Can conservative treatment cure my disc prolapse?

Question

Hello doctor,

I am a 37-year-old male. I was diagnosed with an L5S1 disc herniation 1.5 years ago. During the initial stages, I was having pain in my right leg and buttocks. I have already taken two epidural injections. They gave some relief, but now the pain has come back again. For the last four months, the pain has been more localized in the lower back and sometimes in the testicle. The leg and buttock pain happen sometimes, but not always. My initial spine doctor suggested a TLIF (transforaminal lumbar interbody fusion) surgery.

I then consulted with another Neurosurgeon, and he is against the surgery as he says only fusion does not help with lower back pain. I am currently on 200 mg of GabapinNT and a muscle relaxant. Also, I have been doing core exercises almost regularly for the last year. I had also taken hydrotherapy and needling, but nothing helped much.

But I still get lower back and testicular pain even after taking medication. I can barely stand for 10 minutes, but I can walk for 30 minutes until my back gets stiff again.

My current MRI (magnetic resonance imaging), taken a week ago, still shows bilateral compression on the exiting nerve.

How can this lower back and testicle pain be treated?
Can fusion, ADR (artificial disc replacement), or any other surgery treat this condition?
Since close to one and a half years have passed, will conservative treatment help?

Kindly guide.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. Do not feel depressed. I will try to help you. You have attempted medications and epidural injections. There are two things I would like to know.

What do you do, and how much physical activity do you have in your daily routine?
Please share the MRI (magnetic resonance imaging) and images of the previous and current MRI for comparison to know if the herniation has progressed or not.

Also, after sharing your images, I suggest you have a phone consultation with me. This way, I can answer all your questions in detail.

I hope this is helpful.

Thank you.

Answer 2

Hello,

Welcome to icliniq.com.

I do not think your disc prolapse has increased much compared to your previous MRI (magnetic resonance imaging). However, there is effusion in your facet joints.

What kind of epidural have you taken, interlaminar or transforaminal?

I am available to speak right now. You can book an audio or video consultation at your convenience. Please keep all the documents in hand while we are talking, as I will ask for a lot of information regarding your previous treatment.

I hope this will help you.

Thank you.