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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Orthopedics
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Doctor, I am 68. 5'6" 180, and one month ago I

Customer Question

Doctor, I am 68. 5'6" 180, and one month ago I developed bad sciatica in both buttocks and pain down left and primarily right leg into the calf. I have taken meloxicam and Tramadol for 1 month....plus ice....and I am still walking on the indoor walking
track. . I had a round of steroid pills....They helped a lot but the pain returned but not as bad..... I met with a doctor who ordered an MRI. It said : (quote) L3-4 There is a minimal concentric disc bulge with a new superimposed small broad based right paracentral
disc protrusion that does not cause nerve root impingement. Facet arthropathy is minimal . There is no spinal canal stenosis. No significant neural foraminal stenosis is seen L4-5.. There is a mild concentric disc bulge with a superimposed small central disc
protrusion. There is suggestion of a crescentric band of overlying extruded disc material. This measures 14x3x7 mm and there is indentation of the left ventral aspect of the thecal sac with probable impingement upon the descending left L5 nerve root. The lateral
recesses are narrowed and spinal canal stenosis is moderate to severe with contribution from severe bilateral facet arthropathy and moderate ligamentum flavum thickening. Fluid is noted in the facet joints and there are bilateral extraspinal facet synovial
cysts inferiorly. There is mild right and mile to moderate left neural foraminal stenosis. L5-S1--There is minimal concentric disc bulge. Bilateral facet arthropathy is moderate to severe. No spinal canal stenosis is demonstrated. Proximal right neural foraminal
stenosis is minimal... My question to you is this.....The doctor recommended an epidural steroid injection in the lumbar. It was scheduled for September 30... Within the past week, I have really improved. It doesn't hurt me to sit, walk or stand. It primarily
hurts when I bend over at the waist..... and it hurts for about 20 minutes when I get up out of bed in the morning. I would like to postpose the injection ( ESI) and wait until IF I get worse or digress. My pain level is good now....Im taking the Meloxicam
(7.5 mg) and Tramadol 25 mg (half the regular dose) every day....I avoid bending over and lifting over 10 lbs.What do you think???
Submitted: 1 year ago.
Category: Orthopedics
Expert:  Dr. Thomas, MD replied 1 year ago.

Hello

None of this is the correct approach.

See an MD specialist of physical medicine and rehabilitation for a completely manual medicine program.

Injections alone will simply let this progress, and get worse, and wind up in surgery.

You can arrest this process.

The same specialist can handle injections in conjunction with therapy, traction, etc.

OK, so that is an initial answer….

Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.

Customer: replied 1 year ago.
Im not sure what a "manual medicine program " is. Can you tell me
Expert:  Dr. Thomas, MD replied 1 year ago.

Starts with a structural exam, then tailors a program to what you need, which could include physical therapy, home exercises, specialized traction, electronic techniqes, and pain control

Please click a positive rating.

Come back as needed.

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