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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is Lumbar Disc Bulge At L5-S1 Level With Minimal Impingement On A Nerve Root Cause Frequent Sharp Pain In Buttock, Legs And Numbness And Cold In The Feet, Neuropraxia ? What Is The Cure And Future Of It?

Hi..I'm Mel. i'm 30. i was diagnosed with lumbar disc bulge 2 years ago at L5-S1 level with minimal impingement on a nerve root (MRI). At that time i had backache and occasional numbness in my left leg which resolved after about 2 weeks. subsequently there'd be bad days when i have those symptoms and good days when i'm symptom- free, and i can manage without any medication. However lately it bothers me that my bad days are more frequent with more bothering symptoms such as pins and needle in both legs and feet, sharp pain down my buttock and legs. sometimes my feet feels numb and cold. i cant stand sitting or driving for more than 10mins. my doctor advised for a repeat MRI but didn't elaborate further. is this worrying? am i going to have some permanent nerve damage soon? my doctor only said that i will have to live with some neuropraxia (i hope this is true because from my understanding neuropraxia is temporary and may resolve) but is that it? please tell me what should i expect and where will this disease bring me further. is surgical management the best option for me now? thank you.
Fri, 20 Dec 2013
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Radiologist 's  Response
Hello
Thanks for writing to HCM

According to history you have degenerative disc changes in spine in lumbar region.

1.You have disc bulge at L5-S1 level and bulged disc is causing minimal impingement on a nerve root.

Degenerative changes occurs due to aging and development of weakness in annulus fibrosis which allows herniation of disc.

I don't think you need any surgical intervention at present. You have minimal impingement on nerve roots.

Treatment for pain includes physiotherapy or surgery.
Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc.
Treatment can be planned after consultation with neurosurgeon.

You should also modify your life style like don't abruptly bend forward and avoid standing for long time.Don't lift heavy objects.
Get well soon.

Take Care
Dr.Indu Bhushan
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Is Lumbar Disc Bulge At L5-S1 Level With Minimal Impingement On A Nerve Root Cause Frequent Sharp Pain In Buttock, Legs And Numbness And Cold In The Feet, Neuropraxia ? What Is The Cure And Future Of It?

Hello Thanks for writing to HCM According to history you have degenerative disc changes in spine in lumbar region. 1.You have disc bulge at L5-S1 level and bulged disc is causing minimal impingement on a nerve root. Degenerative changes occurs due to aging and development of weakness in annulus fibrosis which allows herniation of disc. I don t think you need any surgical intervention at present. You have minimal impingement on nerve roots. Treatment for pain includes physiotherapy or surgery. Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes. Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc. Treatment can be planned after consultation with neurosurgeon. You should also modify your life style like don t abruptly bend forward and avoid standing for long time.Don t lift heavy objects. Get well soon. Take Care Dr.Indu Bhushan