Question
I would be grateful for your advice regarding my MRI scan done a year ago results

Degenerative change in the L3/4 and L4/5 intervertebral discs with a central to right paracentral disc protrusion at L4/5 which distorts the thecal sac and impinges the L5 nerve root in the lateral recess. No nerve root compression.

I was told no need for surgery just do back exercises which makes things worse and a year on I can barely sit for longer than an hour at my desk

When the pain is really bad it is like a knife going through me.

I have tried everything form muscle imalance exercices, specific stretches for tight leg/back muscles but can seem to get little relief except for a couple of days and am at my wits end.

Any advice would be appreciated.

Answer
Dear Grace,

I agree that there is no need for surgery.  Yes the degenerative disks can be problematic, but this does not have to be a source of pain.  Additionally the lateral disk bulge can be reduced with effective techniques.

Have you tried chiropractic care?  I see cases like yours in my office all the time and get great results utilizing decompression techniques in the spine to focus on the low back.  This can be accomplished with a variety of techniques such as manual spinal adjustments, Cox flexion/distraction, Inter-vertebral disc decompression, and the Posture Pump...I use them all in office.

However, you will need to perform rehab exercises to stabilize the area, but this should be started only after your pain levels are reduced and any radiating symptoms down the leg are going away.  The muscles that need to be targeted are the internal stabilizers of the spine, and the Multifidus muscle seems to be the most important.  You do not want this muscle to atrophy and weaken as the loss in muscle mass will be replaced with fat deposition and this leads to chronic pain.

Sitting postures are highly detrimental to the disk due to the increased forces created.  Seated postures increase the compressive stress on the spine more than running does...so you need to take frequent breaks at work and get out of the chair...not to mention your seated posture needs to be upright as much as possible. Slouching will increase the pressure even more.  A lumbar support for your chair, or a small wedge to sit on can improve the posture significantly and reduce pain and compressive stress.

My suggestion:  Research the above named techniques online so you can get a better appreciation of how they work and find a good local chiropractic physician to address this issue.  Good Luck.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net