Disc prolapse

I was diagnosed with Disc prolapse by a Spinal specialist three months ago but have been in pain for about 7 months now! I have been suffering from lower back pains (on and off) since the age of 14y (I am now in my mid 30s).

Here is what the specialist said after the mri three months ago:

There is multilevel spondylosis. At L4/5, the disc hight is fairly well preserved, although there is slight reduction in T2 disc signal, compatible with desiccation. There is a posterior and left paracentral disc protrusion measuring approximately 15mm transvere x 5mm AP diameter. There is slight extrusion inferiorly with disc material extending approximately 4-5mm posterior to the L5 bertebral body. The left lateral recess is obliterated by intermediate signal material, isointense with disc material, and there appears to be compression of the descending L5 nerve roots. The descending S1 nerve roots on the side are displaced posteriorly slightly. Mild central stenosis. The intervertebral formina are widely patent, no exiting L4 nerve root compression. The right descending L5 nerve roots in the lateral recess appear to contact the posterior disc margin also, no compression demonstrated.

At L3/4, the disc hight is mildly narrowed and demonstrates sign of disc desiccation. A small posterior central disc protrusion measuring 3mmAP diameter indents the anterior thecal sac and a tiny left paracentral annular tear is also noted. The lateral recesses are mildly narrowed with no evidence of decending L4 nerve root compression here. The intervertebral foramina are mildly narrowed, butno evidence of L3 nerve root compression.

There is some more in the report, but with no significant findings!

As to my personal impression of my condition and pains... in combination with the shooting and sharping pain into the left leg, there is indeed also some light cramps mostly in the lower left leg! I sometimes feel discomfort in the upper leg, but it is mostly felt in the lower leg! And the cramps happen more on the outside left of the lower part of the leg! I also sometimes feel a tingling in my leg associated with some numbness, the usually appears after I stand or sit in the same uncomfortable position for longer than a few seconds, that said, there really is no comfortable position!

Two months ago now I purchased myself an inversion table to decompress my spine (as a suggested by a chiropractic as a more conservative way to assist with possibly avoiding a surgery, and I have used it intermittently during the day a few minutes at a time. For a while it felt like helping but a couple of weeks ago during the beginning of our tropical/wet season here, I started to develop stronger than ever pain, to the extend that I finally decided to go to hospital and get a Morphine shot, as all my other medications did not help ( I am on maximum dosage of Voltaren, Paracetamol and Codeine).

The Morphene shot however only helped short term and therefore I again looked up the internet and tried a few other ideas! Three nights ago I decided to stop sleeping directly on my relatively firm mattress and instead have started placing a 12mm plywood sheet on my Mattress and covered it with a thick blanket. Changing sleeping positions from my back to my stomach several times throughout the night. The first night there was no serious change noted, but my back was slightly less stiff in the morning. Two days ago I read about relaxing the back with a moist heat treatment and decided to try a hot bath! The next day I woke up with no stiffness and almost no pain to speak off and reduced my medication intake to half! Also since yesterday, I started feeling a change in my condition, instead of the needles and shooting pain ion my lower leg I now only still have a slight discomfort in my lower back and the lower part of my left leg is permanently numb! I am not sure if this is a good sign, but for the time being I have completely stopped the codeine, paracetamol and only still take one third of my daily dosage of the voltaren (but only as a precaution, as I am still worried about the pain returning!)

In the meantime, I am trying to enjoy the time I have without pain and am wondering what to do next as I was very closed to accepting an appointment with a surgeon to have my prolapse removed permanently.

Does anyone have any suggestions on what I should do????

Thanks a lot!!!!

Dear prolpasesven

I would still be concerned. I am tempted to say be a little more concerned with new symptoms...

