Herniated Disc Questions and Answers Archive 2010 Part 2

This Q&A section is not intended to diagnose or treat any medical condition. Any medical condition should be referred to a qualified medical professional.

Q: Good Morning, I am 24 years old and first herniated discs at age of 16. The L3-L4, and L4-L5 has a small central annular tear L4-L5 has a mild crowding of the left lateral recess. L5-S1 is the real problem. I have a broad based left paracentral disk protrusion measuring 10mm in width at its base x approximately 9 mm in height x approximately 5 mm AP dimension. This abuts and posteriorly displaces by approximately 1 mm the descending left S1 root in the left L5-S1 lateral recess. The central canal and neural foramina are patent. I have done physical therapy several times, I have tried chiropractic care and recently tried epidural steroid shots. The steroid shot only offered relief for about 3 weeks. What would you consider to be the next best option. I have people telling me to try NUCCA which is chiropractic care in your neck and I don't seem to see how this could help. The Orthopaedic doctor I see is telling me to consult with a surgeon. What do you think? Karalee

Q: Hello, I found your site while looking for information for my mother. My mother has been told by various doctors that she has a herniated or ruptured disc because she has constant pain in her lower back and in her abdomen. She has tried all the treatments and nothing works and she is having a terrible time trying to find some relief from the constant pain. I was wondering what you might think her options are?? She has had the epidurals, all the other treatments but still nothing helps. Can you recommend something?? Thank-you, Susanna

Q: I have dealt with disc herniations from auto accidents, farming, and football in my cervical and lumbar spine over a 30 year time period. It was severe enough that, I was given an erroneous diagnosis of atypical ankylosing spondylitis (AS) because the vertebrae had "fused" together so I just lived in severe pain because surgery was deemed to risky. I recently found out that I actually have severe spinal stenosis, disc herniations impinging on nerves, and facet arthrosis, and disc disease and not AS... My question to is this still psychosomatic even though my pain has come after near fatal car accidents, and can it be helped by "knowledge" thinking alone? I do believe that stress in any form can exacerbate a condition, but if it is from physical trauma, does your "knowledge" thinking still apply? Thank you for your time and assistance on this matter. Corey

Q: I have had an MRI with the following reading. I will try to see a doctor next week but wondered what this means and what should I expect? I saw injured in 1985 and lower back injuries were found and might this be consistent with an old injury?There is straightening of the usual cervical lordosis. Mild disc-related bone marrow signal changes surround the C4-5 interspace. Remaining vertebral bone marrow is normal in signal intensity. Vertebrae are normal in height.C4-5: There is disc desiccation and disc space narrowing with shallow posterior disc osteophyte complex. Bilateral uncal joint osteophytes are present, greater on the left than right.C5-6: There is disc desiccation and broad-based posterior disc protrusion that contacts the ventral surface of the spinal cord. AP diameter of the central canal is reduced to 8 mm. Left and right paracentral disc osteophyte complexes are present, and there are bilateral uncal joint osteophytes.C6-7: There is disc desiccation and disc space narrowing. Broad-based posterior annular bulge is present. Left greater than right uncal joint osteophytes are seen.Remaining interspaces appear normal. The spinal cord is normal in signal intensity throughout. CONCLUSION:1. Multi-level degenerative disc and uncal joint changes in the cervical spine.2. At C5-6, there is broad-based posterior disc protrusion and generalized spinal stenosis. There is left greater than right neural foraminal narrowing.3. Mild chronic degenerative disc,changes at C4-5 with left greater than right neural foraminal narrowing.4. Broad-based posterior annular bulge at C6-7 with mild left neural foraminal narrowing. DAVID

Q: Hello, I just received my MRI report back and am having trouble understanding the results. Could you please give me your best interpretation of this?L4-5: disc is dehydrated and shallowly posteriorly protrudes with subtle annular rent; gently encroaching upon ventral dural sac. Mild facet arthropathy is depicted. Spinal canal is lower limits of normal in size. L5-S1: disc is dehydrated and shallowly herniates posterocentrally minimally eccentric right at 6 mm AP encraoching upon right S1 nerve root. Moderate facet arthropathy occurs. Conclusion: 1. L5-S1 shallow right paracentral disc herniation abutting/encroaching upon right S1 nerve root. 2. L4-5 broad posterior mixed spondylotic disc protrusion with subtle annular rent encroaching upon ventral dural sac. Borderline small spinal canal. Thanks for all of your help. Trent

