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  • Q&A with Australian Health Practitioners

    What should I do about lower back pain that isn't improving?

    I hurt my back 4 weeks ago. CT shows flattened, bulging disc at L4-5 and moderate arthritis in facet joints of L 4 & 5. I've been taking analgesia and am seeing a physiotherapist. Have been doing all that is advised but the pain is no better than it was after the first week. What are my options for treatment?
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    Dr Frank Thomas

    Pain Medicine Specialist

    Dr Thomas studied medicine at the University of Otago in New Zealand, graduating with distinction in 1992. He subsequently trained in anaesthesia and pain medicine, … View Profile

    You have been doing the right thing so far. Consulting your GP for advice on analgesic medications, maintaing activity and seeing a physical therapist are the usual first steps. Sometimes assistance from a pain psychologist will be recommended (ask your GP or physical therapist). Assuming your disc bulge is not compressing a nerve there is no obvious reason to see a spinal surgeon. It isn't clear which structure is generating your pain, for example the facet joints, discs or soft tissues (sometimes it is impossible to specify any individual structure). Consulting a pain medicine specialist should enable clarification and then direction for further treatment. Good luck.

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