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Doctor insights on: L5 S1 Radiculopathy Treatment

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Dr. Brian Le Dr. Le
2 doctors agreed:
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23m s/p l5-s1 discectomy w/ daily moderate-severe back pain & radiculopathy both leg. What is my next treatment option? More epidural? Fusion surgery?

Dr. Brian Le Dr. Le
2 doctors agreed:
23m s/p l5-s1 discectomy w/ daily moderate-severe back pain & radiculopathy both leg. What is my next treatment option? More epidural? Fusion surgery?

Failed back: It appears that you have failed back syndrome. Please see a pain specialist for evaluation and treatment. You might benefit from additional therapy, medications, injections like epidural steroid injection or spinal cord stimulation. ...Read more

Dr. Kornelis Poelstra
288 doctors shared insights

Radiculopathy (Definition)

Also called “pinched nerve root,” this occurs when a spinal nerve root is compressed, inflamed, or damaged, causing symptoms of pain, numbness or weakness. Often, nerve roots are affected in the neck or in the lower back. This leads to symptoms that affect certain regions of ...Read more


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What could cause 'clicking' in the lower back at the l4/l5 s1 level. It's centralized. Occurs with extension and no radiculopathy. With severe pain.

What could cause 'clicking' in the lower back at the l4/l5 s1 level. It's centralized. Occurs with extension and no radiculopathy. With severe pain.

Facet Arthropathy: Could be facet arthropathy/arthritis. There are joints in the spine where the bones articulate and can develop bone spurs and cause the clicking with pain typically with extension. I would consider seeing a pain/spine specialist to see if facet injections or radio frequency ablation would be helpful for you. ...Read more

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Have moderate /severe radiculopathy that started and progressed more than a year after L5/S1 ADR surgery.EMG showed compressed nerve. Causes for this?

Have moderate /severe radiculopathy that started and progressed more than a year after L5/S1 ADR surgery.EMG showed compressed nerve. Causes for this?

Postlaminectomy synd: Post Laminetomy syndrome can be flared following ADR surgery. The resulting nerve pain is due to altered kinetics, gravity or possibly scar. Other times the surgery just can't stop progression of disease and nerve damage. See your surgeon right away to evaluate: starting physical therapy focusing on core strengthening, postop imaging, epidural injection or SI joint examination or possible injection. ...Read more

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Can you please suggest treatment for L5 s1 spondylolysis?

Can you please suggest treatment for L5 s1 spondylolysis?

Several Options: Congenital variety genetic origin occuring in 6%-8% of us population particularly in certain high level athletes like swimmers, gymnasts, pitchers, football linemen to name a few. Most treated non operatively (90%)including bracing, physical therapy leading to regular exercise ; medication and activity modification. Epidural steroid injections can also be considered. ...Read more

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Does an annular tear, and disc herniation, at L5-S1 ever go away, and what is the best treatment for it?

Does an annular tear, and disc herniation, at L5-S1 ever go away, and what is the best treatment for it?

Back pain treatment: Subacute and chronic lower back pain are very common in primary care. For patients with acute pain, rapid improvement in pain is the norm after a month.

Remain active, and limit bedrest. Try yoga. Use short courses of nonopioid analgesic medications (acetaminophen or NSAIDs like ibuprofen or naproxen) for acute exacerbations of subacute or chronic low back pain ...Read more

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I'm 27 years old and developed a Right Paracentrl Disc Protrusion on L5-S1. Is this an uncurable condition? What is the best form of treatment?

I'm 27 years old and developed a Right Paracentrl Disc Protrusion on L5-S1. Is this an uncurable condition? What is the best form of treatment?

Fairly common: Lumbar disc bulges are common. Many are found incidentally are not likely to cause symptoms. Aprox 20 — 35% of adults have disc bulging on MRI. The incidence of sciatica symptoms is 2%. Some disc herniations may be resolved with conservative treatment. Some will progress. If you have persistent symptoms despite conservative therapy, then surgery maybe warranted. ...Read more

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After paracentral disc protrusion at l5 s1 level inMri after three weeks rest/medication pain is almost negligible what is the best treatment going forwad?