Q: Hi, I am 38-year old male with history of back pain for 11 years. I was under chiropractic care for 7 years and I was doing fine. I can no longer avail chiropractic care since the last 3 years and low back pain transcending into may right back-of-the-thigh and calves has returned with vengeance. I have been under physio therapy and here are the MRI impressions:

L5-S1: Dessicated disc with narrowing of the discal space and endplate degenerative type of S1 changes. Broad based right postero laternal and caudal disc protrusion is seen indenting the right S1 nerve root. Small left postero laternal discal protrusion is seen mildly indenting left S1 nerve root. Thecal sac mildly indented. Ligamentum flavum normal. Facet joints are normal. There is narrowing of the right nerve root canal and less marked narrowing of the left nerve root canal by discal protrusions. Central spinal canals are of adequate dimensions Paraspinal soft tissues in view normal.

My doctor is telling me that I am the ideal candidate for micro surgery and the risk of surgery is far lesser than not doing it and letting the weakness in my legs and who knows where set it. What do you advise? Thank you. Mitesh

Q: at L5-S1 there's an 8MM right postlateral extruded disc herniation with slight caudal migration compressing the thecal sac and the right S1 nerve root. Is 8MM a large herniation? Is this a surgical condition? Anthony

Q: I have suffered many years of back pain and tenderness in my lower back. Most recently, I have had not only back pain but tailbone pain as well. My MRI results are as follows: At the L5-S1 disc desiccation and mild degenerative plate changes are present. A 4 to 5 mm left paracentral disc protrusion is present which does approach the exiting nerve root. Could this be causing the pain in my tailbone and the numbness in my toes? Also, is surgery required? Any feedback you could provide is greatly appreciated. Randilyn

Comment: Just wanted to say thanks for a fantastic site and book. You have lots of fans out here! Nice work. Salli

Q: I have a 20mm herniation at L4-L5 and a 2mm bulge at L3-L4. I am trying Spinal Decompression Therapy now. Do you think that they can fix the issue with this method or is a discectomy in my near future? They said that the biggest herniation they have worked on is 17mm. What do you think? Michael

Q: I had an MRI and the results stated: L3-L4 mild left paracentral posterior disk bulge' which creates moderate inferior narrowing of the neural foramina without visualized nerve root contact/compression. What does this mean? I have severe pain lower right side of my back. Thanks! Michelle

Q: I have had whiplash two times. Over the course of fourteen years I have been to physical therapy and even a neurologist who told me I would have to live with my symptoms. I exercise regularly to control pain symptoms. I have had a recent MRI which indicated a broad disc protrusion at c4-c5 pushing on my spinal cord. I have neck, shoulder pain and weakness in my hand. I have had traction, physical therapy and massages to assist in the healing. It is recommended I have surgery as all other options have been exhausted. Am I making the right choice. I have until May to find new answers. I am taking meds and wear a tens unit consistently to control pain along with my regular visit to the gym 3-4 times a week. Janelle

Q: Hi Sensei, I am a 34 year old lady. Sometime back,I had this terrible pain in my left leg just below my left hip and this accompanied by numbness of the entire left leg from below the hip to the toe.When I consulted a doctor, he mentioned that I had a slip disc problem and to have a more definitive reason for the pain, I went in for a MRI. Here's what the MRI Impression saysMRI lumbosacral spine reveals desiccated disc L5-S1 with subtle disc dessication L4-L5.L5-S1 disc reveals left postero-lateral disc protrusion with compression and obscuration of left side S1 nerve root. L4-L5 disc reveals focal left lateral protrusion with hyperintensity along peripheral disc contour suggestive of tear in its annulus fibrosis indenting the left side exiting L4 nerve. L1-L2 disc reveals a mild left posterior paracentral protrusion with no nerve compression. what according to you is the best remedy for this problem. I have been on leave for last 3 weeks and my condition now is that I cannot walk for more than 100 mts. I need to get back to work ASAP. MY doc says prolonged Physiotherapy may work if not a surgery may be needed. Please advise. Regards, Usha

Q: I was diagnosed with a herniated disc in June last year. I am 15 years old. So far i've been thru therapy and yet the pain has not gone away. The pain has just changed. It is now an aching that i cant get rid of. Everyone tells me that my disc pain should have gone away by now...that 9 months is way too long to just be from my back. yet the pain continues. Ive been under alot of stress lately, from a few different sources. Do u think my chronic back and leg pain could be from this stress? and that's why its not healing? i would appreciate any answer. thank you. James

Q: I have very sharp neck,shoulder and upper arm pain. It started a few weeks ago at night and now goes all day long -- but is worse at night. It is now in my right shoulder as well. I can't even lift my arms. I did pain meds to help control it but It is still very painful and the pain meds aren't as effective... I am now having tingling in my feet. it will be a few weeks till I can see the neural surgeon and wanted to get an idea of what all the mri results mean????

