Degenerative disc disease
Q: I am serving in the army and I have a problem in my back. Last year while playing football I had a fall due to which I sustained injury in my back. I was bed ridden for few days as doctors said it is muscular injury. But now after a year I have done MRI scan of my back and it showed degeneration of discs L4-L5 and L5-S1 and also herniation in L5-S1 areas. I have mild pain daily in my left low back and left hip. At times the pain does radiate down upto the left knee. At times I have burning sensation in my left thigh. I am in the army and I want to get back to my original physical fitness. I am now placed in low medical category and excused tough duties. But I want to be back for the original duties so that I can be back in shape to serve the nation. I hope I shall be helped out.
A:I have gone through the details provided by you and understand very well your anxiety to get back to your normal working routine. Degenerative disc disease is a common enough entity and is related to many factors, getting older and the water content of the disc being reduced as a consequence there of, being the major contributing cause. Other reasons of course are related to the strain the back is put to.
In your case you have a prolapse of disc at one level (L5-S1) and evidence of degeneration at another. Further managemnt clearly depends on two factors:
1. Extent of neurological deficit
2. Amount of pain and the disability that it causes.
It would seem from your letter that the prolapsed disc may be impinging on a nerve root (considering the pain that goes down to the leg). The further manangement would range from a trial of conservative treatment involving strict bed rest to surgery in case the pain worsens or any neurological deficit is detected (even radicular pain classifies as neurological compromise in this case). Surgery is indicated also, if the conservative treatment fails to bring any relief. Also if the MRI image clearly shows compression of the nerve roots then removing the offending disc is the best way to proceed further. You may need to discuss these details with your treating neurosurgeon before taking further action. In case of any further queries, I will only too glad to answer the same.