How to treat prolapsed intervertebral disc? - #9387

Shahid, I can completely understand how frustrating and exhausting it must be to deal with constant pain for two years. Living with discomfort 24/7, not being able to stand for more than 10 minutes, and now experiencing pain radiating to your thigh must be affecting your daily life in every way. Since your MRI confirmed L4-L5 and L5-S1 disc prolapse with vertebral canal stenosis and loss of lumbar lordosis, and despite medications and exercises, you’re still struggling, it’s time to reassess things. 1. Pain & Nerve Involvement – Since the pain is now radiating to your thigh with movement, it suggests nerve compression is worsening. NSAIDs helping but not completely resolving the pain means inflammation is still a factor. 2. Sacroiliitis Symptoms? – Morning stiffness in your SI joint region that improves with NSAIDs does resemble sacroiliitis, but we need to confirm it with a clinical examination and MRI of the SI joints. 3. Why No Relief from Treatment? – When pain persists despite NSAIDs, pregabalin, methylcobalamin, and physiotherapy, it means either the nerve compression is severe, or the current approach needs modifications. What You Can Do Now: 1. Stronger Pain Management: Since your pain is constant and affecting mobility, epidural steroid injections or nerve root blocks could help in reducing inflammation and nerve irritation. 2. Revised Physiotherapy Approach: Your current exercises may not be effective anymore. McKenzie therapy, core strengthening, traction therapy, and hydrotherapy (swimming, water exercises) could be more helpful. 3. Surgical Consideration: If pain is significantly limiting your daily activities, a microdiscectomy or laminectomy could be an option to relieve nerve compression. 4. Checking for Sacroiliitis or Ankylosing Spondylitis: Since morning stiffness in the SI joint region is present, we should rule out seronegative spondyloarthropathy with HLA-B27 testing and MRI of SI joints. 5. Lifestyle Adjustments: • Avoid prolonged sitting, standing, or lifting heavy weights. • Use lumbar support while sitting and maintain good posture. • Try an anti-inflammatory diet (foods rich in omega-3, turmeric, and ginger). • Swimming or water therapy can reduce strain on the spine while keeping you active. What’s Next? Since your pain is worsening despite treatment, I strongly recommend a follow-up MRI and consultation with a spine specialist. If sacroiliitis is suspected, a rheumatologist’s opinion will be helpful.