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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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MRI Shows Disc Dessication, Indentation Over Thecal Sac. Precautions?

my MRI of lumbar spine reveals disc dessication with mild posterocentral disc bulge at L4-L5 level causing indentation over ventral thecal sac . What is the treatment and what precautions should i take. I had my first episode in April 2012, and again about 3 days back. both the times there has been severe pain lasting for a more than a month the first time. please help.
Sun, 30 Sep 2012
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General & Family Physician 's  Response
Hello
Usually 1-2 attacks of low back pain (in young age) are self limiting and not need much medication.
But you have to follow the precautions so that you don't get such type of pain in future.

1. Alternate hot and cold fermentation.
2. Use hard bed to sleep, avoid pillow.
3. Do not massage it, only apply anti-inflammatory gel gently to reduce pain.
4. Do regular physiotherapy and exercise by consulting you physiotherapist.
5. Avoid all long term sitting, standing and driving.
6. Avoid jerky movements of back.
Hope this will help you and you have a pain less spine.
Best Wishes
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Emergency Medicine Specialist Dr. Sujjalaxmi Bharali's  Response
Hi.
Lumbar disc prolapse at L4-L5 level is the commonest site. You have to take care so that the cord compression does not worsen.
Conservative treatment usually helps except in cases of severe nerve root compression and recurrent cases that surgery might be required.
Suggestions:
1. Avoid lifting weight and avoid forward bending.
2. Physiotherapy
3. Oral combined anti inflammatory - muscle relaxant agents are reqiured in acute phase of pain.
4. If you also get pain in leg along with occasional tingling and numbness then take tab pregabalin 75 mg at bed time for about a week.
5. Vitamin B12 supplements like methyl cobalamine ( tab Methycobal 500 mcg) for nerve protection.

Thanks.
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MRI Shows Disc Dessication, Indentation Over Thecal Sac. Precautions?

Hello Usually 1-2 attacks of low back pain (in young age) are self limiting and not need much medication. But you have to follow the precautions so that you don t get such type of pain in future. 1. Alternate hot and cold fermentation. 2. Use hard bed to sleep, avoid pillow. 3. Do not massage it, only apply anti-inflammatory gel gently to reduce pain. 4. Do regular physiotherapy and exercise by consulting you physiotherapist. 5. Avoid all long term sitting, standing and driving. 6. Avoid jerky movements of back. Hope this will help you and you have a pain less spine. Best Wishes