All my tests show a disc problem at L4/5. What are my treatment options for this problem?

You'll want to check with your doctor about his or her recommendations. Having the specific test results of what the problem is and how involved the disc is helps guide treatment decisions.

On the conservative side, some disc problems respond to nonsteroidal anti-inflammatory drugs and physical therapy. The therapist can show you certain positions to use to help
the disc move away from the nerve root. Symptoms can be relieved by taking pressure off the nerve root. Posture, proper lifting, and good positioning in bed will also help.

Steroid or chymopapain injections into the disc space have been used for many years. Both require an outpatient operation with some sedation. Both dissolve the disc material. The results vary from patient to patient. Long-term effects of steroids scare some people
away from steroid treatment. It can dissolve other tissue in the area besides the disc causing a weak and unstable spine.

Very rarely, use of chymopapain can cause serious side effects. These include leg paralysis or even death. Some patients can have a severe allergic reaction to this chemical.

Surgery is a final option. The doctor can take some of the disc or bone out to take pressure off the nerve root. The spine can be fused if it's unstable.

Some studies show the end result 10 years after disc pain began is the same in all patients no matter what treatment was used. In light of that information, treatment is geared toward managing the symptoms.

Abhay Khot, MS(Orth), DNB(Orth), FRCS(Orth), et al. The Use of Intradiscal Steroid Therapy for Lumbar Spinal Discogenic Pain. In Spine. April 15, 2004. Vol. 29. No. 8. Pp. 833-837.

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