I had an MRI with the following results: at c4-5, disc desiccation and broad based disc bulge are present with resultant ventral thecal sac effacement. at c5-6, disc desiccation and a broad based disc bulge and an associated midline annular tear are present. There is resultant ventral thecal sac effacement and mild central canal stenosis at this level. at c6-7, disc desiccation and a broad based disc bulge are present coupled with a large disc protrusion extending from the central aspect of the disc space far latterally on the left. there is resultant mild central canal stenosis, left lateral recess stenosis, and left neural foraminal stenosis. the disc protrusion measures 5 mm in AP diameter. effacement of the exiting left c7 nerve root sleeve is questioned.

impression: multilevel degenerative disc disease, most severely noted at c6-7 with a large disc protrusion resulting in mild central canal stenosis, moderate left lateral recess and neural foraminal stenoses, and exiting nerve root sleeve impingement. ddd at l4-5 and l5-6 additionally present with a resultant c5-6 mild central canal stenosis additionally noted. Deb

Q: Hi, I am 31, and have suffered from lower back pain and pinching sensation in between my shoulder blades for some time now. I have been a CNA for 15 years and it has taken a toll on my body. Lately the pain has been moving down my left leg with numbing in my foot, heal and toe's. I also have pain in my tail bone, and at times numbing in my back starting at my shoulders. I had a MRI of the lower lumbar and report says. At L4-L5, there is central and left-sided asymmetric bulging of the disc. At L5-S1, there is a central herniation with anterior impression on the thecal sac with moderate bilateral encroachment related lateral bulging of the disc and hypertrophic facet joint change. What does this mean? Do you think this can ever be corrected and if so would I be able to return to work and I'm not sure why they only did a MRI on the lower lumbar should I ask for another MRI for the pinching in my upper back. Could any of these findings be causing the numbness in my back. Crystal

Q: my husband just had surgery for L5/S1 prolapsed disc his pain has eased up a great deal but he still seems to have numbness and stiffness of the calves and the tingling in the toes is the normal? SherryAnn

Q: My fiance is in a terrible amount of pain from his herniated lumbar disc. He had discectomy performed and it failed. He gets the injections and is still in so much pain it is ruining the quality of life because he is miserable all the time and will not even have sex. Is there a procedure to remove the disc or something else that would get rid of it forever? -Thanks, Katherine

Q: Hello, can 4-5mm bulge disc cause a person to experience numbness from the buttock down to the toes and constipation and i should I see a chiropractor? thank you. Verpie

Q: I have pain from the vertebrae in the middle of my back, just around the bra line, pain goes around both rib cages and under my breast, could a bad vertebrae cause this? Sandra

Q: Hi. I had a car accident 10 years ago that left me with herniated disc in the lumbar region and extreme pain. I learn to live with it, however recently I started having pain in my neck ( also from the same car accident) to the point that I couldn't move it. I had cortisol injection that helped me for a week and the pain got back. This is what was in the MRI :Reversal of the cervical alignment with normal vertebral stature present. Degenerative end plate changes present at c3-94 through c5-c6 C3-c4 mild diffuse bulging outer annulus abutting the ventral thecal sac w/o central or foraminal compromiseC4-c5 facet arthrosis C5-c6 degenerative bulging outer annulus with disc osteophyte complex eccentric toward the right paracentral region where it abuts the ventral cord w/o cord compression- mild to moderate central stenosis w/o foraminal compromise C6-c7 bulging outer annulus with broad-based left paracentral disc herniation present causing mild central stenosisImpression: Cervical spondylotic changes, most apparent from c3-c4 through c6-c7 This was done on july 08 The dr told me I don't need to worry about it too much, is that true? Thank you. Monika

