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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45977
Experience:  Board Certified Physician
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Spinal vertebrae disc advice

Resolved Question:

Spinal vertebrae disc advice
Submitted: 10 months ago.
Category: Medical
Customer: replied 10 months ago.
MRI files here, apparently a disc is compressed causing the issue. Would surgery resolve this and what are the risks?
Customer: replied 10 months ago.
This is for a friend of mine who is in constant pain with pins and needles in her left foot everyday. The doctor is reluctant to perform surgery. She believes surgery is the only answer. If the disc is operated on to reduce size would she then be pain free, are there any risks involved?for some reason I cannot attach files? Can I email them separately?Thanks
Neil
Expert:  Shantal-Mod replied 9 months ago.
Hello,
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Expert:  Dr. David replied 9 months ago.

This is Dr. David

how old is she?

I need her MRI scan report.

has she tried a steroid injection and oral steroids and anti-inflammatories yet?

has she tried physical therapy yet?

is she overweight? has she tried to loose weight?

Customer: replied 9 months ago.
Hi Dr David,Thank you for your response.She is 33, only had anti inflammatory drugs and not taking anything now, just lots of rest. Her condition has been ongoing for around 3 years, each time she has an mri the disc size has changed and she is told it could rupture but her doctor will not operate. Hence I am trying to find a second opinion and help her. Her weight is always 50 - 52kg definitely not overweight.For some reason I cannot attach the mri details, I suspect the file is too large even after zipping. Can I email to you? Or upload elsewhere for you?Thanks
Neil
Expert:  Dr. David replied 9 months ago.

you can upload the MRI scan report and images to a large file sharing website,

like dropbox or google files

and then post the http link here for me to download.

has she tried a steroid injection?

has she tried physical therapy yet?

Customer: replied 9 months ago.
Hi,Files are here https://www.dropbox.com/sh/p5lfcsz3y4a2x1k/AADO0Ovu1N25PTKbgmw6a0pMa?dl=0She has not tried a steroid injection, would this only be a temporary fix though? As she is looking for a permanent solution.She has tried physio Therapy but the exercises made her worse.Thanks
Neil
Expert:  Dr. David replied 9 months ago.

I looked at the 2013 and 2016 MRI scan of the lumbar spine.

I don't see dramatic changes. I don't see disks at risks for rupture.

she should ask for a trial of a steroid injection into her lower back area where she is having pain

the steroids could help decrease inflammation enough so the disk goes back into place to help the pain.

I suspect she would still have pain after surgery.

she can ask to try a TENs unit. I would not do spine surgery at this point.

Customer: replied 9 months ago.
Many thanks for your answer, I will pass on your advice.
Expert:  Dr. David replied 9 months ago.

let me know if you have other questions.

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Customer: replied 9 months ago.
Hi,My friend has sent the below text. Could you please help to answer her questions?When is the surgery required for a herniated disc? Three years ago I herniated L3-L4, L4-L5 and L5-S1. I took unpaid holiday for a year as I could barely walk, I could not sit on a chair at all and when standing always felt pins and needles into the feet, with numbness in some of the toes.After that year I went back to work with 4 hours and a height adjustable desk. I make a huge effort to rest, lay down all the time, even at work I go and lay a half an hour at each 45 minutes. I cannot do basic activities at home without feeling numbness into the feet and/or toes, like taking clothes from the washing machine (and this I only tried to do after 2 years). I did not lift anything at all, the most 500 grams in one hand.I also cannot walk properly sometimes because I feel numbness in the left feet and this is very scary for me. Basically I cannot work and live, and I do not want to wait until I have the nerve compressed again.
Which may demand an emergency surgery and probably lead to permanent nerve damage. Another thing is that if something bad happens and I really need surgery I cannot arrange to have it done in a week or two. I have to wait for this and as I am living alone nobody can arrange things for me. I just do not understand while no Doctor recommends surgery, even if the L5-S1 is 12/7/7 mm and it was initially 15-5-10 and i have Sciatica every day. The other 2 disc are ok now, but this one has not shrunk enough.These are the reasons for which I would like to have a surgery. I see that they let you home in 24 hours because the surgery is minimally invasive method with microscope.I am 33 years old, 52 kg and I tried physical therapy in the past but every time that put me in the worse condition because the sciatica and numbness in the feet aggravated and I could not walk at all.So, another question is what is the cause for the numbness in the feet and toes? is not that portion of the disc who is touching the nerve? because if it is a mechanical cause than the surgery will remove that and everything should be fine. I just feel that I cannot possible wait all my life like this doing nothing every day at home and struggle to work with 4 hours. For me is somehow clear that the symptoms will not disappear by itself.Thanks for any further advice you can give.Regards
Neil
Expert:  Dr. David replied 9 months ago.

she doesn't ask questions in her text

I know she has bad herniated disks.

she may need to do back spine exercises to help strengthen her spine muscles

she should be tested for connective tissue disease to see if she has a connective tissue disorder causing her problems with her spine.

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45977
Experience: Board Certified Physician
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