What Causes Severe Lower Back Pain When Diagnosed With Lumbar Bulging Disc?
I am 30 year male.
I have been diagnosed with lumbar disc bulge (L4-L5 and L5-S1) in the central region (not on branch region of nerve). Doctors have advised for physical exercises twice. One is lying with stomach down and raising each leg in straight position and holding for few seconds, with each leg. Second is lying with stomach down and raise upper half of body from waist and hold, with help of folded arms. Also frequent break in sitting office position is advised. No forward bending has been advised.
There is no significant issue with this, except that lower back pain exists often and many times it shoots little bit whenever incorrect posture is adopted or advised exercises are not done.
My query is from Physiotherapy or Neuro Consultant is, whether cycling (the one having gears) can be done in this case or not, or I need to wait for recovery up to some good point (when there is less frequent pain episodes despite of minor incorrect postures or no advised exercises), then it should be started.Also, in addition to main query, further query is that (a) how can the degenerated disc can be rehydrated and regenerated, (b) how can be the minor disc bulge be pushed back/ reverted completely.
MRI is as per attached document.
Cycling not advisable till late in recovery.
Detailed Answer:
Hi ,I am Dr Gopal Goel Orthopedic Surgeon.
First of all let me compliment you on excellent presentation in writing and films.
You have Slipped disc at L4-5 ,L5-S1 levels mainly , occasionally pressing on the nerves giving rise to shooting pain.
You have started on right exercises , however I would like to add exercises to strengthen your abdominals also- any physio will demonstrate you how to do it. Your rest of the program for exercises and precautions is okay.
Cycling exercises are not recommended since they cause flexion at spine and may aggravate the pain.You can do cycling once all the pain is gone and your muscles are in good shape.
Disc cannot be re-hydrated.Once the disc becomes dry , it will shrink in size and the compression is relieved ( relieving the pain also)
Thanx for the question. Please feel free to ask any further question.
May I further ask for:
1. Whether the extent of bulge in my case is reversible by physiotherapy or not.
2. How much time it takes in general (using only physical therapy), to recover from disc bulge, up to the extent, as in my case.
3. Is running and brisk walking advisable or not.
4. Is sports like badminton or basic gym activities like treadmill advisable or not.
5. What is role of lack of physical activities in disc bulge, as so far I am not doing physical activities like walking, running, sports etc (for at least 20 minutes per day), since about 3-4 years. Should I start physical activity (for at least 20 minutes per day) like brisk walking, running, sports etc. Will it have positive, neutral or negative impact on disc bulge.
6. What extra care is needed apart from the inputs which I am currently following, and for what period.
7. Is there direct relation between nerve connection cut-off and paralysis.
8. What is the possibility of existence of Lumbar Lordosis, as one doctor (local) said after looking at x-ray that you have Lumbar Lordosis and nothing else.
9. What are the two bean shaped black figures in rib cage (in both x-ray).
10. How much sitting should I do per day, as I use to sit in office from 9am to 5pm with lunch break only and at home 90% of the time sitting on computer (generally without break) i.e. in general from 6pm to about 11pm-12pm.
not reversible
Detailed Answer:
Hi
As I have told you earlier the disc dries and shrinks in size over a period of time .
There is no definite time frame
Brisk walking is good but not running.
Sports - not at present.
Precautions as have been advised.
Some questions are based on personal experiences of some doctors- and I am not going to comment on their professional opinion.
Thanks