Q: I've been experiencing lower back pain for 14 years now (on and off). Previously, my doctor told me that it was due to slipped disk and he gave Celebrex. I had my MRI and had the following remarks: desiccated disk with mild posterior disk bulge and and posterior annular tear at L4-L5. My doctor reviewed my MRI results and told me that I also have foraminal spinal stenosis. He advised that I needed fusion or microsurgery using X-Stop. Please do kindly comment on this. Many thanks for being a great help. Sha

Q: I'm 30 years old and I've had surgery to remove a section of my disc back in 2000. Now I have 2 herniated disc. My doctor wants to give epidural shots every couple of weeks. I don't have a problem with the shots, but I don't want the shots if they will interfere with my sex life (Getting Erection). Will these shots affect me in this way. Thank you for your time Jason

Q: I had a micro'd in April 09 on L-5. S-1 root decomp. I fell on ice in Jan slamming my back hard on steps. The Orthopedist sent for p/t. Didn't help. MRI finally done, report says "herniation L-5 impinging upon s-1 nerve. I'm in a lotta pain, foot numbness. I went to my neuro and brought him the report and the diskette. He reviewed it and said "the discs look fine". He then finally conceded there may be a slight herniation. Who do i believe? I'm at a loss and in pain.Thanks, Paul

Q: I have a right lateral disc herniation at L2-3, producing mild to moderate right foraminal stenosis is the way the mri report reads. Mri was done in 10/08 I am still in pain. I was put on cymbalta 60mg it has helped but I still have leg and back pain. The problem is I do not have heath Insurance. Should I still be in pain 1 yr and a half. Kim

Q: I was wondering if from the following MRI you could provide some kind of evaluation and in which direction to proceed. I have constant pain from the thoracic and low back which continues to the buttocks and legs with an overall inflamed feeling throughout. All blood tests come back normal. 51 years of age, 6'1" and overall healthy. Thank you in advance.

Indication: Low back pain. Radiculopathy.Technique: MRI of the lumbar spine was obtained using a High Field 1.5 Tesla Siemens Symphony MRI scanner. Images are available in sagittal Tl, sagittal T2, sagittal T2 FS, and axial T2 sequences. Slice thicknesses are 4 mm in size.FINDINGS:There is a 7-8 mm focal, hyperiRtease lesion seen hi the medial right kidney that may represent a cyst. The vertebral bodies have normal height, without evidence of compression fracture or bone marrow edema. The conus is unremarkable. Paravertebral soft tissue is intact.T12-L1: Mild disk desiccation with 1 -2 mm diffuse bulging. There is no stenosis.L1-L2: Disk desiccation. Mild to modest decrease in disk height. 2 mm diffuse posterior bulging is seen without stenosis.L2-L3: Disk desiccation with mild decrease in disk height 2 mm diffuse bulging is seen with bilateral inferior neural foramina! encroachment. There is no stenosis of the central canal.L3-L4: Mild disk desiccation with preservation of disk height. 1-2 mm diffuse bulging is seen with subtle central annular tear without stenosis. Mild hypertrophic changes are seen of the facet joints.L4-L5: Mild disk desiccation with preservation of disk height. 1-2 mm diffuse bulging is seen without stenosis.LS-S1: Mild disk desiccation with 2 mm diffuse bulging and tiny central annular tear without stenosis.IMPRESSION:1. T12-L1: Mild disk desiccation with 1-2 mm diffuse bulging. There is no stenosis.2. L1-L2: Disk desiccation. Mild to modest decrease in disk height 2 mm diffuse posterior bulging is seen without stenosis.3. L2-L3: Disk desiccation with mild decrease in disk height 2 mm diffuse bulging is seen with bilateral inferior neural foraminal encroachment There is no stenosis of the central canal.4. L3-L4: Mild disk desiccation with preservation of disk height 1-2 mm diffuse bulging is seen with subtle central annular tear without stenosis. MQd hypertrophic changes are seen of the facet joints.5. L4-L5: Mild disk desiccation with preservation of disk height 1-2 mm diffuse bulging is seen without stenosis.6. L5-S1: Mild disk desiccation with 2 mm diffuse bulging and tiny central annular tear without stenosis.7. There is a 7-8 mm hyperintense lesion, medial right kidney, could represent a small cystThank you for referring this patient. - Gary

