Small herniation and obesity

This 30+-year-old female patient presented to me with low back pain. She had been treated by other providers and still had low back pain. She came to me through her employer’s recommendation. It should be noted that she is morbidly obese, and since I am interested in helping her for the long term, this must be addressed. In the short term, however, I must try to help her with her pain.

As you’ll see on these lumbar MRI images, she has a very small herniated disc at L5-S1, and it is not pinching any nerve roots. Her anatomical problem is minor, but her pain is sometimes severe. I have treated her a few times, but she is limited in terms of distance from my office, and other personal demands of family, so her treatment is not optimal, but such is life. I treat many patients who have many other important things competing for their attention so it is common for people to neglect their needs until they’re incapacitated by their pain.

In any case, the few treatments I have provided have helped, and she came back recently with her pain exacerbated for reasons she is uncertain, as is often the case with patients. In fact, usually, the precipitating cause is not grossly traumatic, and may be a simple thing, sometimes not identifiable. This does not usually matter, except as an instructive point, and for future prevention.

Small herniation and obesity

In the longer term, however, given her morbid obesity, I must talk to her about her interest in losing weight, it’s contribution to long-term pain, and degeneration, and some general advice about how to approach fat loss, both in terms of food choices and psychology. In fact, I think the most effective weight loss requires a psychological approach, and good food choices. If weight loss is mental warfare, it will not be lasting.

If I can help you with your neck or back problems, please call me at 404-558-4015.