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Treatment will depend upon the degree of encroachment. In my experience mild anterior thecal compression (diagnosed by MR scanning) can be associated with acute onset of severe low Back pain which may be midline or paravertebral and is frequently associated with a reduced straight leg raise on examination. This sign is generally recognised by clinicians as being associated with more frequent nerve root compression and consequent sciatica which is typically absent in these cases. I find patients with this syndrome respond well to simple rest, modified activities and whatever pain medication they can tolerate together with a thorough explanation of the pain mechanism. Most recover well in a few weeks. However, the problem may well be a precursor of a further disc prolapse and so advice to avoid activities which compress the spine excessively would seem sensible. Perhaps the use of a 'backswing' traction device might be useful for some sufferers.

Bill Kusiar, Chiropractor.

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Related Questions

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