Q: Hi, I was reared ended Feb. 20, 2010. My neck and lower back are still hurting. I had a mri done it said: 1. L 4-5 disc hydration with a small disc protrusion impinging on the thecal sac. 2. Mild S shaped scoliosis of the thoracolumbar spine.What does this mean and I am looking a surgery? Linda

Q: Ok so I was in a car accident in July of 09. Hit by a drunk driver. I flew forward in to the center consul between the drivers seat and passengers seat. I landed on the right side of me head and smash my shoulder and back in to the center consul as well. About 1 week after the accident my neck and back were in lot of pain. To the point I could not move. I have been seeing a chiropractor of my neck and back. After an adjustment my right hand started going numb. My thumb and 1st 2 fingers. It continued and went threw my whole hand and started going up my arm. My elbow hurts and my right shoulder hurts. My Chiropractor told me that sometimes that happens and it is normal. I did not think so. My back is in so much pain and the pain goes down in to my hips, and in to my thighs. I went and saw a neurologist to get and EMG done. I do not have the results from that. But was told I have carpal tunnel in my right hand. I had an MRI done on my neck and my lower back and the results were , At C6/C7 mild disk bulge that measures less than 2.0 mm in all planes. At C5/C6 mild disk bulge that measures less than 2.0 mm in all planes. Loss of the normal cervical lordosis. In my lower back L2/L3 there is a 3.0 mm broad based diffused disk protrusion that effaces the thecal sac. The disk protrusion measures less than 2.0 mm in flexion, and 3.7 mm in extension. The chiropractor is not helping, I have done Message therapy and acupuncture with some PT from the Chiropractor. I don't know what else to do. The pain is very much mood altering and I am getting frustrated. I get a tingling feeling in my neck and shoulders and I am at a loss. And could my carpal tunnel be from my neck? Everyone that I see seems so concerned about my neck. That pain I can deal with. It is my back that is the worst. HELP PLEASE. Mikelle

Q: Hello, I would like your opinion on what options I have regarding my herniated disc. I've had a herniated disc for about 6 months with limited results as far as getting better. My orthopedic doctor reviewed the results of my MRI and X-rays and concluded the following:

. MRI of the lumbar spine - Demonstrated a large central disc protrusion at L5-S1 abutting the S1 nerves bilaterally and resulting in moderate central canal stenosis.

. A complete set (5 views) of the lumbar spine-AP, lateral flexion, lateral extension, right oblique and left oblique were taken and demonstrate minimal osteoarthritis.

He initially prescribed Voltaren, which I took for a month along with attending physical therapy. Before taking Voltaren and receiving physical therapy my pain/discomfort level fluctuated from 1-4 (10 being the worst). While taking Voltaren and conducting daily stretches/back exercises the pain/discomfort level improved slightly and fluctuated from 1-2.

I just had my follow up visit with my doctor and he took me off the Voltaren to see if my small improvement would stay at this level without the medication. The range of my pain/discomfort now is fluctuating from 1-3. My doctor and I discussed getting an epidural steroid injection, but he stated that it wouldn't significantly help since my pain is not that severe and that the steroid injection is just a temporary fix and is less effective on conditions that have been ongoing for over 6 months. Therefore, he is recommending that I skip the epidural steroid injection and seriously consider receiving a microdiscectomy (surgery).

I'm reluctant to get surgery, but also would like to get better. What other options are available besides surgery? If I decided to wait it out without surgery, what are the chances of my body eventually breaking down and absorbing the herniated disc on its own? James

Q: Hi Sensei, I sent you a question back in February and your answer was very helpful i would like to ask one more question based on the following information from my MRI report do you think i will have to get surgery "T8-T9 left paracentral disc herniation deforms the left ventral cord mild to moderate facet hypertrophy no foraminal. T11-T12 broad-based disc bulge mild facet hypertrophy no canal or foraminal stenosis" please keep in mind i am Continuously sore, stiff and in pain. please and thank you, John

Q: Hi I have a 16 year old daughter. She woke one morning complaining of left hip pain. She had a lot of weakness in the left leg could not lift it while laying down. Had a MRI and it showed fluid in joint plus bone edema. That was in Sept 2009. Pain is still there and it runs into the left side of the back plus down the front of the left leg to the ankle. She had a MRI of the hip and back(Feb 2010) the hip came back good but the back showed that there is epidural lipomatosis which is mild at the l4 becoming moderate at the l5 and quite prominent at s1.at the S1 level the sac is effaced by the high epidural lipomatosis. At the upper portion of the S1 inferiorly the sac tapers. Is this what could be causing the left leg pain? She has also been having bladder problems and has started to dribble a little bit. Is this from the back? The have also said she needs to see a Neuro plus a endocrinologist? Thank you for your help. Stacey

