Orthopedics Questions? Ask an Orthopedist for Answers ASAP
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?
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.
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.
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
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.
The older MRI may not have much bearing on your current situation.
You need to have a fresh one to know the current situation.
Dr may I please ask another on Wednesday of next week and tell you what the MRI says that I take Saturday
You are most welcome.
Start the first question with "For Dr.Sawhney only".
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
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.
What would you recommend for conservative treatment.
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.