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My MRI shows a prolapsed disc at L45 but I decided NOT to have surgery no matter what. That leaves me with fewer options but I don't really know what those are -- can you help me figure out where to go from here?
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Even though you have opted out of surgery, your surgeon is still the best one to advise you. The standard of conservative (nonoperative) care is physical therapy and medications such as antiinflammatories.
Antiinflammatory drugs work well because they provide relief from pain. But they also reduce swelling around the nerve, thus taking pressure off the nerve and reducing irritation that leads to pain.
A specific type of physical therapy approach is used for patients with lumbar disc prolapse and resultant sciatica (leg pain). The concept is to find the direction of spinal movement that does not cause pain and does not reproduce the sciatica. The patient is then taught how to safely move in that direction repeatedly. The goal is to reduce the leg pain and centralize or move the pain to just the low back region (without leg pain).
Some physicians prescribe muscle relaxants like Valium but a recent study from Germany disproved any thoughts that this approach works. Patients in the placebo group (sugar pills) got twice as much pain relief, left the hospital sooner, and went back to work faster than any of the patients receiving the Valium.
Consult with your surgeon for the best plan for you. Factors such as severity of prolapse, intensity of pain, age, general health, and previous history of disc problems are just a few of the many variables that can direct treatment one way or another.
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