Mild Disc Protrusion: Symptoms, Recovery, and Treatment Options

Mild intervertebral disc protrusion?

Hello Doctor, I am a 24-year-old male, 172 cm tall and weighing 64 kg, with no smoking or drinking habits.
At the beginning of May, I injured my lower back while cleaning and moving a bed, which caused me to suddenly lose my vision and hearing, accompanied by dizziness and nausea.
I went to the hospital for a CT scan, which revealed: 1.
Mild disc protrusion at L5-S1.
2.
Localized Schmorl's node formation at the superior endplate of L4-L5.
After a month of bed rest, my back pain improved, and the doctor recommended swimming.
However, while changing my pants, I accidentally pulled my leg, which caused me to twist my back again for balance, resulting in another back injury.
This time, I experienced dizziness and nausea again, along with loss of vision and hearing.
Currently, I have significant pain in my lower back and coccyx.
I would like to ask: 1.
Why do I experience loss of vision and hearing, dizziness, and nausea every time I injure my back? 2.
The first time I injured my back, I only had back pain, but the second time, in addition to back pain, I also have pain in my coccyx.
Could this be due to prolonged bed rest, or did I injure my coccyx this time? How can I assess this myself? 3.
Given my current lower back and coccyx pain and discomfort from bed rest, is there a possibility of inflammation? Could you provide medication recommendations? 4.
How can I take care of myself in daily life to improve my condition? 5.
How long should I rest in bed for a mild disc protrusion? After how long should I start physical therapy? What exercises do you recommend?

Quan, 20~29 year old female. Ask Date: 2021/07/05

Dr. Wang Shouji reply Orthopedics

Hello, the symptoms in the eyes and ears should not be related to the lumbar spine; they are likely caused by pain.
Lumbar injuries can refer pain to the lower back and buttocks, which is not uncommon in clinical practice.
Applying heat should help alleviate the discomfort.
If inflammation is causing pain, the physician may prescribe anti-inflammatory medications, pain relievers, muscle relaxants, and vitamin B complex to initially relieve symptoms (which may take several weeks).
Afterward, it is important to strengthen the core muscle groups.
If there is no involvement of the lower limbs with neurological symptoms, long-term bed rest should not be necessary.
Using a soft back brace is advisable, and heat application can be continued.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/07/05

More Info

Understanding mild disc protrusion is essential for managing symptoms and recovery effectively. Based on your description, it seems you are dealing with a mild disc protrusion at the L5-S1 level, which can lead to various symptoms, including pain and discomfort in the lower back and potentially affecting other areas, such as the tailbone.

1. Why do you experience dizziness, loss of vision, and nausea when you injure your back?
The symptoms you describe—dizziness, loss of vision, and nausea—could be related to several factors. When you experience a sudden injury to the back, it can trigger a stress response in your body, leading to a release of adrenaline and other stress hormones. This response can cause dizziness and nausea. Additionally, if the injury affects the lumbar spine, it may also impact the nerves that control balance and coordination, leading to sensations of dizziness. It’s also possible that the pain itself can lead to hyperventilation or anxiety, which can exacerbate these symptoms.

2. Why did the first injury only cause back pain, while the second injury also affected the tailbone?
The first injury may have primarily strained the muscles and ligaments in your lower back, leading to localized pain. However, during the second incident, if you moved awkwardly while trying to maintain balance, it could have resulted in additional strain or injury not only to the lumbar region but also to the coccyx (tailbone). Prolonged bed rest can lead to muscle weakness and stiffness, making you more susceptible to re-injury. It’s essential to maintain some level of activity, as long as it’s safe and within your pain tolerance.

3. Is there a possibility of inflammation, and what medication can you take?
Given your current symptoms of pain in the lower back and tailbone, inflammation is indeed a possibility. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and alleviate pain. However, it’s crucial to consult with a healthcare provider before starting any medication, especially considering your history and any other medications you may be taking.

4. How can you care for yourself to improve your condition?
Self-care is vital in managing mild disc protrusion. Here are some recommendations:
- Rest and Activity Modification: While it’s important to rest, avoid prolonged bed rest. Engage in gentle activities that do not exacerbate your pain.

- Ice and Heat Therapy: Applying ice to the affected area can help reduce inflammation, while heat can help relax tight muscles.

- Gentle Stretching and Strengthening: Once the acute pain subsides, gentle stretching and strengthening exercises can help improve flexibility and support the spine. Focus on core strengthening exercises, as a strong core can help stabilize the spine.

- Posture Awareness: Maintain good posture when sitting, standing, and lifting to reduce strain on your back.

5. How long should you rest for mild protrusion, and when should you start physical therapy?
Typically, for mild disc protrusion, a period of rest for a few days to a week is recommended, followed by gradual reintroduction of activity. If symptoms persist, physical therapy can be beneficial. Generally, you can start physical therapy within 1-2 weeks after the initial injury, focusing on pain management, flexibility, and strengthening exercises. Swimming is an excellent low-impact exercise that can help strengthen your back without putting too much strain on it.

Conclusion
In summary, managing mild disc protrusion involves understanding your symptoms, engaging in appropriate self-care, and gradually returning to activity. If your symptoms persist or worsen, it’s crucial to follow up with a healthcare provider for further evaluation and tailored treatment options. Always listen to your body and avoid activities that exacerbate your pain.

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