Conversation: The conversation between human and AI assistant.
[|Human|] Sir , My mother mri report reveals straightening of spine .diffuse disc bulge at L5-S1 causing thecal sac indentation.vertebral bodies and rest of the invertebral disc are normal in height and signal intensity .No other focal disc bulge or protrusion us seen. Visualised spinal cord show normal bulk and signal intensity. Can you please tell me how she can be treated as all the doctors till give medicine and there is no sign of recovery . Now she cant even stand for more than 5 minutes. Thankyou Navdeep kamboj 0000
[|AI|]  Hi there.  Thanks for your question at Chat Doctor. Her MRI findings suggest that one of the discs is bulging. But her management will depend on her pain distribution, severity, duration and response to treatment like medicines and physiotherapy.  It is also important to know whether she has only back pain or back pan with pain radiating to legs or buttocks. Scenario 1: if her pain is only in the back with no leg pain or numbness, it is best to wait and watch. She will get better with medicines, corr stabilization back exercises, physiotherapy modalities like ultrasonic massage and microwave diathermy. (if she has no contraindications. Surgery is very seldom indicated in only back pain. Scenario 2: She has back pained with radiation to legs.  Same protocol of medicines and physiotherapy to be followed for 6 to 8 weeks. If she does not improve next step would be steroid injection in her back(2 to 3 shots over 2 to 3 months. If still no improvement final step in management ladder would be surgery.  In both the scenarios urgent surgery required if she develops weakness in legs, significant numbness, unrelenting severe pain, urine or stool passing problems. Hope this helps you. All the best.  Regards.  Chat Doctor.