
What Does This MRI Of Spine Regarding Pain In Buttock And Leg Indicate?

Question: Hello Doctor,
hope you could rember me .
I had the below slip disp issue last year dec 25th
MRI :-
L4 – L5 disc shows minimal bulge indenting thecal sac.
L5 – S1 disc shows diffuse bulge with small posterior right paracentral protrusion impinging on right S1 root.
The numness in my leg with burning sensation was stopped , however the pain in my butnock( sciatica) and leg pain still presist. Its almost 5 month completed, , but still i am unable to walk fast and stand for a long time, some time i used to get pain in my knee and touse with pin point pain in spine.
I will not say no improvement, But i want to know how long will it take to recover completely.
Note : iam still doing the physo theraphy in home.
Please advice me on this.
Regards,
XXXXXX
hope you could rember me .
I had the below slip disp issue last year dec 25th
MRI :-
L4 – L5 disc shows minimal bulge indenting thecal sac.
L5 – S1 disc shows diffuse bulge with small posterior right paracentral protrusion impinging on right S1 root.
The numness in my leg with burning sensation was stopped , however the pain in my butnock( sciatica) and leg pain still presist. Its almost 5 month completed, , but still i am unable to walk fast and stand for a long time, some time i used to get pain in my knee and touse with pin point pain in spine.
I will not say no improvement, But i want to know how long will it take to recover completely.
Note : iam still doing the physo theraphy in home.
Please advice me on this.
Regards,
XXXXXX
Brief Answer:
Normally, Pt takes about 8-10 months
Detailed Answer:
Hello, Thanks for coming to HealthCareMagic. I have gone over your previous conversation with the previous doctor.
Given the sciatic issues and the fact that the MRI shows much impingement on the S1 nerve (that is the nerve which gives pain sensation to the buttock and the anus).
I would say that you should have a backup plan in case physical therapy does not work well for the pain. It may be that you need surgery in the future.
If you have already discussed this with your previous doc, i'm sorry, i missed it, just that i don't know how well the compression issue can be managed with PT.
Vinay
Normally, Pt takes about 8-10 months
Detailed Answer:
Hello, Thanks for coming to HealthCareMagic. I have gone over your previous conversation with the previous doctor.
Given the sciatic issues and the fact that the MRI shows much impingement on the S1 nerve (that is the nerve which gives pain sensation to the buttock and the anus).
I would say that you should have a backup plan in case physical therapy does not work well for the pain. It may be that you need surgery in the future.
If you have already discussed this with your previous doc, i'm sorry, i missed it, just that i don't know how well the compression issue can be managed with PT.
Vinay
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar


Doctor, i heard there are many XXXXXXX in surgery and am scared of it. How about alternate treatments like Ayurveda panchakarma? Alone with PT what would be the normal recovery period ? One of my friend got cured after 2 years with this kind of problems.I would like to try with out surgery ,how about epdorial injection? please advice . thanks & regards, XXXXXXX
Brief Answer:
Surgery has gotten safer, i can't help with Ayur.
Detailed Answer:
Hello, Thanks for following up.
The risks of surgery and anesthesia are certainly real. There is no denying that. But if you get the surgery done in a well run place.. the risk is statistically minimal. That having been said, you are always free to hold off on getting surgery until you have explored your other options.
Epidural injections are excellent in situations of arthritis of the vertebrae, etc. Not so helpful when it comes to nerve impingement. Again, that does not mean that you shouldn't try it. All it means is that I do not believe it would be very successful in the long run.
As I am not trained in Ayurveda and other branches of Alternative Medicine, i cannot comment on what treatments you should pursue in those areas. All I can really say is that the problem is one where the disc is pressing physically on your nerves and i don't see how ayurveda can help in this case.
As far as medications go. Until you decide what you want done, I would suggest you start taking Pregabalin (lyrica) or Gabapentin (Neurontin) to control your nerve pain and give you time to look at your options. Your spine doc will be able to give you the dose and prescription.
Hope this helps.
Vinay
Surgery has gotten safer, i can't help with Ayur.
Detailed Answer:
Hello, Thanks for following up.
The risks of surgery and anesthesia are certainly real. There is no denying that. But if you get the surgery done in a well run place.. the risk is statistically minimal. That having been said, you are always free to hold off on getting surgery until you have explored your other options.
Epidural injections are excellent in situations of arthritis of the vertebrae, etc. Not so helpful when it comes to nerve impingement. Again, that does not mean that you shouldn't try it. All it means is that I do not believe it would be very successful in the long run.
As I am not trained in Ayurveda and other branches of Alternative Medicine, i cannot comment on what treatments you should pursue in those areas. All I can really say is that the problem is one where the disc is pressing physically on your nerves and i don't see how ayurveda can help in this case.
As far as medications go. Until you decide what you want done, I would suggest you start taking Pregabalin (lyrica) or Gabapentin (Neurontin) to control your nerve pain and give you time to look at your options. Your spine doc will be able to give you the dose and prescription.
Hope this helps.
Vinay
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar


Thanks for the clarification, please let me know which doctor ( ortho or neuro) would be the right person for surgery.
Brief Answer:
Both fields do the same in your case
Detailed Answer:
Hi, Thanks for following up. Me personally, i am a Neuro-Spine guys so i am partial to Neurosurgeons... Though in your case.. a good surgeon from either specialty can do the job. More important than either field is their experience.. go to a surgeon who has done this kind of decompression alot.
Vinay
Both fields do the same in your case
Detailed Answer:
Hi, Thanks for following up. Me personally, i am a Neuro-Spine guys so i am partial to Neurosurgeons... Though in your case.. a good surgeon from either specialty can do the job. More important than either field is their experience.. go to a surgeon who has done this kind of decompression alot.
Vinay
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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