Had Injury. X-ray Report Shows L5s1 Disc Bulge Or Herniation. Recommend Exercises?

Posted on Tue, 22 Oct 2013

Question: See MRI report.
Its been 9 months since injury and I have been walking everyday. Walk fine and everything pain if I am standing straight. Attached xrays as well. L5s1 disc bulge or herniation. What exercises can you recommend? flexion or extension or what else.

Answered by Dr. Sudhir Kumar (13 hours later)

Brief Answer:
Back extension exercises would be helpful.

Detailed Answer:
Hi,

Thank you for posting your query.

I have gone through the MRI spine and X-ray spine reports.

First of all, I would like to reassure you that the findings do not suggest any serious neurological problem, and there is no need of surgery.

As you suggested, physiotherapy is the best treatment at this stage. You would benefit from back extension exercises. In addition, you should avoid bending forwards, or lifting heavy weights.

If pain is present in back or legs, then, pregabalin or gabapentin capsules would be useful.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (3 hours later)

But why wont it fully heal after 9 months? My spine is tilted to the right also. Do you think the muscle is pulling it to that direction because i have a feeling it is. My pain is centered at the disc and have short sharp pains when i move and the disc impinges the nerve around the buttock area. Can you go over the science of how the disc is supposed to go back in the normal area over time and stay there?

Answered by Dr. Sudhir Kumar (8 hours later)

Brief Answer:
My replies are below.

Detailed Answer:
Thank you for getting back.

First of all, your spine is not tilted to right, it is normal in alignment. What they have mentioned is that, the disc bulge is more on the right side, which is pressing on the right sided nerve. So, we can expect more pain on the right back, buttock, and leg.

Over time and with treatment, the bulged disc would not go inside, only your symptoms (pain) would improve. In other words, you would become normal (pain would go away), but your MRI would still show the disc bulge. This improvement happens with muscle strengthening in the back area and healing of nerve and inflamed tissues.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (15 minutes later)

How long does it take to heal nerve and tissue? If the bulge is touching the nerve, how do i not feel it then? So there is no way to to recover 100% if the disc dont go back in place? What doesmuscle strengthening have to do w it? Please let me know.

Also if you look at my xray, my lumbar spine is tilted to the right

Answered by Dr. Sudhir Kumar (6 minutes later)

Brief Answer:
Yes, this could happen with muscle spasm

Detailed Answer:
I agree with your impression, however, it is common when some one has back pain. This leads to muscle spasm, causing the spine to bend to one side. The vertebral bodies and spine are normal. So, once your pain improves, this bending to one side would also go away, and it would become normal.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (14 minutes later)

Dr,
Ive done extensive research online. Shy dont discs reseat themselves over time?

I dont want to take painkillers you recommend to simply dull the pain. I can handle that. What i want to fix is the underlying problem and should i take muscle relaxers for it?

Answered by Dr. Sudhir Kumar (4 minutes later)

Brief Answer:
My reply is below

Detailed Answer:
Discs bulge out because of degeneration, injury, dehydration, etc. As you notice, none of these are reversible. So, it is easy to understand that once a disc disease has started, it can not be made to become normal. However, with exercises, vitamins, and adjustments/precautions in daily life/lifestyle, further degeneration and worsening can be stopped/slowed.

The only method that can totally make the disc normal is disc replacement surgery. If the disc disease is severe with severe degeneration, there are options today to replace it with an artificial disc by surgery. In your case, the disease is minor and this surgery is not required.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (8 minutes later)

1Should i take muscle relaxers to correct my spine alignment? If so which one?

2. Can i do deadlifts or squats ever again?

3. Why cant i run? It hurts my buttock when i run? Even after 9 months? If it is going to get better, when? Will growth hormone help?

Thanks

Answered by Dr. Sudhir Kumar (8 minutes later)

Brief Answer:
My replies are below

Detailed Answer:
1. You can take muscle relaxants, but remember it is only for symptomatic relief and pain releif in short term. Good ones in India are Myospaz forte and mobizox. you can find their equivalents. Myospaz and mobizox contain chlorzoxazone.

2. You would be able to squat, etc once pain becomes less.

3. Sometimes, it does take longer, especially if the disc was impinging on the nerve.

4. Growth hormone generally does not help.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (9 minutes later)

Thanks dr,
Will I be able to live a normal life if I cut my bodyfat from 25 to 10-15?

Im 5-8 190 male 26 yr age,

Answered by Dr. Sudhir Kumar (17 minutes later)

Brief Answer:
You would be able to live normal

Detailed Answer:
Yes, I am sure you would be able to live a normal life. I have seen people who were much worse than you, and they are 100% normal, in terms of life, job, etc.

Wishing you a speedy recovery and all the best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar