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Dr.Sawhney
Dr.Sawhney, Orthopedic Surgeon
Category: Orthopedics
Satisfied Customers: 6823
Experience:  More than a decade of post qualification experience
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Doctor, I am 68. 5'7" 186. I have some back pain but the

Customer Question

Doctor, I am 68. 5'7" 186. I have some back pain but the main pain is in my buttocks. It especially hurts when I stand up straight from a sitting position ...and sit down from a standing position,and also when I bend from the waist over to pick up something (and dont bend knee). This has lasted 8 days. Prior to that I was not having pain. I was walking and had even started playing golf A LITTLE after staying off it for 10 months. I cant say a certain event caused this. A week ago I had received a back massasge and then walked inside for 45 minutes and then stretched for 15 minutes. Last Tuesday, Aug 25 I had some "trigger point" injections into the spine area from a pain doc who treats my neck and upper back) and she gave a steriod dose pack 6 day supply. ...and Meloxicam 7.5 mg.I cant say the trigger point injections helped much.
Does this sound like a herniated disc?
Because the pain referred down to the inside of the right leg and a little tingling (not often tho), Im to get an MRI tomorrow Saturday.
Is it ok to do some light stretches laying on the ground ( I learned these from PT last October)
Can I walk on an inside track like I do all the time (it doesnt hurt to walk)
Im concerned but needed your thoughts.
Submitted: 1 year ago.
Category: Orthopedics
Expert:  Dr.Sawhney replied 1 year ago.

Hello

I am an Orthopaedic surgeon and I would be happy to help you today.

Why did you have to stop playing Golf for 10 months?

Were you having any back pain or radiating pain down the leg prior to this episode?

Thanks

Customer: replied 1 year ago.

In October last year I was playing golf with no problem. Then I played in Oct 2014 and began having buttock pain both sides and pain bending over. I went to doc and did PT. Stopped playing golf because I didnt want to aggravate it in back and bilateral buttock area. Did PT for 2 months and the pain subsided and so I walked alot on the track and stretched alot and got back massages for 5 or so months. I did that routine until June of this year. I began taking golf lessons again because it felt good and also to help get a less stressful swing so as to not hurt the back. . and played 3 times. last Thursday the 20th, I got a massage, walked and stretched,,,,I was feeling good...and by that night I have a raging back problem...as previously explained. Pain in buttocks (both) and etc.

Expert:  Dr.Sawhney replied 1 year ago.

Thanks for replying.

I have read your question and your reply carefully.

This can be a prolapsed disc. This may also be an annular tear that is a tear in the outer covering of the disc. This can cause irritation of the nerve roots passing right behind and going into lower limb. MRI would be able to clarify the picture.

You can walk within level of your comfort and also do light stretches even if it is a disc prolapse. Just keep in mind to avoid or stop any stretch or walk if it causes pain. You may use heat or Ice whatever makes you feel better. There is no definite recommendation for this.

Feel free to ask any follow-up questions.

Customer: replied 1 year ago.

If it a plolapsed disc, does that mean definite surgery. Id like to avoid that. In the realm of possibilities, can something else be done, in dealing with this, assuming that it is a disc prolapsed or annular tear?

Is time an ally for me?

I forgot to say that last October 2014, I had an MRI and it showed no herniatiion but did show 1. broad based disc displacement most pronounced in the central and bioforaminal position with mild facet hypertrophy at the L4-5 level contributes to abutment of the existing right L4 nerve and abutment of bilateral descending L5 nerves......" 2."shallow disc displacement with leftward orientation and moderate to evere facet hypertrophy right greater than left contributes to abutment of the exiting left L5 nerve and abuttment of the descending right S1 nerve"....Ill have the MRI tomorrow for this recent episode.

This was Oct 2014

Expert:  Dr.Sawhney replied 1 year ago.

A prolapsed disc does not mean definite surgery. In fact most people with a prolapsed disc do not need any surgery. Time is definitely an ally and more than 90 % off prolapsed discs go on to get better over time without any intervention. Annular tears also heal with time though the time required can vary.

Expert:  Dr.Sawhney replied 1 year ago.

The older MRI may not have much bearing on your current situation.

You need to have a fresh one to know the current situation.

Customer: replied 1 year ago.

Dr may I please ask another on Wednesday of next week and tell you what the MRI says that I take Saturday

Thanks !!!!!!!!!!!!

Expert:  Dr.Sawhney replied 1 year ago.

You are most welcome.

Start the first question with "For Dr.Sawhney only".

Customer: replied 1 year ago.

Doctor this is Don and I think Ive crossed up my accounts here. Can you please answer my MRI question on this connection. I got crosswise on the site and this is my usual account. Thanks

Don Curdie

Expert:  Dr.Sawhney replied 1 year ago.

Dear *****

As per your wish I am replying here.

I would treat this conservatively with anti inflammatory medication and a drug like pregabalin.I would give 12 weeks of conservative treatment as most patients would improve over this period.

If pain persists surgical decompression can be considered. For pain relief epidural steroid injections may also be considered.

Customer: replied 1 year ago.

What would you recommend for conservative treatment.

Expert:  Dr.Sawhney replied 1 year ago.

I have already written about conservative treatment.

You may continue with anti inflammatory medication like Meloxicam.Stronger medication like Diclofenac can be discussed with your doctor.

Additionally pregabalin is an excellent medication for pain going into buttocks or leg.

Epidural steroid can be considered for pain relief as it helps deliver steroid right at area of nerve compression.It decreases the inflammation at area of nerve compression.

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