Specialization :- Boon or Bane ?

A 32 yr old Female with low back pain Chief Complaints Pain in low back region radiating down to left side of leg. Pain during bowel movement Pain suddenly increased during monthly periods. Physical Examination SLR negative Slump test positive No sensory loss , despite feeling of heaviness No motor deficit or weakness Investigations MRI revealed increase in disc bulge compared to previous xray Pelvic exam suggest infection and inflammation in pelvic area Patient is on medication for hypothyroidism. Diagnosis Is the back pain related to disc bulge or pelvic inflammation ? Management Patient had recovered with Physiotherapy , pain was centralized and activities of daily living had become comfortable. Sitting tolerance had improved. During monthly cycle, pain got exacerbated and patient was unable to get relief with medication or Exercises. Patient was advised bed rest for disc bulge by orthopaedic. Relief was achieved. Pain reoccurred when monthly cycle occured. What is the ideal holistic management in this case ?

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She would most likely be suffering from endometriosis. Treatment of endometriosis and physiotherapy for the disc bulge and concurrent treatment of hypothyroidism.

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Disc bulge is never an emergency n can be managed conservatively..... infilimation n infection of pelvis needs to be evaluated thoroughly ... I suggest a Gynae consultation .... USG pelvis will be of help..... if anything found in USG MRI needs to be done to rule out any Malugnancy

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