Q: About 10 years ago I was involved in a cliff diving accident which left me temporarily paralyzed. The paralysis lasted only about 5 minutes. I went to the hospital and at that time I was told that I had spinal compression and massive contusions. I was told then that as a result of my accident I could end up permanently paralyzed if I suffered another blow like the one before. Now that I am getting older my back hurts all of the time. I am allergic to most medications and just plain hate taking pills so I just suffer through the pain. I recently went to the doctor and after an MRI she told me that I have small disc protrusion in lower thoracic spine T11-T12 and narrowing of my spinal canal. I don't know which questions to ask or how to proceed. I have periodic numbing of my left leg and foot. I have also had numbness in my mid back. I am only 29 and don't want my back to cause me to be in a wheel chair by the time I am 60. What are my options? Thank you for your time. Marie

Q: Hi! I am a 32 years old male. I am suffering with acute lower back pain from last 6 days. It's all started suddenly when I woke up at the morning but initially I ignored because I thought it could be a result of a sleeping problem. But the same day, in the evening pain increased many folds and then next 3 nights I didn't able to sleep. For your information, I didn't fell anywhere neither I lifted any heavy weights except a 22 hours flight journey from Detroit to Delhi 4 days back. So far I have consulted 5 orthopedic surgeons, I Urologist and 1 Nuro-Surgeon. I did a AP and Lateral Lumbar-Spine X-ray which tells that "Mild Scoliosis of spine is seen with concavity to right, marginal osteophytes seen, L5-S1 disc space is reduced, rest of the IV disc spaces are preserved". My pain starts from centre of the lower back pain and moves towards right hip area and then comes down towards thigh and groin area, it is a continuous pain. I was adviced to do a full abdomen Ultrasonography and the report was clean except "Right Kidney measures 11.2 x 4.7 cms and shows presence of hydronephrotic changes with dilatated ureter {? ureteric calculus} suggest clinical corelation". So I was referred to a Urologist and the Urologist cleared me from any kind of kidney stones because my pain is continuas because for a kidney stone case, the pain should not be continuous. So the Urologist referred me to a Neuro-Surgeons who told me to do Uric acid test and a MRI Lumbar-Spine. In between I was consulted by another 3 orthopedics and also did lots of blood tests like complete blood count with ESR, Serum Uric Acid, Serum C-Reactive Protein and HLA B27 Flow Cytometry, Blood. The blood reports were slightly higher Serum Uric Acid (7.2 mg/dL), C-reactive Protein was <6 and HLA-B27 was negetive,Complete Blood Count was normal (Mean Copuscular Hemoglobin was slightly high: 34.6 g/dL)and ESR was 06 mm at 1 hr. I also did a Lumar-Spine MRI scan and the report was, "Normal lumbar lordosis is maintained. Early anterior and posterior osteophytes are present on lower lumbar vertebrae with small Schmorls nodes on L3-4 and L4-5 end plates. Vertebral heights and marrow signal are maintained. There is degenerative loss of signal in L3-4 and L4-5 discs. A focal left foraminal protrusion with an associated annular tear of L-4 disc is narrowing the ipsilateral neural foramen and contacting the exiting nerve root. A diffuse bulge of L4-5 is present with bilateral foraminal narrowing (L>R). Rest of the IV discs are normal in height and signal intensity.IMPRESSION: Disc degeneration L3-4 and L4-5 with left foraminal Compression at L3-4 and bilateral foraminal narrowing (L>R) at L4-5. Suggest Clinical correlation." Now because of all these confusion, I contacted another Orthopedics and he told me that my pain is at right side but my disc problem is at Left side i.e. L-R. So this pain should not be because of your disc problem It could be a problem of serum Uric Acid. So please let me know what should be the actual reason of this pain because I am totally confused with different opinions and findings and suffering with this pain from last 6 days. Shantanu

