Hello doctor, I am a 29-year-old female. I have low back pain with bilateral hiop and leg pain to the knees for several years. I have fibromyalgia, scoliosis and my left leg is 7m shorter than my right leg. My MRI result indicates: Large broad-based right paracentral disc protrusion at L4-5 and compresses the descending right L5 root and encroached on the descending left L4 root. The disc causes moderate to moderately severe central canal stenosis. Shall central protrusion at L5-S1 contacts the descending right S1 root. No nerve root compression is identified. Mild degenerative template signal L4-5 noted. Can you explain these to me in labor terms and suggest the most likely treatment options? I have don't just about everything but surgery and chiropractic care have been the most effective but I have had chronic pain for years, sometimes debilitating. Is rather not have surgery but is it inevitable? My ana test is negative. I am currently taking Gabapentine.
Hello. Vertebrae has a central canal where the nerves from the brain run to reach the legs. At each vertebrae level, there is a shock absorber called the disc. Often this gets displaced due to the pressure put on it and it starts to put pressure on the nerves that run down the leg leading to what is called sciatica. You have a disc between number 4 and 5 vertebrae that is the source of your pain in the legs more so than your spine and lower back. You have not sent me the films for me to judge the actual size of the disc, not everyone requires surgery. You should be on Pregabalin 75 mg twice a day. You should be having physiotherapy or chiropractic treatment which seems to be working. If a good trial of six weeks to three months is over and you have more leg symptoms than back, then you need attention surgically.