14 doctors weighed in:
I have large left posterolateral disc herniation at l4-5 extending inferiorly and compressing on left l5, moderate central spinal stenosis. Help?
14 doctors weighed in

Dr. Alexandre De Moura
Orthopedic Surgery - Spine
4 doctors agree
In brief: Surgery is an option
If you have failed conservative treatment by 6-8 weeks than surgery is an option.
Excruciating sciatic type pain from this type of herniation would be well treated with surgical intervention if you cannot tolerate your symptoms. As always, surgery as a last resort. See you orthopedic spinal specialist.

In brief: Surgery is an option
If you have failed conservative treatment by 6-8 weeks than surgery is an option.
Excruciating sciatic type pain from this type of herniation would be well treated with surgical intervention if you cannot tolerate your symptoms. As always, surgery as a last resort. See you orthopedic spinal specialist.
Dr. Alexandre De Moura
Dr. Alexandre De Moura
Thank
Dr. Kenneth Tepper
Orthopedic Surgery
4 doctors agree
In brief: Multiple options
If you have normal strength, time, steroids (oral or injected epiduals), or physical therapy may be all you need.
If your symptoms are more severe, surgical decompression may be required.

In brief: Multiple options
If you have normal strength, time, steroids (oral or injected epiduals), or physical therapy may be all you need.
If your symptoms are more severe, surgical decompression may be required.
Dr. Kenneth Tepper
Dr. Kenneth Tepper
Thank
Dr. Thomas Dowling
Orthopedic Surgery - Spine
2 doctors agree
In brief: First realize that
Most herniations get better even with spinal stenosis.
In 60% of herniations treated nonop with a repeat MRI done 6 months after the first one, the disc has resolved or decreased in size consistent with the fact that time is a good thing. Medication, activity modification, exercise/physical therapy and/or epidural steroid injections are options usually before considering surgery.

In brief: First realize that
Most herniations get better even with spinal stenosis.
In 60% of herniations treated nonop with a repeat MRI done 6 months after the first one, the disc has resolved or decreased in size consistent with the fact that time is a good thing. Medication, activity modification, exercise/physical therapy and/or epidural steroid injections are options usually before considering surgery.
Dr. Thomas Dowling
Dr. Thomas Dowling
Thank
Dr. Jay Rosenfeld
Physical & Rehabilitation Medicine
2 doctors agree
In brief: See a doc
I would recommend seeing a physiatrist.
Such a specialist will do a good history and examination and be able to decide whether this can be handled conservatively, ie with medications, physical therapy, injections or whether you need to be referred to a spine surgeon.

In brief: See a doc
I would recommend seeing a physiatrist.
Such a specialist will do a good history and examination and be able to decide whether this can be handled conservatively, ie with medications, physical therapy, injections or whether you need to be referred to a spine surgeon.
Dr. Jay Rosenfeld
Dr. Jay Rosenfeld
Thank
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