My reasons are:
1) pain is not always a bad sign...it just tells you something is wrong and be careful, in your case it was intermittent meaning nothing was permanently pressing on anything...(disc on nerve root), so even though your pain was bad...but it was a good sign...
2) now you have little pain but a pemanent numbness, that implies some unchanging neve damage...e.g, something pressing on something and its not moving or something as pressed on something and changed its properties..in this case disc on nerve ?
3) your pain is going away...its not unusual to have a eduction of back pain symtpms with emergence of lower limb symptoms...that usually can represent the progression of a back problem, not meaning things are better

so i would still be a more concerned...perhaps more than when your symptom wasnt constant...

my impression is, you have either taken the condition through its natural process which is for a disc to be sequestered (chipped off) so its logding permanent on the nerve and not movng...if this is the case, it would gradually resorb on its own, the nerve damage maybe irreversible...

or... the stenosis you have is become more serious and the disc problem resolving...

To make this clearer, I would have a couple of questions
1) ANY MUSCLE WEAKNESS? OR FEELING OF WEAK LEGS? NOT BEING ABLE TO WALK PROPERLY OR TENDENCY TO FALL?
2) ANY NUMBNESS BETWEEN YOUR THIGHS? OR PAIN BTWEEN YOUR THIGHS AND GENERALLY IN THAT AREA?
3) any bladder problems? be it, difficulty to void, not percieving a full bladder...etc

if your answer to any of these questions is a no then do not be alarmed by my replies, if anything at al what is certain is the protruding disc has changed, if you ave another MRI, you would probably see this and you might find where the posterior extrusion is may be larger...

I would suggest a quick visit to the specialist again, to clarify whether this change in nuero signs doesnt mean a permanent and irreversible nerve damage...

Meanwhile, having backpain since 14...thats pretty unusual...mmmmmmmmmmmmm

Thanks so much for the response, very helpful!

To your questions... no not really any of them, I only notice that on my good leg I can stand on the heal no problem, but the other leg not possible at all!

Also, unfortunately a quick visit to the specialist or another MRI are not that easy to do, as I will have to travel overseas for that, I am an a little pacific island and will have to go to New Zealand to do this!

P.S. I was also always worried about my early symptoms of back pain, but was always told to take medication and it wil go away... and it always did... until now!!!

Thanks,
Sven

Ur inability to heel stand on your bad leg, has that always been the case or this is something new in relation to since your backpain started currently?

Dear Dr. Damien,

No, that has not always been the case, I first noticed the inability to properly heel stand at my first Doctor appointment a few months back, but it was assumed that it might have to do with the pain it created! But now that there is no more pain when trying it I hoped that it would have improved... but quite the opposite, I feel rather less strong on that heel now than a few months ago!

You describe some muscle weakness...from your words seem progressive...id suggest you see a specialist the sooner you can really...

Dear
As you wrote your pain was alleviated by moist heat . it indicates that consrvative treatment is effective so physiotherapy and manipulative physiotherapy can help , particulary excercise therapy is of value.
laser therapy is usually recommended to relief infalmmatory reaction on the nerve roots .

Hi,

I have since my last post been 100% pain free and without the need for any pain medication. Also I have "just in case" travelled overseas and seen my spine specialist. The advise I received, if a bit of numbness in my lower/outer left leg is the only symptom remaining, it would be best to leave it alone for the time being but to stay aware of any changes in the condition! I can still hardly believe that a strong pain (that stayed around for 7 months) had so abruptly disappeared. As I mentioned, I believe that the wet heat is a very important part to my recovery and I think that the change in sleeping conditions (see my earlier post) also made a big difference (it finally gave my spine a real period of rest ;-)

I have in the meantime, by the way, also visited a Physio and have received advise on posture etc. which I am trying to remember to apply as often as I remember to and hopefully there will come a time when my mind takes it in and it becomes the
norm for me.

Otherwise, I have not been this well for several months and I hope that everyone out there "that are still enduring similar pains" are going to find a way(s) to get rid of them, as they are impossible to live a normal live with.

Hi There my name is Hasan Ali and im 23.
i have been suffering from back pain for almost 2 years now last from 3 or 4 weeks i have pain in my right leg i went to the doc he said to me to have a MRI.
what MRI says is.'' there are multilevel areas of disc is a region of disc herniation at L45 and L5S1 region with the disc at L45 having a central and bilateral para central component with bilateral neural tissue compression.
the disc at L5S1 is having central and right sided component with right sided compression to nerve root.
now doc suggest me to go down for a surgery but i don't wanna do that i just want to have your opinion what should i do in this situation plz guide me further
thanksssss