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Back Pain

In summary L5/S1 disc protrusion with right S1 nerve root encroachment

Was wanting to know please what does this mean and how is it treatable

Thank you
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Hi and welcome to the back pain community.

What it means is that the disc between the L5 and S1 vertebrae is bulging and the portion of the disc that is bulging out from underneath the vertebrae is pushing up against the S1 nerve root on the right.  With this type of injury, you may experience shooting pain down your right leg and maybe your left leg along with low back pain.

I have the same thing going on as you along with complete disc dessication (desiccation) at L5-S1. I also have a disc rupture at L4-L5 that is pushing up against the L5 nerve roots on both sides with bone spurs, thickened ligaments, osteoarthritis, and spinal stenosis.

My treatment plan involves a multitude of medications: long-acting opioid (Opana ER), short-acting opioid for breakthrough pain (Percocet 5/325), anti-depressant, valium, muscle relaxer, anti-convulsant (Gabapentin - this medication is a key component in reducing the nerve pain), and an anti-inflammatory (low dose over the counter Aleve).  I also go in for epidural steroid injections every 3 months (these injections have helped me a lot with the low back pain but not so much with the leg pain from the nerve damage).

I have been told any surgeon would gladly perform a 2 level spinal fusion; however, I have researched and received information from very reputable sources that there is a 50-50 chance that the fusion would eliminate my pain.  The chances are much higher that the fusion would stabilize the spine (prevent further degeneration).  It is also very likely that I could have increased pain from the 2 level fusion due to scar tissue.  My Dad had a friend who committed suicide after a spinal fusion as his pain increased 10 fold and no pain med out there would touch his pain.  So nope!  Surgery is not for me and my doctors all agree that I should exhaust conservative treatments first before even considering surgery which is what I plan to do.

There are other treatment options as well.  Physical therapy can teach you how to stretch and excercise without adding more injury.  When doing physical therapy be sure to stop when something doesn't feel right.  I made the mistake of not doing that and now I have worse leg pain that doesn't seem like it will go back to the way it was because I let a physical therapist do some weird maneuvers to get my hips to move...bad idea.  Only do what feels comfortable.  

Also there are other types of spinal injections that may be helpful for relieving your pain.  I recommend that you see a physiatrist or spine orthopedic can find these types of doctors at teaching hospitals.  They will help build a treatment plan that is effective for you.

Wishing you more days with less pain.

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