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Diagnosed With Degerative Disc Disease Resulting In Spinal Stenosis. What Is The Cure And Treatment?
Question: My MRI scan showed at L3-4 and L4-5 there is a small annular disc bulge as well as bilateral facet joint and ligamentum flavum hypertrophy. I have been diagnosed with degenerative disc disease at L3-4 and L4-5 as well as spondylotic changes throughout the lumbar region, with small disc bulges at L3-4 and L4-5 resulting in spinal stenosis at these levels. What is the cure or treatment?
Hi,
Thank you for writing in.
Based on your symptoms and MRI report you seems to have lumbosacral radiculopathy (impinged nerves) secondary to mild annular disc prolapse as mentioned above levels with narrowing of spinal canal (spinal stenosis) which has occurred due to degeneration of spine ,ligament and adjacent joints.
Clinical examination especially sensory examination, motor power of limbs, muscle tendon reflex helps one to plan treatment.
I treat my patients here with lumbosacral belt, neuralgic drug like pregabalin or gabapentin with vitamin B12 supplements which helps in regeneration of nerves.Short course of pain killer to take care of inflammation ,and calcium supplements.Such small discs can be managed with medical treatment for 8 weeks.If symptoms persist then to go for epidural steroids.
Precaution to be taken are avoid weight lifting and strenuous exercise .Once acute pain settles requires spinal exercises to strengthen paraspinal muscles
Most of the patient recover by a month or two.
Hope I have answered your query..If you have any quires you can consult me again or if you do not have any clarifications, you can close the discussion and rate my answer. Wish you good health.
Regards
Dr Sandhya Manorenj
Neurologist
Hyderabad
Thank you for writing in.
Based on your symptoms and MRI report you seems to have lumbosacral radiculopathy (impinged nerves) secondary to mild annular disc prolapse as mentioned above levels with narrowing of spinal canal (spinal stenosis) which has occurred due to degeneration of spine ,ligament and adjacent joints.
Clinical examination especially sensory examination, motor power of limbs, muscle tendon reflex helps one to plan treatment.
I treat my patients here with lumbosacral belt, neuralgic drug like pregabalin or gabapentin with vitamin B12 supplements which helps in regeneration of nerves.Short course of pain killer to take care of inflammation ,and calcium supplements.Such small discs can be managed with medical treatment for 8 weeks.If symptoms persist then to go for epidural steroids.
Precaution to be taken are avoid weight lifting and strenuous exercise .Once acute pain settles requires spinal exercises to strengthen paraspinal muscles
Most of the patient recover by a month or two.
Hope I have answered your query..If you have any quires you can consult me again or if you do not have any clarifications, you can close the discussion and rate my answer. Wish you good health.
Regards
Dr Sandhya Manorenj
Neurologist
Hyderabad
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor. Does recovery mean that the problem is cured or is it likely to recur.
Hi,
In view of minor disc and canal stenosis one can expect 85% recovery.Symptoms can come and go as per your work .Because chances of further protrusion of disc is there if you are lifting wait, travelling a lot. One can predict based on your neurological assessment after 2 months (symptoms and signs)
I apologize for delay in response
Regards
In view of minor disc and canal stenosis one can expect 85% recovery.Symptoms can come and go as per your work .Because chances of further protrusion of disc is there if you are lifting wait, travelling a lot. One can predict based on your neurological assessment after 2 months (symptoms and signs)
I apologize for delay in response
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor. I used to walk for at least half to one hour on mornings before the problem started. It just happened suddenly, one morning I got out of bed to go for my walk as usual but found that I had this pain in the hip, gluteus XXXXXXX thigh and lower leg that I was unable to even lift my feet up to put my socks on. Since then with its repeated recurrence it has discouraged me from undertaking that exercise as a routine.
Does it mean that I have to discontinue my walk permanently?
I notice that you indicated that lifting weights and travelling a lot can cause further protrusion of the disc. In my present job, I do about three hours driving per day sometimes four...but the rest of the job may entail sometimes four to five hours of sedentary office work.
What are the risk associated with this type of work? And how do you suggest I can restructure my working pattern to minimize these risks?
Does it mean that I have to discontinue my walk permanently?
I notice that you indicated that lifting weights and travelling a lot can cause further protrusion of the disc. In my present job, I do about three hours driving per day sometimes four...but the rest of the job may entail sometimes four to five hours of sedentary office work.
What are the risk associated with this type of work? And how do you suggest I can restructure my working pattern to minimize these risks?
Hi,
Regarding walking ,initially you can do graded ambulation ( means walk initially level grounds few distance , if you are comfortable then increase the distance day by day and duration can also increased).Most important is that you need to wear your lumbosacral belts when you are walking.If pain is more then at time you need to take rest. Avoid climbing up and downstairs,use lifts.
Regarding driving,need to wear belt while driving and see that you does not take sudden brakes,proper back rest should be there while working at office also ,see that spine should be erect (90%) .Avoid gutter roads.
Risk of further worsening is there if precautions are not taken.Then one may need to reconsider regarding laminectomy and dissectomy.
Please get back if you require additional clarification
Regards
Regarding walking ,initially you can do graded ambulation ( means walk initially level grounds few distance , if you are comfortable then increase the distance day by day and duration can also increased).Most important is that you need to wear your lumbosacral belts when you are walking.If pain is more then at time you need to take rest. Avoid climbing up and downstairs,use lifts.
Regarding driving,need to wear belt while driving and see that you does not take sudden brakes,proper back rest should be there while working at office also ,see that spine should be erect (90%) .Avoid gutter roads.
Risk of further worsening is there if precautions are not taken.Then one may need to reconsider regarding laminectomy and dissectomy.
Please get back if you require additional clarification
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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