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How to manage disc herniation and spondylolisthesis?

Q: I am 34 years old. A year and a half back, I lifted a bucket of water while squatting, due to which I got a catch in the back. I have consulted a local physician who took my x-ray and advised me to rest for sometime. The x-ray report was fine. I recovered after sometime but 10-15% of pain was always there. From the past 3-4 months, even simple twists and turns lead to a catch in the lower back. Sometimes my body looks like as if it is curved. I took an MRI and the results are - L4-5 broad centric disc herniation with extrusions causing thecal and bilateral L5 neural compromise. Spondylolisthesis of L5 Over S1 Vertebra probably due to facet subluxation associated with focal disc herniation with cephalad extrusion causing thecal compromises and facet joint synovitis. The doctor advised me to take physiotherapy. The physiotherapist has asked me to do hot patch and ultrasound for 2 weeks. But there isn't much improvement. I am doing stretching exercises. How long will the pain take to subside? I have been suffering from pain for the past 1 and a half year. Do i need to be concerned about something serious. Is exercise is the only way to stabilise my lower back and relieve pain? Will yoga/homeopathy help me.

A:Your problem is a little tricky to handle. You have a combination of two clinical disorders: 1. A disc herniation 2. Spondylolisthesis a condition in which one vertebrae slips over the other. Both these conditions can be treated conservatively. However, the conservative treatment for the combination is difficult as the exercise of the one worsens the symptom of the other. What you need to know is that spondylolisthesis basically causes back pain which may radiate down. Where as disc herniation essentially causes neck pain but patient may have back pain also. 1. There is no way of knowing or predicting if and when the pain will subside. 2. It is not serious in the way you need to be worried about a life or limb or something ominous happening. It is serious only to the extent that if your pain does not subside then the surgery that is required is an extensive surgery. 3. As I said earlier, you could start of with gentle exercises under the supervision of a physiotherapist and see the response. If your pain reduces, well and good but if it gets worse stop that exercise. The guiding principle being that avoid anything that causes pain. Exercises is not the only way and surgery may also be done. 4. I have no knowledge of Yoga or Homeopathy therefore I cannot answer this question. However in all back pains there is an element of stress that is associated and this may be relieved by Yoga and Homeopathy.

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