Advice on disc protrusion

[monkey]

Hi Sonj,
I have recently joined this forum and only skimmed through the thread. I am not sure whether the original question on natural resolution of a disc prolapse has been dealt with. I have always advised patients that natural resolution does occur and surgery is simply a means to alleviate present symptom levels. Patients often feel they should have surgery to stop them having problems in the future but having spinal surgery now actually makes you more likely to require surgery in the future. Of course there are cases where surgery has to be performed but if symptoms are resolving then leave to a natural recovery.
I have MRI scans of patients with large disc prolapses who have had repeat scans a year later and the disc prolapse has shrunk to a small bulge. The way I usually explain this is in laymans terms: when the disc first prolapses it is full of fluid, like a grape, with time it loses its water content and becomes more like a raisin (due to proteoglycan deterioration and dehydration).
So yes disc prolapses do resolve but disc degeneration will remain.
The problem is there is poor correlation between size of disc prolapse and symptoms and virtually no correlation between disc degeneration and symptoms.
The good news is that a huge proportion of the elderly population are walking around with severely degenerate discs which are not causing them any problems. This is why the epidural is useful, very often the symptoms are due to chemical rather than mechanical factors.
The best evidence for self care is try and gradually return to normal activity, try not to worry. Fear of re injury is a big barrier to recovery.
Good luck with your shoulder, I can't help you with this, except being a spinal specialist I would probably put it down to a C5 nerve root problem.

[Sonj]

Thanks for that. Aye, fear of re injury was strong at first (you keep expecting the pain) but once I got back into climbing I don't tend to think about it anymore. The pain is now all but gone with just the occasional flicker and occasional numb foot and a bit sore first thing in the morning which resolves as soon as I'm up and moving. The one thing that's still bothering me though is that I still can't sit down for very long or I get a pain in my bum (piriformis?) but this again resolves as soon as I get up and move about. I'm still doing all my stretches daily and there def helping. I still havn't had a big long day on the hill yet with going down steep ground but hoping to shortly to see how my back copes with it. Couple of weeks ago I did go down some pretty steep ground carrying a pretty heavy sack and there was no problems but I was only going down for around 5mins as opposed to the hour or so that I was used to before.

Re the shoulder thing, been no more twinges but it does ache a little sometimes when I'm climbing so I'm just continuing with the rotator cuff stretches as they seem to do the trick. Lol, I abs refuse to have another nerve root problem going on!