Symptoms
- Shooting (lancinating) pain in to the leg ± pins & needles / numbness ± muscle weakness affecting the leg
- 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
Diagnosis
| 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 durationNOT responding to Muscle Balance Physiotherapy | Prolapsed Disc irritating the local Nerve± High Intensity Zone or disc leaking pain producing products | MRI Scan advisedFurther Conservative care + increased analgesia,
Nerve root blocks, Caudal epidural injections, Facet Joint Injections. (Chronic Pain Management) |
| Recurrent repeated episodesFailed 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 with nerve root | Endoscopic Lumbar Decompression & Foraminoplasty / Microdiscectom |
