Patient: Degenerative changes at L4 L5 and S1.A small diffuse posterior disc bulge at L4 L5 resulting in some narrowing of the spinal canal with anterior impingement of the thecal sac and some exiting nerve root impingement. My question is will this heal in time. A new physio has now said that my leg pain is not from my back but from my hips? I find it difficult to walk at a nornal pace for more than a few minutes.
Doctor: According to the description of the MRI this is most likely a Lumbosacral nerve root compression. Some of the major cau uses of acute and chronic low back pain (LBP) are associated with radiculopathy (nerve compression). However, radiculopathy is not a cause of back pain; rather, nerve root impingement, disc herniation, facet arthropathy, and other conditions are causes of back pain..Lumbosacral radiculopathy, like other forms of radiculopathy, results from nerve root impingement and/or inflammation that has progressed enough to cause neurologic symptoms in the areas that are supplied by the affected nerve root, the leg in your case.During the acute phase of the pain, the physical therapy is very important and involves the use of ultrasound, TENS, heat to control pain, teaching you back-protection techniques (e.g., proper lifting, posture awareness).A lumbar stabilization program is also useful in instructing you in various techniques to control back pain, and you also can work on strengthening the stabilizing muscles of the lumbar spine. If after follow a physical therapy program, and try every conservative measure the pain and the neurological symptoms do not improve, the surgical possibility should be considered to release the compressed nerve and avoid more damage