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Suggest Treatment For Disc Bulge At L4-L5 Level

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Posted on Thu, 24 Jul 2014
Question: Hello Dr .. My MRI reveals that I have mild diffuse posterior disc bulge at L4-L5 level causing compression of thecal sac and minimal impingement of bilateral nerve root. What is the treatment procedure for this and how long it take to be normal ?
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Answered by Dr. Dr. Praveen Tayal (18 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for posting your query.
We have discs present between the vertebra and they act as shock absorbers and cushions.
Degeneration or wear and tear are the most common reasons for the disc prolapse like you are having.
As they weaken they may protrude, in your case the protrusion of the disc has resulted in an indentation of the thecal sac (membrane surrounding the spinal cord and nerves). As a result of this you may experience pain going down your leg/legs, numbness or any abnormal sensation in your lower limbs.
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.
- Maintain optimum body weight,if you are obese
- Avoid lifting heavy weights as it imparts more strain on your back
- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed.
- Use a lumbosacral back support to stabilize your spinal muscles
- Intermittent pelvic traction might be helpful to cause a regression of the protruded disc
- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.
- Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain.
It usually takes 6-8 weeks for recovery and further progression can be retarded with lifelong back strengthening exercises.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
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
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Answered by
Dr.
Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12315 Questions

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Suggest Treatment For Disc Bulge At L4-L5 Level

Brief Answer: Details below. Detailed Answer: Hello, Thanks for posting your query. We have discs present between the vertebra and they act as shock absorbers and cushions. Degeneration or wear and tear are the most common reasons for the disc prolapse like you are having. As they weaken they may protrude, in your case the protrusion of the disc has resulted in an indentation of the thecal sac (membrane surrounding the spinal cord and nerves). As a result of this you may experience pain going down your leg/legs, numbness or any abnormal sensation in your lower limbs. 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. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. It usually takes 6-8 weeks for recovery and further progression can be retarded with lifelong back strengthening exercises. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal