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Pain, Discomfort In Lower Back And Leg. CT Scan Showed Impingement Of The S1 Nerve Root. Prognosis?

Posted on Mon, 6 May 2013

Question: I have pain and discomfort from right side of lower back mostly starting near top of buttock and down back of leg. Main comment in CT scan is "There is impingement of the right S1 nerve root by a broad disc bulge extending into the lateral recess at L5/S1. No spina stenosis noted. No focal disc protrusion noted XXXXXXX 2 GP's I saw both leaning on the side of live with it but one did refer to neurosurgeon... Wondering if they are the best and only options...

Answered by Dr. Saurabh Gupta (3 hours later)

Hello and Welcome to XXXXXXX
Thanks for writing to us.

You are suffering from disc bulge at L5/S1. This disc bulge is compressing upon a nerve root(S1) that either exits or traverses through that level. Having known this basic anatomy, you must avoid any activity that aggravates the condition, like bending forward and lifting heavy objects, sitting long hours on computer, inappropriate sitting posture, etc.

There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.

For this condition you have to do stretching & strengthening exercises in which you have to stretch tight muscle & strengthen weakened ones which will alleviate stress on facet joint and disc.Kindly note that exercises should only be done when it doesn't hurt. Adequate rest and proper nutrition is equally important. Drink lots of fluids since dehydration affects the disc.

If you don't get better with these treatment ,another option is surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms.

Hope this helps you. Please do write back if you have any additional concerns.
Please accept my answer in case you do not have further queries.

Wishing you good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.

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

Follow up: Dr. Saurabh Gupta (50 minutes later)

Thankyou for your response. As far as strengthen and strectching exercises how do I find out which ones to do? Is it a matter of seeing a physiotherapist?

When you say only do exercises when it doesn't hurt do you mean that the exercise it self shouldn't cause additional pain? Since the pain is always there just mostly is quite dull and I distract my self from it but most annoying when trying to sleep.

As far as medicines and injections who would i see to try them since the GP's I tried didn't offer those options? Do I need to try more GP's and/or specifically ask for certain treatments?

Thanks

Answered by Dr. Saurabh Gupta (4 hours later)

Hi,
Thanks for writing back.

There are certain back strengthening exercises that you must learn from a physiotherapist and perform them at home or work whenever possible.

When there is acute stage of pain then you have to avoid exercises. Otherwise do these exercises, they will helps you a lot.

I suggest you to consult an orthopaedic surgeon for detailed examination and discuss about various options as I have already suggested you.

Hope this helps you,if you have any further queries I am happy to answer, if no kindly close the query & give your reviews about the service.

Wishing you good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

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