Q: I am 22 years old. I underwent a lumbar L5-S1 surgery. It was a microscopic surgery done after a year since the problem was diagnosed and alternative treatment was tried. Everything was fine. But now I have developed the same symptoms like leg pain and back pain again. What could be the reason for this? Should I take any immediate rest or medication?

A:Occasionally you may have exacerbation (worsening) of symptom of pain even after disc surgery. This could be because of a disc at another level or a residual disc at the same level or related to degenerative changes at the level of the disc problem because the normal shock absorbing function of the disc is lost. In majority of cases it settles with conservative treatment of pain killers and restricted activity. You do not have to be on strict bed rest only restricting those activities that cause pain is to be restricted. Rarely if your symptoms do not subside in two to three weeks time, you may need a fresh MRI and plan depending on your MRI report. Now that you are far away from home, do not panic. If you go to a hospital setting they might make you go through the full regime of orthopaedic/neurosurgical evaluation, MRI and other procedures. Unless you want to go through that, I feel it will be better for you to take simple over-the-counter analgesics (for example Tylenol) and restrict your physical activity. Sitting on low seats and getting up after long drives can be a problem, therefore, if you have to drive or be driven sit back with your back supported by the back of the seat. Stop your vehicle after about 40 minutes of driving, get out, stand or walk about 5 minutes and then drive again. This is easier on the back. If you are driving yourself keep your seat closer to the steering than normal. This will avoid leaning forward which makes the pain worse.