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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Back Pain Caused By Indentation In Cal Sac And Paracentral Discprotrusion With Perineural Fat?

iam having back pain for 2months,and MRI reveals identation of thecal sac and paracentral disc protrusion with perineural fat.im doing spinal extension exercise everyday,but stil didnot relief my pain.will it be for my lifelong?wat will be the best treatment for me?
Thu, 30 Jan 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

As per your description, you suffer with Lumbar disc disease. The initial management of this problem includes the following -

- Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though.
- Take rest breaks throughout the day, but avoid sitting for long periods of time.
- 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 (under the supervision of a physiotherapist) 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 and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain.

If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care).

Hope this information is helpful. Good day
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How To Treat Back Pain Caused By Indentation In Cal Sac And Paracentral Discprotrusion With Perineural Fat?

Hi, thanks for writing to HCM. As per your description, you suffer with Lumbar disc disease. The initial management of this problem includes the following - - Usually 1-2 days of bed rest will calm severe back pain. Do not stay off your feet for longer, though. - Take rest breaks throughout the day, but avoid sitting for long periods of time. - 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 (under the supervision of a physiotherapist) 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 and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months. There is good evidence that epidural injections can be successful in 60-70% of patients who have not been helped by 6 weeks or more of conservative management ( nonsurgical care). Hope this information is helpful. Good day