Do your lumbar: Strengthening exercises to increase your paraspinal muscle tone and durability, which in the long term will help strengthen your back against trauma and/or recurrence of symptoms. Physical therapy is always a good answer for vertebral problems. I would make sure I do my back exercises every day for at least 15-20 mins, and avoid situations where you may have to strain your L5-S1 disc. ...Read more

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I had an MRI done on my lower back. Results show L5-S1 radiculopathy and right brachial plexopathy. What does that mean, and what can be done for it?

I had an MRI done on my lower back. Results show L5-S1 radiculopathy and right brachial plexopathy. What does that mean, and what can be done for it?

Radiologist: In cases like this I recommend that your physician sit down with the radiologist and review the images while describing your symptoms to the radiologist. Radiculopathy May be caused by a bulging disk or vertebral arthritic spur. Brachial plexopathy affects the upper extremity rather than the low back. The radiologist may recommend additional studies or referral to other specialists for evaluation ...Read more

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Mri saw disc herniation on l5/s1, very painful, all day/every day, has it been misdiagnosed and be lumbar radiculopathy? If so, should MRI be reviewed?

Mri saw disc herniation on l5/s1, very painful, all day/every day, has it been misdiagnosed and be lumbar radiculopathy? If so, should MRI be reviewed?

Not really: The material herniating from a disc may displace a nerve and that is radiculopathy. You can have both. Talk over the results with the doctor that ordered the mri. ...Read more

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Can I receive proper medication for my back injury in ohio I have L5 s1 disc herniation and radiculopathy and cronic pain in back and both legs

Can I receive proper medication for my back injury in ohio I have L5 s1 disc herniation and radiculopathy and cronic pain in back and both legs

Complicated: Relying solely on medications is not an optimal solution. Pain meds won't fix your problem and thus taking them will lead to tolerance and risk dose escalation. There is a role for pain meds if used sparingly and only in times of severe breakthrough pain. At 41, they shouldn't be used around the clock. Also consider medications for nerve pain but again they won't fix the problem. ...Read more

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I'm a bay area police officer suffering from a l5/s1 ruptured disc. I'm 39 yrs old. Pain is growing unbearable. What are treatment options?

I'm a bay area police officer suffering from a l5/s1 ruptured disc. I'm 39 yrs old. Pain is growing unbearable. What are treatment options?

MEDROL, (methylprednisolone) analgesics..: First, have you tried a Medrol (methylprednisolone) (steroid pack) which can relieve the 'nerve inflammation'. You may need a steroid injection, later. Analgesics and muscle relaxers can help. Sometimes a chiropractor who does traction may ease the disc back 'into place'. Most 'bulging discs' resolve without surgery so hang in there! ...Read more

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I'm 19 and I have bulging disc in L5-S1 diagnosed on 18th. Advised minimum 23hrs of bed rest for 2 more weeks. Is this the right course of treatment?

I'm 19 and I have bulging disc in L5-S1 diagnosed on 18th. Advised minimum 23hrs of bed rest for 2 more weeks. Is this the right course of treatment?

No. Bed rest more : Then 2 days is of no help and may delay recovery which should be with guided exercise like PT and use of medication as needed to help symptoms based on medical hx with need to make sure you exercise, stay trim and avoid tobacco. ...Read more

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Mri shows I have herniated dics on l4-l5 and protrusion on l3-l4 and l5-s1. What is the treatment?

Mri shows I have herniated dics on l4-l5 and protrusion on l3-l4 and l5-s1. What is the treatment?

Depends on symptoms: If you have no symptoms, you may not require any treatment. With symptoms limited to pain, non-surgical treatments should be attempted first — physical therapy, massage, analgesics, etc. If those treatments fail, minimally invasive or surgical options can be considered. If you have severe symptoms such as inability to walk, bladder or bowel incontinence, surgery may be necessary. ...Read more

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Seeking non-surgical treatment options for adolescent bilateral grade 3 spondylolysis (pars defects) with herniated l5-s1 disc?

Seeking non-surgical treatment options for adolescent bilateral grade 3 spondylolysis (pars defects) with herniated l5-s1 disc?

