Possible lumbar nerve compression

Patient

Q: I have a really bad pain in the right side of where my hip is the doctor gave me tramadol and said i could have a slip disc or a crumbling spine. i had an xray and nothing showed up. someone said i could need a hip replacement can you help

Doctor

A:   The type of pain that you described and according to the opinion of your doctor might be due to a nerve compression, caused by a degenerative process or a bulging disk at lumbar spine level, and you can feel it worst in some positions because in certain positions the intervertebral space gets smaller and compress the correspondent nerve. The pain can radiate to the upper thigh, leg or even to the foot depending of the lumbar segment involved. In order to confirm this diagnostic impression, the best imaging study is the MRI, the plain and simple X rays are not specific or sensitive enough for to establish the diagnosis. Basically the conservative treatment is Physical Therapy aimed to recondition and stabilize the lumbar spine by re-educating you , teaching you a daily stretching routine for the lumbar area, strengthening of abdominal muscles, and other important general recommendations as follows: sleeping with a pillow between the knees lying on the side, avoid activities that place additional strain on the lumbar spine (example: weight lifting). All of the above, with the objective to keep you as far as possible from episodes of acute low back pain, and also to preserve your quality of life. If the conservative measures do not seem to work, the local corticosteroid injection may be considered.
 

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