“Lumbar Issues?”
Hello. I first injured my back at the gym in 2015. Took months before I completely recovered and even after my recovery, doing anything strenuous would leave me needing to recover again but only for a few days at a time. Earlier this year I re-injured my back pretty bad, but it wasn't until I sneezed while getting out of bed one morning that I felt as if I tore something, and I wasn't able to put any pressure on my left leg at all for over a week. I know I should've consulted a Dr. from the initial incident, but I knew after this that it was a must.
My question is: Would weight loss have any positive impact on the below issues? I currently weight about 285lbs (40"waist) 6'5". Also, what is the best recommended option for me, and is there a non surgical option as well? There is mild degenerative disc disease and there are mild diffuse posterior disc bulges at L3/L4, L4/L5 and at L5/S1.
At L3/L4 there is a central disc extrusion. There is moderate central canal spinal stenosis. At L4/L5 there is a large central left paracentral disc extrusion which extends below the disc space 2cm and in the left recess. There is a compromise of the left L4 and the left L5 nerve roots. There is moderate central canal spinal stenosis. At L5/S1 there is a broad-based disc extrusion which compresses both S1 nerve roots left greater than right.
My question is: Would weight loss have any positive impact on the below issues? I currently weight about 285lbs (40"waist) 6'5". Also, what is the best recommended option for me, and is there a non surgical option as well? There is mild degenerative disc disease and there are mild diffuse posterior disc bulges at L3/L4, L4/L5 and at L5/S1.
At L3/L4 there is a central disc extrusion. There is moderate central canal spinal stenosis. At L4/L5 there is a large central left paracentral disc extrusion which extends below the disc space 2cm and in the left recess. There is a compromise of the left L4 and the left L5 nerve roots. There is moderate central canal spinal stenosis. At L5/S1 there is a broad-based disc extrusion which compresses both S1 nerve roots left greater than right.
Male | 27 years old
5 Answers
Losing weight is always helpful with lower back pain. That said, your symptoms are very significant and the reason for them is the disc extrusions that you have. There is no conservative treatment that will give you any sort of long-term solution. You have to get rid at least of the extruded portions of the discs, which would require surgery.
Based on your mri results, you appear to have significant disc herniation at L4-5 that needs treatment. I recommend you see a spine surgeon to evaluate you.
As your imaging suggests, you have a very large disc herniation, which is the primary problem. The degenerative disc disease (arthritis) is a secondary issue. Disc herniations are generally treated with medications, injections and physical therapy for core strengthening and nerve mobilization. In general, 90% of patients will get better without surgery. In your case, with a very large disc herniation, the odds shift more towards the need for surgery, but it is certainly reasonable to try the non-surgical treatment first. The arthritis will not get better with time and there is really no treatment to improve the MRI findings for the arthritis. Having said this, arthritis does not have to be painful. You are correct that carrying less body weight can decrease the pain related to the arthritis. Core strengthening will help provide stability to the lumbar discs to decrease the grinding and pain related to their movement. If you can keep the discs stable with the exercise, they may fuse and stabilize on their own without a need for surgery.
Jeffrey R. Carlson, MD
Jeffrey R. Carlson, MD
You’re very thorough. In general, any pound you carry on the front of your trunk (chest, abdomen) is 3 to 4 pounds of reactive force on your low back in standing position. So if you have 20 pounds of extra weight on your belly, losing 20 pounds belly will relieve 80 pounds of stress on your back. I hope this is helpful.
Hello. You’re just a big guy with a bad lumbar spine. So if you still have left sided numbness and it was my back (I lift 4-5 days weekly and also had left sided hernia toon with numbness) I would initially try therapy, merrily dospack, and with therapy CORE strengthening. If no rapid improvement within 2 weeks I would consider epidural steroid injections and continue therapy. It may take 6-8 weeks for pain to resolve. If still no improvement I would at least discuss microdiskectomy for left sided disks. I would get several opinions before any larger lumbar procedure. Good luck
