“Should I get surgery for a space narrowing at L5-S1?”
I'm 44 years old, couple of months ago I started feeling an annoying pain in the posterior right leg while driving, and now it's very bad pain. I can't walk, can't sleep and I have been at the emergency room many times, they gave me a lot of morphine and this last time they prescribed oxycodone/acetaminophen 10-325mg. And they also told me I need surgery. But I'm researching and the surgery seems very dangerous. My pain is getting worse now that my pain killer is over and I don't know what to do. Is there anything that we can try to avoid surgery?
Female | 44 years old
Complaint duration: 3 months
Medications: oxycodone/acetaminophen/alprazolam
Conditions: Depression/anxiety
3 Answers
Try PT and epidural injection first.
Firstly, I’m sorry you’re not feeling well. I also am unable to fully view the attached image and so do not have that information.
Reasons to get surgery without other treatment are weakness, numbness, bowel or bladder issues and severe pain. If you do not have any of these and only have pain you do not need to jump into surgery. You most likely would benefit from a series of epidural injections prior to considering surgery. These should be done sooner than later to avoid any other issues. If the pain is absolutely unbearable, then surgery is a reasonable option.
Reasons to get surgery without other treatment are weakness, numbness, bowel or bladder issues and severe pain. If you do not have any of these and only have pain you do not need to jump into surgery. You most likely would benefit from a series of epidural injections prior to considering surgery. These should be done sooner than later to avoid any other issues. If the pain is absolutely unbearable, then surgery is a reasonable option.
Arthritis is very common and does not happen suddenly. You will need an evaluation by a spine surgeon to guide through the treatment options. It sounds like you are compressing the nerve root at that L5-S1. There are 3 basic treatments, 1) Medications: this can be pills by mouth that will help with the pain or shots of cortisone around the nerve root to stop the inflammation and pain around the nerve root, 2) Physical therapy/chiropractics to move the nerve root away from the disc and open the space around the nerve root to stop the pain and irritation, 3) surgery to physically remove the pressure on the nerve and stop the pain. As long as you don't have weakness in the leg, you can try the other methods to help with the pain and promote healing. If you have weakness in the leg, the nerve is likely being damaged and is best resolved with surgery.
Jeffrey R. Carlson, MD
Jeffrey R. Carlson, MD
