How can I get rid of persistent back pain that is not responding to physiotherapy?

Doctor's Answers 1

Thank you for your email and I am sorry to hear about your ongoing pain symptoms. This can be an issue after surgery even if it does resolve the disc issue/symptoms that you were experiencing.

The only way to resolve pain is to assess you and consider the pain generators in the back - unfortunately there can be many. It could be residual pain from degenerative discs, facet joints, nerve irritation, muscular tightness, scar tissue formation and so on. Sometimes it might be require focussed treatments such as facet joint, medial branch or nerve root injections to eliminate these as potential causes. I do this for patients who have complex pain presentations and where a clear diagnosis might be difficult to achieve.

Perhaps you could consider the following:

1. Revisit your operating hospital/surgeon and discuss your pain with them

2. Review your symptoms with an MSK/Sports Physician

3. Review your symptoms at a pain clinic

You may need up-to-date investigations to aid whoever sees you.

There have been several questions about back pain on this site and it might also be useful to look at these answers.

Good luck with your back pain.

BW

Dr Dinesh

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How do I treat a bulging disc that is causing lower back pain?

Thank you for your email. I agree with what Dr Chung or Dr Dinesh have said. It is an extremely common problem seen in people, whether young or old. First line of treatment is always medication and physiotherapy to strengthen the core and paraspinal muscles. If that does not work, and the pain is persistent, and if MRI does show a disc bulge and/ or annular tear, another option that you may want to consider is a nucleoplasty, annuloplasty and facet block of the affected levels. It works very well, and may patients do find symptomatic relief.

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