spine specialist. What would be the best course of action for him?
Asked On : Sat, 17 Nov 2012
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Spine Surgeon 's  Response
Thank you for your question to HCM.

Medicines and physical therapy usually form the first line of treatment for disc herniation which he has already tried for around 6 weeks. Another medicine which can be tried is pregabalin or gabapentin which is specifically for nerve pain.

Depending upon the location of disc herniation in the MRI and the compressed nerve, selective nerve root block is a next option. It is an injection of a streroid and local anesthetic in the spine. This helps many patients and is also diagnostic that the compressed nerve is the problem. The injections can be repeated if needed.

If the injection helps for some time but pain recurs surgery (microdiscectomy) is indicated. Surgery is only for pain relief in the short term as results of surgery and no surgery are same at 2 years. At the age of 17 I would recommend trying all measures to control pain and avoiding surgery unless it becomes absolutely essential.

Hope this is helpful. I would be happy to answer any questions.
Answered: Mon, 9 Sep 2013
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