What is the cure for a back pain due to injury?
Q: I got married recently. My wife is 25 years old. Just one month before the marriage she slipped doing some exercise and has a pain on her back. After 2-3 days as the pain increased she consulted an orthopaedic doctor. The doctor had advised her to be in traction. She was under traction for a week but no improvement was observed. The doctor then advised her to do X ray. As the report of X-ray was not clear doctor advised her to do MRI. The MRI report says as follows: 1. Straightening of lumber spine 2. Diffused disc bulge seen at L4-L5 with thecal sac indentation and bilateral neural foraminal narrowing with compression of nerve on left side. Presently, as advised, she is taking medicine Robinaxol, Valus, and Methycobol daily. She is getting more pain sometimes also. Please advise how to get rid of this problem? Is any exercise or operation required?
A:It is difficult to help with the description that you have presented regarding your wifes problem. Backache is a very common symptom occurring in almost 75% of population some time in their life time. The causes are innumerable. X-rays are often normal in a majority of cases. Most of them get reported as showing spondylotic changes. Which is actually not a disease but normal ageing process. MRI which is commonly available now often shows disc degeneration and disc prolapse even in normal people who have no backache. Therefore, the decision to treat is dependant not only on the X-ray and MRI finding but also on the clinical findings. You need to find out from your doctor whether the clinical finding corroborate with the MRI finding of disc prolapse at L4, L5 level. This can be done easily by a simple clinical examination. Assuming your wife has disc prolapse, the medicines that she is taking seem alright but they do not change the status of the disc prolapse. They only help her tide over episodes of pain. Current understanding on low back pain suggest that strict bed rest is also not essential. Patient can do activities within limits of pain tolerance. Those, patients who do not get relief may need surgical intervention. The usual indications for surgery are: 1. Severe unrelenting pain that does not get better with medicines or rest. 2. Recurrent attacks of pain that cut into the economic activity of the patient. 3. Disc prolapse associated with some paralysis. 4. A massive disc prolapse with a major paralysis in the limbs - this might need emergency surgery. 5. Occasionally when the diagnosis is in doubt, surgery may be done for some biopsy.