Q. Do I need surgery for compressed nerve and back pain?

Answered by
Dr. Chirag Solanki
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 01, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I suffered a back injury at work before nine months while lifting an order of 20 batteries weighing 20 kg each. When I lifted the last battery of the order, I felt a sharp pain in my lower back, and my left leg that made me collapse and I was rushed to the hospital. I have seen a number of doctors over the last nine months without any improvement. I was diagnosed with L5/S1 broad annular tear, paracentral disc bulge, compression of the exiting nerve canal and a swollen S1 nerve root.

Symptoms that occurred since my injuries are bladder issues (dribbling, cannot stop peeing and leaking during the night in the bed), muscle spasms leaving indents in my lower back, redness in left foot (photo attached), muscle twitching in the left thigh, calf and big toe, left big toe and two other toes stick up with pain, swollen Achilles tendon and swollen foot and lower back pain (radiating to the left leg).

The treatment I underwent since the injury are nerve blocking injection in the L5/S1, nine weeks of physiotherapy and hydrotherapy, three months of medication program that included Endone 5 mg two times a day and Gabapentin 100 mg twice a day. My doctor suggested L5/S1 disc replacement surgery. I would like to get your opinion on the treatment. I have attached some MRI scans and photos.

Dr. Chirag Solanki

General Surgery Neuro Surgery Spine Surgery
#

Hi,

Welcome to icliniq.com.

  • Firstly, I would suggest you undergo endoscopic or microsurgical discectomy surgery for your back pain as soon as possible without further delay.
  • You can also consider disc replacement as an option.
  • Regarding your symptoms, I would like to tell you that we human beings have jelly-like material (disc) between the spine bones (vertebra). They act as shock absorbers. But as you lifted quite a bit of weight, there was significantly increased pressure in the disc, so the covering of the disc (annulus fibrosus) ruptured and inner material of the disc came out. This is causing pressure on the nerve or nerves which are coming from spinal cord towards leg and causing all of your symptoms.
  • Another important thing is weight reduction and activity modification. Both are risk factors for disc prolapse which you have. So even after surgery to prevent recurrence at other levels, you need to reduce weight. You should not lift a heavy weight or bend your back in front.
  • For the redness in your left foot, I wanted to ask since when have you developed this problem. Do you have a fever or other symptoms which suggest infection?

For further queries consult a general surgeon online --> https://www.icliniq.com/ask-a-doctor-online/general-surgeon


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Thank you doctor,

Yes, the foot problem started about two months after my injury, and I still get the redness on and off. I have never had a fever or any other symptom. Can you please tell me your opinion about my injury with the scans attached?

Dr. Chirag Solanki

General Surgery Neuro Surgery Spine Surgery
#

Hi,

Welcome back to icliniq.com.

  • As I have already explained, this injury is due to lifting heavy weight. Considering your symptoms, you will have improvement in pain immediately after surgery, but the tingling and numbness will take some time to improve.
  • As there is already bladder involvement, it needs surgical intervention as soon as possible.
  • The longer the compression stays, the longer it will take for improvement, and many a time some symptoms may not improve.

For further queries consult a general surgeon online --> https://www.icliniq.com/ask-a-doctor-online/general-surgeon


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