My spouse (F) age 35 years suffering from back pain. As per MRI report following point has been arise. 1) Focal disc protrusion at L3-L4 level causing thecal sac indentation. 2) Diffuse disc bulge at L4-L5 level causing thecal sac indentation. Please suggest what is the next level of treatment.
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Source of back pain in your case is the intervertebral disc bulge causing pressure over spinal cord and nerve roots. You have not mentioned details of your wife's problem like duration of pain or associated symptoms like weakness of legs or bladder / bowel incontinence. Treatment depends on duration of symptoms and neurological symptoms. Such disc bulge generally responds to rest, anti inflammatory drugs and exercises within 12 weeks of onset. In cases where symptoms persists beyond 12 weeks or progress intervention is needed. You can consult an Interventional Pain specialist in such situation and get treatment called epidural steroid injection. In this procedure anti inflammatory drugs (steroid along with local anaesthetic ) is injected at the nerve roots affected under X Ray guidance in operation theatre. This gives pain relief and decreases nerve swelling too. Patient can undergo effective physical rehabilitation and exercises after pain relief. Surgery like decompression of nerve roots is needed in less than 1% cases where there is weakness of leg muscles or loss of bladder , bowel control. You should follow the treatment plan given by your doctor after patient assessment.
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