Options: Congenital variety genetic origin occuring in 6% us population in particularly in certain high level athletes like swimmers, gymnasts, pitchers, football linemen to name a few. Most treated non operatively including associated with herniated disc with bracing, physical therapy & medication and activity modification. Epidural steroid injections can also be considered with 90% treated nonop. ...Read more

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I had a l5-s1 large disc protrusion in 2009 and now my lower back is sore again (x5 days). What is the best treatment to avoid it getting worse?

I had a l5-s1 large disc protrusion in 2009 and now my lower back is sore again (x5 days). What is the best treatment to avoid it getting worse?

Careful exercise: The risk of a recurrence is 5%. Start by avoiding prolonged positioning & any repetitive twist or bend maneuvers. If you had physical therapy with your last episode, resume those exercises. Use of otc medication will help control symptoms. Cardiovascular workouts may help except for rowing & maybe running. If you did not have physical therapy, you may want to get a session to learn exercises. ...Read more

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What are the best treatment options for l5-s1 slipped disc with numbness and shooting pain in entire leg.

What are the best treatment options for l5-s1 slipped disc with numbness and shooting pain in entire leg.

Multilevel : Physical therapy, nsaids, cessation of tobacco and avoidance of aggravating factors is a start. However, since there is shooting pain in the "entire leg", the disc is likely irritating more than one nerve root (s1, l5, and possibly l4). Lumbar epidural steroid injection may be beneficial. If not readily available, a 7-14 day Prednisone taper can be tried but less effective. Surgery may cure it. ...Read more

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I'm 27 and have degeneration in L5-S1 and early osteoarthritis in SI joints. What's a typical treatment for that?

I'm 27 and have degeneration in L5-S1 and early osteoarthritis in SI joints. What's a typical treatment for that?

Muscle/Stretch: Stretching, exercise, massage.
Focusing on good posture when exercising and making sure surrounding muscles specifically the rhomboids, paralumbar muscles, glut's and hamstrings aren't tight.

Also, I'm assuming they rule out seroarthropathies such as HLAB27 condition and rheumatoid arthritis?
Otherwise, as I mentioned. ...Read more

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What treatment would you recommend for MRI results: Moderate size midline L5-S1 disc protrusion with mild effacement of the left S1 nerve root sleeve?

What treatment would you recommend for MRI results: Moderate size midline L5-S1 disc protrusion with mild effacement of the left S1 nerve root sleeve?

Lumbar disc disease: As with any ailment you need to get expert opinion. If you don't have any weakness in legs, sensory deficits or urinary issues then treating it conservatively would be appropriate at this time, taking Advil (ibuprofen) or Ibuprofen, Physical therapy, heating pad may help it if symptoms persist then see a Neurologist. ...Read more

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Got MRI report, broad based dic bulge l4, l5. Facet hypertrophy l4, L5 and l5, s1. What are treatment options? 3mths pain, no improvment w/pt or st shot

Got MRI report, broad based dic bulge l4, l5. Facet hypertrophy l4, L5 and l5, s1. What are treatment options? 3mths pain, no improvment w/pt or st shot

Complex answer: The Best way to reduce back pain is to be as light as you can (optimal weight) be as fit as you can (high level of fitness with good core muscle strength) and don't smoke. The intermittent use of anti-inflammatory medications will help as well. If the epidural was not effective the injection can be placed in the facet joint or the disc. The pain generator needs to be found. ...Read more

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Back pain for 10 months. MRI last week showed, mild broad-based posterior disc protrusion at l5-s1 but no nerve root comprression.Whats the best treatment?

More info. needed: I often tell my patients the following. If I (metaphorically) pull 10 people off the street, at random, who don't have back related problems, and have them get an MRI of their lumbar spine, > 5 of the 10 will have 1 or small 'imperfections' in their disc appearance(s). In your case the strong probability is that the noted finding on your MRI has no relationship to the cause of your back pain. ...Read more

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Mri says protusion at l5 s1 left greater than right s1 nerve root but pain is at right hip and leg no pain at left side what treatment is best.

