[Naresh]

#28290

Hi Dr Corenman,

I have injured my back 3 years ago when i herniated my L5-S1 disc. Though it did not show any nerve compression, so i do not have pain in my legs. I just had back pain. I have taken medications and physiotherapy. I feel better, but i feel pain when i do travel on my motorcycle when i get jerky movements, or even in car, after that i have to stretch by bending backwards with hands on my waist,that reduces the pain. Same goes for sitting for longer durations like 1 or 2 hours. At the end of the day, i stretch like this and the pain reduces. The next morning there feels almost no pain but again when i ride motorcycle to my work, it gives me pain again. As on sunday, where mostly i am doing nothing, i feel almost no pain. And yes, if i sit on the floor, or sit without any support on the back, it gives me pain. Not sure what is the source of this pain.

[Donald Corenman, MD, DC]

#28291

Back pain from an annular tear is not uncommon. I assume you have strengthened your core and have had education regarding how to properly lift, bend and load your spine. The next step is an epidural steroid injection. These are generally not a permanent cure but can yield up to a year’s worth of relief. Over time, if the disc becomes more degenerative, it can stiffen and become less painful. There are individuals who develop IDR (see isolated disc resorption on the website) and need surgery but many individuals can improve. Have you had a new MRI lately?

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Naresh]

#28292

I have had three 3 MRIs, last one was done 15 days ago. In the initial two MRIs,which were 1.5 – 2 years back, the readings did not show any degenerative changes, just herniation at L5-S1. But the last one’s readings said degenerative changes in L4-L5 and L5-S1 and same herniated disc at L5-S1, Has it gone far to become worse? What shall be next steps? My doctor has said it is common to see degenerative changes and asked to keep continue exercises regularly. Also, i have now started taking calcium and D3 supplements.

You said the disc degenerates over time and becomes stiff and less painful or more painful? Do you think i need a surgery now(and would it be fusion?)? Or would i need it in future? If yes, is there any way i can avoid it even in future?

[Donald Corenman, MD, DC]

#28302

I cannot tell you if you need a surgery as that issue is somewhat more complex that the information we have shared here. See: https://neckandback.com/treatments/when-to-have-surgery/ to understand this issue.

Normally, as the disc degenerates further, the patient will reduce activity to a tolerable pain level but some patients will continue to have pain that is impairing is spite of activity reduction. Degenerative disc disease is generally a genetic problem so your additional level of L4-5 is not surprising. It may be that this level is not symptomatic and the original L5-S1 level is causing all your pain.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Naresh]

#28698

Hi Doctor,

I still have a good amount of pain in back. Not sure really how it would be relieved. When talking about surgery, are we talking about a discectomy or a fusion? I am just 24, and would not want to have a fusion as it will put more stress on other levels and i might end up having a cascade of surgeries. Would a discectomy help in my case as it is a herniated disc only although it is otherwise quite healthy and not degenerated a lot?

[Donald Corenman, MD, DC]

#28699

If your back pain is more one-sided (unilateral) and on the same side as the herniation, you have a better chance of back pain relief with a microdiscectomy. With unilateral pain on the same side as the herniation, the chances are about 70% for acceptable relief. If the back pain is central in nature, the chances of relief with a microdiscectomy are more like 50%

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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