Mother of three with persistent back pain

Patient

Q: I had an accident at 21 yrs with no external injury but severe back ache. It became a dull consistent lower back pain after 5-6 months. With every pregnancy (3) and time (I am 38yrs) now, it is increasing and has spread whole back. Recent MRI showed atleast 2 herniated discs. Doctors say take care of back but never tell how. What shouls I do?

Doctor

A:   Apparently the herniated discs are compressing the lumbar nerves, causing inflammation (neuritis) that is producing the pain. In the younger patients, as you, lumbar radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, radiculopathy is often a result of spinal canal narrowing from bone spurs (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The conservative treatment strategy usually includes: a physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory medication (Aleve, Motrin), also a re-education of your habits and posture in order to improve your quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. If after all these, you still continue having pain, I strongly recommend you an evaluation by a Spine specialist to explore if the surgical treatment is an option for you.

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