Back pain: You are too young. Just take some over the counter Aleve (naproxen) 500mg 2x a day after food. Do proper back exercises which you can do after watching some free videos in the internet. Be patient and wait. It will take 2-6 weeks for it to heal on its own. ...Read more

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Is physical therapy really the best choice for an obiterated l5-s1?

Is physical therapy really the best choice for an obiterated l5-s1?

Avoid back surgery: At all costs as it does not guarantee results. If you have weakness, you don't have a choice but if therapy can be attempted first, it should always be done to avoid surgery. ...Read more

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I have a fusion at l5/s1 on 5-11-12. Is there any type of decompression therapy I can safely do for my low back?

Postop care: Hate to say it, but that is a personal decision your operating surgeon needs to make by interpreting your x-rays and exam. If all clear, save some cash and buy an inversion table. Consider asking for a referral to a mckenzie certified pt. Please don't do anything without your doctor's blessing. ...Read more

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What are best the non cirurgical treatments for spinal disc herniation L5 s1?

What are best the non cirurgical treatments for spinal disc herniation L5 s1?

Back Pain Options: This back pain as you suggested is the result of an irritated nerve or facet joints or other injury typically in the lumbar spine (low back) which are caused by herniated disks, spinal stenosis or degenerative disc disease, etc requiring further evaluation by a spine specialist and may be candidate for facet injections/radiofrequency ablation and epidural steroid injection. ...Read more

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I have a minor disc bulge (l5-s1) caused by ddd that hasn't resonded to physical therapy, what should I do?

I have a minor disc bulge (l5-s1) caused by ddd that hasn't resonded to physical therapy, what should I do?

Try Osteopathy: Often a skilled osteopathic physician (do) who practices omm/ nmm (neuromuscular medicine) have help with alignment that cannot be addressed in pt. S/he may recommend a different physical therapist. Find a hands-on do at the amer academy of osteopathy (find a specialist in nmm/ omm), the osteopathic cranial academy (look for someone who does high % of cranial) or biodynamic osteopathy (biodo. Com. ...Read more

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I had l5/s1 disk herniation and through surgery it is fixed but i still have bladder problems. Cystoscopy says bladder is healthy, is there any tretment?

I had l5/s1 disk herniation and through surgery it is fixed but i still have bladder problems. Cystoscopy says bladder is healthy, is there any tretment?

See Urologist: Depends on what urodynamics showed. Nerve issues can cause over and under active bladders. Get the cysto and then follow advice. Good meds to calm bladder down if that is the issue. On the other hand, if your bladder is hypoactive there are some things you can consider (bethanachol, interstim etc.). ...Read more

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Are there non steroidal and non-surgical treatments for a l5-s1 disc hernia?

Are there non steroidal and non-surgical treatments for a l5-s1 disc hernia?

Therapy: You can try Ibuprofen over the counter and physical therapy as a first line treatment of a herniated disk without surgery.
If you fail therapy and your pain persists, you may need surgery.
Try to do physical therapy first. Williams and mckenzie exercises help quite a bit. ...Read more

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Can massage therapy be good for L5 s1 3mm retrolisthesis where I have a herniated disc? Is a tens device better therapy?

Can massage therapy be good for L5 s1 3mm retrolisthesis where I have a herniated disc? Is a tens device better therapy?

Both can help: Massage will help with some sore muscles that are aggravated by the irritated nerves and the tens unit is very good for pain control by something called "gate theory", both modalities work in different ways and both can be of benefit. Physical therapy is the best for this though, so keep that up! Strengthening the supporting musculature and core will help stabilize the slip and herniation. ...Read more

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I had a l5-s1 fusion rev/hardware removal 1 year ago. Therapy done. Why do I still have aching pain in my lt/side hip/iliac crest (tender to touch)?

I had a l5-s1 fusion rev/hardware removal 1 year ago. Therapy done. Why do I still have aching pain in my lt/side hip/iliac crest (tender to touch)?

Possibilities:: While i rarely take iliac crest bone graft because it usually isn't necessary, when I do, my patients never complain of pain from the graft site. It definitely could be si joint pain, you should have your si joint evaluated with the 5 provocative tests for si instability. If at least 3 are positive, then a si joint injection, radioablation, or minimally invasive fusion may alleviate your pain. ...Read more