Q: I am a 20 years old male suffering from lower back pain for the last 10 months. I consulted an orthopaedic surgeon who said that that I have a disc prolapse. I went for physiotherapy sessions regularly for four months, which helped managing the pain. But after discontinuation of physiotherapy, I started getting the pain again. I consulted another orthopaedic surgeon, who after examining my infected wisdom tooth told me that I am suffering from spondylosis and gave me antibiotics. My lower back pain is gone now but I have started getting neck pain. I am confused as none of the doctors suggested an MRI, which I have heard is vital for reaching a correct diagnosis. What is the actual problem? Is it disc prolapse or spondylosis? To add, I also masturbate. Is there any relation between masturbation and back and neck pain?

A:First of all, the diagnosis of intervertebral disc prolapse is a clinical diagnosis. It is not based on X-rays or even MRIs alone. The possibility of diagnosing a disc prolapse on MRI is definitely better than on an X-ray. However, even with an MRI evidence of disc prolapse you always have to co-relate clinically. You are only 20 years old and I am surprised that you have been told that you are having spondylosis. Spondylosis is not a disease it is a normal aging process that occurs in the spine it is normally symptomatic only after the patient is about 35 years or so. So, I would not diagnose your case of neck pain as to be of that from spondylosis. You have also said that you have been given antibiotics after which your pain got cured. This is most unlikely, as antibiotics do not heal pain of disc or spondylosis. What is possible, however, is your neck pain is because of pain because of your infected wisdom tooth, the infection would have settle with the antibiotics therefore you got relief. You say you are confused especially as your doctor has not suggested an MRI. You should be happy that you possibly have an ethical doctor who does not order unnecessary investigations. You are afraid about the possibility of surgery but from the symptoms that you have described that seems unlikely and only exercises should do the job. Masturbating will not lead to such neck pain. You seem to be emotionally distressed that can certainly aggravate your sense and perception of pain. Get back to your orthopaedic surgeon he will be able to guide you better.