Suggest Treatment For Disc Bulge And Nerve Root Compression

Posted on Sat, 18 Apr 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Apr 2015 Answered on

Tue, 5 May 2015 Last reviewed on

Question : I am having leg pain and heavy XXXXXXX in the leg and thigh muscle . As per MRI report my spinal cord is pressed L4 zones .need advice

Answered by Dr. Nishad BN (46 minutes later)

Brief Answer:
Disc bulge and nerve root compression from L2 to S1 levels.

Detailed Answer:
Hi

Thank you for asking HCM.

I have gone thrrough your query. There is disc bulge and nerve root compression from L2 to S1 levels from your MRI report. It can give sciatica back pain radiating to leg with numbness or claudication.

Conservative therapy should be done initially. Therapy should be considered according to your clinical condition. Leaning forward slightly and walk with help of cane will make you better. NSAIDs like nimuslide and muscle relaxants like cyclobezaprine can be taken symptomatically. Exercise therapy with the help of physical therapist can be designed. Stationary biking might benefit you.

Physiotherapy like TENS , infrared heating pads, ice pack application etc will be helpful also. Spinal decompression traction therapy is another physiotherapy procedure which may benefit you. You can discuss that with your physiotherapist or physical medicine and rehabilitation specialist.

If all these not helping then Epidural injections will be benefiting.

If no conservative measures are helping you then you can consider surgical options. Minimal invasive techniques like microendoscopic decompression is available also. Interspinous distractor placement or foraminectomy might benefit for this also.

Hope this may help you. Let me know if anything not clear.
Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Nishad BN (12 hours later)

Dear doctor , thanks for your advice . The local doctor has suggested surgery . The exact words in his prescription - severe lumbar canal slenosis L 4-L5 c PID L3-l4, L5-S1. Adv - 1. Medication. 2. To consider surgery in the form of lumber decomression +\- instrumentation. Now I am not taking pain killer , pain is modarte and occassional in legs. Back side thigh and upper portion is having cramp like sensation and tingling effect . I am healthy and doing yoga and excerise regularly , strong . Is there any possiblity to recover by physio tharapy , on permanent basis . My doctor said my spinal nerve is completely pressed by L4 zone. Kindly advice

Answered by Dr. Nishad BN (2 hours later)

Brief Answer:
If clinically better conservative therapy should be tried initially.

Detailed Answer:
Hi and welcome.

If you are clinical not worse conservative therapy should be tried initially. Full recovery from physiotherapy is usually not possible in this condition. You can go for physiotherapy and physical exercises might improve your condition.

But in case there is worsening of symptoms or no improvement on such measures you can go for the surgical option.
Early and late surgery has same outcome in such case. So you can go with conservative measures like physiotherapy and a regular follow up with your doctor.

Hope this may help you. Let me know if anything not clear.
Thanks.

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