### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I am 24 female I have a central disc herniation at l5 s1 level and I had an epidural shot 2 weeks back. There was no improvement In pain I was hospitalized after it for 4 days n was on traction n the pain is still there. doctors do not suggest surgery as I m too young both of my ankle jerks r absent n the tingling sensation is too much what shall I do

### output:

Hi heartlands for your question at Chat Doctor In general, disc herniation can be managed with a course of conservative care (non-surgical)over 6 to 12 weeks to start with prior to considering spine surgery. A process of trial and error is often necessary to find the right combination of treatments which might include rest, physical therapy, analgesics in oral and topical form, modality based physiotherapy like TENS, Micro wave diathermy etc. Medicines like Pregabalin(Lyrics) or Gabapentin or Erosion prescribed in appropriate doses can help in relieving tingling, You can meet your pain doctor and ask regarding the need and suitability of these medicines for your Earlier surgery will be indicated if there is progressive major weakness(that is weakness which increases markedly over 1 or 2 days) in the legs due to nerve root pinching. Rarely immediate surgical intervention may also be required in caudal equine syn Chat Doctor.  Otherwise, a wait and watch approach is best. It is also important to note that central disc herniation associated with predominant back pain and insignificant leg pain will not respond well to epidurals, whereas one associated with significant leg symptoms and some back pain responds better. Also, if the onset of back pain and central disc herniation was associated with traumatic event, it will be prudent to do a CT scan of your spine, since it is seen that in younger individuals with traumatic central disc herniation minute fractures can be seen in bony end plates adjacent to the disc herniation. This will help understand your tingling sensations better(if traumatic)Hope this helps All the best Regards 