Donald CorenmanKeymasterFebruary 9, 2012 at 2:59 amPost count: 52
my mother is 53 years old and has been suffering with back pain.She underwent an MRI scan and the diagnosis has been given like this.
1.Lumbar canal stenosis
2. L5-S1 Lumbar Spondylosis
3.L5-S1 disc protrusion is markedly compressing the bilateral neural recesses and moderately compressing the thecal sac and
4.Facet joint enlargement at L5-S1
the doc advised to take medicines for 3 months and if it has not been cured, he would recommend a surgery. We are from India.My mother is a household woman. She does perform daily chores only.Other than that, she never told or complained about any accident or falling down. Other than back pain, she doesn’t have any other complaint like neck pain, hand pain or any other pain.She is completely normal except with the back pain.
We want answers for the following questions.
1.can she travel?
2.How should she sleep? which angle?
3.Do you recommend a surgery?
4.Any diet recommendations?
5.Any other precautions while bending,cooking and siting?
i would be really thankful if you can guide us in this regard.
have a nice eveninDonald Corenman, MD, DCModeratorFebruary 9, 2012 at 9:48 pmPost count: 8459
Your mother has two different conditions in the lumbar spine. One is spinal stenosis and the other is a disc herniation at L5-S1. Unfortunately, the physical adaptation for stenosis competes with the compensation position for the disc hernation.
Stenosis is the narrowing of the lumbar spinal canal. Standing reduces the canal diameter even more and most patients tend to lead forward when they stand and walk. Stenosis is posturally compensated by what is called posterior pelvic rotation. Rotating the pelvis backwards (by contracting the abdominal muscles and buttocks muscles) opens the canal but allows the patient to stand more upright.
Disc herniations at L5-S1 typically compress the nerve roots with sitting and most patients compensate by standing to reduce the nerve compression,
Your mother may have both problems which puts her between a rock and a hard place (a dilemma). Compensation for stenosis (leaning forward and sitting) is the exact opposite of compensation for disc herniation (standing). The only position that accommodates both is lying down.
Your mother can travel but travel might be uncomfortable for her. I cannot comment on the need for surgery as that requires a workup to determine what surgery would be helpful.
Sleeping should be most comfortable either with a thick pillow under the legs when lying on her back (90/90 position) or curled up with a pillow between the knees while lying on her side.
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