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What is the treatment for chronic disc disease?

Q: I had low back pain. It was not severe but there was some stiffness and moving was a problem. The X-ray results showed that everything is normal. I was also treated with medicine and traction and recovered slowly. But the same problem recurred but the stiffness was much less. I have problems while sitting and standing but walking is comfortable. I have been exercising and had also taken medicines during that time. But after 6 months, I got another attack which recovered with medicines. MRI of lumbar spine was done. Report says there is disc degeneration at L5-S1 joints with hypertrophy and thickening of ligamentum flavum from L3-L4 to L5-S1 joints. I have also gone through IFT, spine extension exercise and medicine on SOS basis. Now the condition is better. Is my disease curable? What are the causes? What does the report of MRI mean? Is thickening of ligamentum flavum related to disc degeneration? What should be my treatment plan?

A:Your symptoms are quite common in patients with chronic disc disease. The degeneration of the disc simply indicates that the water content of the disc material is reduced and the shock absorbing function of the disc is reduced. It therefore does not function as effectively as in a normal person. The other changes are as a consequence of this loss and this leads to facet joint changes and thickening of ligamentum flavum. Thickening of ligamentum flavum is more of an imaging diagnosis than a clinical diagnosis. I do not think you need to worry about the changes. I would like to suggest the following: You continue with your extension exercises of the back on a daily basis. You may have recurrence of pain from time to time but the indications for surgery are as follows: 1. Recurrent attacks of pain that cut into your economic activity. 2. Attacks of pain that does not resolve despite use of medication. 3. When you develop paralysis as a result of a massive disc prolapse. 4. If the disc prolapse causes urine or bowel symptoms. Some 80% of back pain patients settle with simple conservative treatment of analgesics (pain killers) and exercises. I think you need not worry about your future treatment unless the surgical indications as listed above are present.

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