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L5 S1 protrusion and sciatica

kaifmahmoodkkaifmahmood Posts: 12
edited 06/11/2012 - 7:34 AM in Chronic Pain
Hi everyone,

I have been struggling with a disc protrusion for about a year and a half. I would be really happy to read any information, advice or personal experiences that others talk about.

In early 2008, I came down with severe lower back pain in the area under the trouser belt. I only applied heat to it for a few months and did not see a doctor for it because I was home bound with another illness.

In June 2008, I saw a physical therapist who diagnosed me with mild scoliosis and gave me strengthening and stretching exercises. I did those for about 10 months with fortnightly visits to the physical therapist.

April 2009: The improvement was only mild even after 10 months of regular exercise, so this April I saw an orthopedic doctor. He asked me to get an MRI done which showed that I have a "focal central protrusion at L5 S1 indenting the thecal sac", with "no nerve root compression".

The doctor told me that my protrusion is very mild, and to continue with more or less the same exercises. He said that this condition would come and go all my life but I could keep it mild through exercise. :S

August 2009: Now it has been another four months since then. While my back pain is better and often not there, in the last month I have developed pain in my legs down to my feet. I saw another orthopaedic doctor a fortnight ago and he told me that I should just continue with the exercise because the only other option is surgery, which is not required for such a mild case as mine.

In the last few days the pain has increased and I am wondering what to do. I will be going abroad for studies for 1 year next month, and I am a bit worried about my condition.

I do not understand the following things:

1. Does it really take more than a year and a half for a mild protrusion to heal? Is the doctor right in saying that the protrusion will be there all my life? ~X(

2. Does the fact that I have a sciatica pain now which has almost replaced the lower back pain mean anything? Could it be that my protrusion has got worse?

In the last year and a half the only exercise I have really done is walking. Jogging, sports, lifting light weights, yoga - all these make my condition worse.

I suppose the best thing I can really do now is to find a good physical therapist who can review my exercise programme? The orthopedic doctors I have visited do not seem to be very keen to get into the details of exercise.

New Delhi, India


  • I will try to answer your questions.

    It does seem like a long time for a protrusion to heal. When my husband ruptured that same disc many years ago, he was pretty much pain-free in about six months' time. At a year, or a bit sooner, he was back to running. He was able to do this with rest for the first few days, then physical therapy and continuing with his back exercises. Of course you need to avoid any activity involving bending, lifting, twisting, reaching up or sideways, pushing, pulling.

    Unless they keep imaging your spine, they cannot tell if the protrusion is healing. You can only guess by the other symptoms you are having. It is likely the new sciatic pain is caused by the disc --perhaps it has gotten worse. It sounds like it is now pushing against the nerve root -- at least that would be one cause of the sciatic pain.

    I don't know if the same protrusion will always be there, but I do think there will always be a tendency to have problems at that level. If you are careful with your activities, and continue to keep yourself in shape, you may be able to avoid future incidences.
    Back to my husband -- he has avoided any further problems for 16 years.

    Walking is the best exercise for those with spinal problems. I think your plan to see a physical therapist who specializes in orthopedics is a good plan...certainly shouldn't hurt.

    Here is some further information for your consideration:




    Hopefully with continued conservative treatment, you will be able to get rid of the pain and avoid any surgery.

    Good luck to you.
  • Before I had my 2nd neck surgery for bulging disc the MRI showed it wasn't that bad,but nerosurgeon(who really listened to me) did the surgery anyway and afterwards told me that when he got in there it was worse than what showed on MRI. So maybe a second opinion would b good.
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  • thanks gwennie and holliesterling.

    i did go to a physical therapist last week and he insisted that i come for treatment that involves IFT (interferential therapy), ultrasound gel and back massager everyday for a week. I have been through all these treatments for quite some time with my earlier physiotherapist who thought I only have scoliosis, and it didn't really help. So I am not very keen to spend almost 3 hours (including commuting)and money everyday for the same stuff again.

    do you have any idea about whether these things help relieve nerve compression?

    they do seem to improve the blood circulation and the muscles feel slightly more relaxed for a few hours afterwards, but that's about it. my impression is that these treatments MAY be good for persons who need immediate pain relief, but largely i just want to be sure that i am on the path to recovery. since it has been so long, i am not sure if i am really taking the right treatment.

    thank you so much for the answers again. you guys are more helpful than the doctors :)
  • Do u get any relief from the therapy at all/some/none?
    Or is it worse?
  • in september 2008 i went for 10 sessions of interferential therapy and ultrasound gel (is that what it's called?). i felt a bit more relaxed and soothed in my lower back (that's where i had the pain at that time) after each session for a couple of hours, but then the pain would come back. it did not really make my pain any better over time. i think largely it was a waste of time, and whatever little improvement i had over the months was because of the strengthening exercises.

    so i would say i got almost no relief from it. this time i went for it only once and i am not sure if i want to go for another ten sessions because it wasn't helpful last time.
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  • I know before my second neck surgery I tried therapy and it made "my" pain
    worse. And the pm dr stopped and sent me back to nerosurgeon.
    And like I said before it was worse than he could see on MRI.
    Just as I told him in the first place... Thank God for him, because he listens to me and I did everything else he wanted me to do with no prevail and went back and he did the surgery at my request....I would do it again even though it caused more pain from failed surgery syndrome,but the pain is a different kind than before.
    My neck hurts,but I don't feel the crick I did have.

    Goodluck to u!!!!

  • what kind of therapy did you try? was it exercise or was it a stimulation of your muscles / nerves with electrodes?
  • It was both and also aquatherapy in pool.
    It all made pain worse and dr stopped pt and sent me back to nerosugeon.
  • It was both and also aquatherapy in pool.
    It all made pain worse and dr stopped pt and sent me back to nerosugeon.
  • It was both and also aquatherapy in pool.
    It all made pain worse and dr stopped pt and sent me back to nerosugeon.
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