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Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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I have a disc bulge at L1-L2 fflattening the thecal sac. At

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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: 6 years ago.
Category: Medical
Expert:  Ken replied 6 years ago.
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 and 2 other Medical Specialists are ready to help you
Customer: replied 5 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 5 years ago.

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.

Ken and 2 other Medical Specialists are ready to help you
Customer: replied 5 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 5 years ago.

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

Customer: replied 5 years ago.
Rare doesn't mean impossible. Downhill since the injection, and trying to put puzzle together because doctors haven't
Expert:  Ken replied 5 years ago.
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}.