Hi Dr. Sood

I have treated patient's with weakness having no pain. This is a direct
posterior lateral herniation. Theoretically the back  pain is not experienced
because the posterior logitudinal ligament was not involved and the sensory
fibers of the nerve root no longer transmit pain.

Since the patient is unwilling to have surgery I treat the weakness with
exercise and wait to see if recovery occurs. In a large portion of these
patient's strength recovery occurs in the first year. Since she is already
two years post injury I'm not sure that she can expect much recovery.

Charles T. Filippone, P.T., O.C.S