Q: I have been having everyday lower back pain and pain down my right leg. I did an MRI and here are the results. There is straightening of the normal lumbar lordosis suggestive of muscle spasm. Mild anterior lipping and discogenic endplate changes at the L5/S1 level noted. The L5/S1 intervertebral disc shows reduced T2 signal consistent with disc desiccation. L5/S1: There is a mild diffuse annular bulge with more focal right posterolateral bulge (6mm AP) consistent with right posterolateral disc herniation. The disc herniation contacts the right S1 nerve root in the spinal canal. Does this require surgery? I have had no relieve of pain after doing an epidural injection and being treated with narcotics. Maria

Q: Hi, I am 44 y/o, had on and off back pain that usually goes away with rest and or muscle relaxer. Episodes been getting more and more severe requiring injection. My latest episode started with back pain right side radiating to right leg. Had to go to ER, was given muscle relaxer injection and pain meds and steroids. Back pain went away but leg pain remained along with extreme weakness of right leg and foot (can't flex my foot upwards) ang numbness in right toes. Had MRI, here are the results:

"The marrow signal is normal. There is no fracture, malalignment, or bony lesions. The tip of the conus terminates at L1 and appears unremarkable.Images through,T12-L1, L2-L2, L2-L3, and L3-L4: unremarkable.L4-L5: The disc space height is minimally decreased and partially dehydrated. There is evidence or a moderate-to-large, broad central/right paracentral herniated disc compressing the descending right L5 nerve root in the lateral recess.L5-S1: There is no compressive lesion or stenosis.IMPRESSION: L4-L5, broad central/right paracentral herniated disc compressing the descending right L5 nerve root in the lateral recess and compressing the sac."

Please let me know what that means, I was referred to see a neurosurgeon ASAP. What do you suggest my options are?Thanks in advance. Ralph

Q: I injured my back on 01/15/10, from horsing around in good fun with my husband. I didn't feel immediate pain. Within 24 hrs my lower back hurt (lumbar region)at both the center & right side. By 01/19/10 the back pain increased, and had pain in my right buttocks as well. Was not able to stand upright from a sitting position without the aide of pushing against something, i.e., table, bed, etc. Muscle spasms began that afternoon and I was in so much pain, that I went to the ER that evening. Took Xrays (showed no damage) gave me Dialudid & Valuim which did not help w/the pain. Sent me home that evening with a script for Flexeril and 600mg Motrin. Went to my Primary Care Physician on 01/28/10 with same symptoms, prescribed Vicodin w/Tylenol (7.5mg/500mg) and more Flexeril (10mg). Drugs made pain a bit more bearable, but still was hitting a 10 on the pain scale. This lasted for 3 1/2 weeks from the date of the ER visit. Sleeping and sitting was painful. Felt better standing (with weight shifted to my left side/leg) and walking. As of now 03/02/10, back pain and spasms have subsided, thank God! But now I have a sciatica condition, pain in my right buttocks, wraps around to my hip area, down the back of my leg and foot/toes. Below the knee on the right side and back of calf muscle are numbness/tingling, with burning or a pinching sensation on my right ankle, numbness varies to the top and bottom of my foot. Numbness can vary with all 3 smaller toes on my right foot. Sitting aggravates the sciatica. Walking and standing feel better. PCP sent me for a MRI. MRI report is as follows:Female, Age 40

Technique:MRI sequences were obtained in multiple orthogonal planes as needed. No contrast was given.

Findings: There is a large extruded disc herniation at L5-S1 on the right that extends slightly cephalad. It measures 1.3cm in height and 1.0cm in depth. there is flattening of the thecal sac on the right and impinging on the exiting L5 nerve root on the right as well as the descending nerve roots on the right. The thecal sac is pushed to the left. The conus is at L1-2 and appears unremarkable. The L1-2 through L4-5 discs has normal height and signal. The aorta is normal in size. The paraspinal muscles and soft tissues appear unremarkable. No marrow infiltration is seen. No compression fractures are seen. No spinal stenosis is seen aside from the compression caused by the large herniation.

Impression: Extruded disc herniation at L5-S1 on the right extending cephalad. There is impingement on the exiting L5 nerve root on the right and the descending nerve roots on the right.

Going to Orthopedic spine specialist per referral of my PCP. I would much appreciate your thoughts/opinions to this. My questions to you are as follows:Is this a structural problem that can only be remedied by surgery?Could an epidural provide relief or a solution? What medical treatment, if any, would I benefit from?Thank you in advance. Danielle

Q: a recent back spasm has me in fear to get back on track to exercise again. what should i start doing? Judy

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