How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Ken Your Own Question

Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6353
Experience:  Working as a Doctor who Cares since 2001.
25541092
Type Your Medical Question Here...
Ken is online now
A new question is answered every 9 seconds

I have a disc bulge at L1-L2 fflattening the thecal sac . At

Resolved Question:

I have a disc bulge at L1-L2 fflattening the thecal sac . At L4-L5 a 3.0 disc bulge is flattening the tecal sac with mild bilateral foraminal narrowing. The L5-S1 revels a 3.0m right subarticular disc protrusion with a radiall tear in the outer annulus flattening the thecal sac wtih mild narrowing of the left neroforamen, What treatment is recommended and will it be permanent?
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.
Hello,

I can understand your anxiety.

The above MRI report suggests that you have multilevel disc bulges causing mild compression over the thecal sac and nerve roots. The severity is mild to moderate {if I may say so}. there is no significant spinal canal stenosis suggesting severe form of disease.

The treatment plan consists of taking care of the symptoms {pain - to be more specific} and trying to avoid further deterioration of the disc bulge. In some individuals the disc is seen to go back to its normal position {but not in all}.

The nerve pains are severe pain and medication alone may not help and various other modalities and medication combination like narcotic analgesics, Gabapentin/Pregabalin, muscle relaxants are needed for the substantial pain relief.

Following measures do help -

Avoid activities which increases the pain/ Rest intermittently/ Avoid bending at 90 degrees/ Pushing and pulling should be avoided till pain subsides/ Avoid prolonged sitting and standing/ Avoid sitting or sleeping on floor.

Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants/ Local analgesic gels or sprays / ointment/ Hot fomentation/ Electrotherapy like trans cutaneous electrical nerve stimulation/ ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback do help.

Good supervised physiotherapy/ reduce weight for long term benefit/ Epidural steroid shots do make a lot of difference.

Surgery is the last resort and is generally thought if there is no relief from medical {non-invasive} treatment.

Wish you well. God bless






Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6353
Experience: Working as a Doctor who Cares since 2001.
Ken and 3 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
After the steroid injection, I had fecal incontinence
And now, the incontinence has worsened. I am negative with pelvic floor exam.
Have you ever heard of the nerve being damaged
And nobody recognizing?
Expert:  Ken replied 2 years ago.
Hello,

I am sorry for the delay, I was in an emergency.

It is less likely to damage a nerve during steroid shot to cause fecal incontinence.

You are right in thinking of the nerve damage as the cause. It can happen due to varied etiologies like - demyelination at the brain or cord/ ischemia or diabetes. I would think of these first before thinking of the nerve damage secondary to steroid shot. MRI Brain and cord, blood tests should help.

Best
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6353
Experience: Working as a Doctor who Cares since 2001.
Ken and 3 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
Not possible? I've read that certain types of injections
Can cause problems and, although unlikely,
A needle can damage a nerve. Would injection
area be the wrong location?
Finally have referral for new spine and brain MRI.
It's been a nightmare.


Expert:  Ken replied 2 years ago.
Hello,

The needle can damage the nerve or the cord for sure but it is rare to have this in experienced hands.

Best
Customer: replied 2 years ago.
Rare doesn't mean impossible. Downhill since the injection, and trying to put puzzle together because doctors haven't
Expert:  Ken replied 2 years ago.
Hello,

You are right - Rare does not mean that it is impossible. I am sorry to repeat but I would think of other causes before pointing to a rare cause. I am happy that you have got a referral for MRI. It will surely give us more answers {the abnormality or trauma due to the needle}.

Best

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    14679
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2562
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11961
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/CO/commissure/2011-4-15_192514_REISD20080926JR1090.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    10667
    Experienced Physician trained in New York City. I'm ready to help.
 
 
 

Related Medical Questions