- Low Back pain ± buttock pain
- Aggravated by flexion / extension of the back ± coughing / lifting eased by lying down
- No associated systemic disease such as cancer
- No or limited slippage of one vertebra upon the next
- No disturbance of sphincter function or loss of sensation in the perineum
| Presentation | Diagnosis | Options |
|---|---|---|
| First episode <6 weeks duration | Muscle strain or facet joint strain | Muscle Balance Physiotherapy |
| Prolapsed disc irritating the local nerve | Muscle Balance Physiotherapy, anti-inflammatory medicines, pain controlling medicines (Conservative Care) | |
| First Episode >6 weeks duration NOT responding to Muscle Balance Physiotherapy |
Prolapsed Disc irritating the local Nerve ± High Intensity Zone or disc leaking pain producing products |
MRI Scan advised Further Conservative care + increased analgesia, Nerve root blocks, Caudal epidural injections, Facet Joint Injections. (Chronic Pain Management) |
| Recurrent repeated episodes Failed Chronic Pain Management |
Prolapsed Disc irritating the local Nerve ± High Intensity Zone or disc leaking pain producing products |
Endoscopic Lumbar Decompression & Foraminoplasty / Microdiscectomy. |
| Worsening signs of weakness or numbness ± lessening back pain | Increasing size of prolapse and nerve root compression ± disc wall disruption & extrusion. | Endoscopic Lumbar Decompression & Foraminoplasty / Microdiscectomy. |
