Herniated Disc Questions and Answers Archive 2010 Part 6

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: Hello Sir, I am 34 Yrs serving in Indian Army since 14 yrs and I am sportsman playing a several games in Army since last 12 yrs and now last 2-3 yrs i have an problem for lower back pain on particular area. when i am standing for long time pain will start slowly to the particular area on rt side on low back and also its paining and burning on both leg bottom hill mostly in rt leg. When i am playing or running there is no pain when body is warm up but after cooling down than start paining slowly again. i have done MRI and its reports are POSTERIOR AND RIGHT PARACENTRAL PROTRUSIONS OF L3-L4 AND L4-L5 DISCS CAUSING NEURAL FORAMEN COMPRESSION WITH SPINAL CANEL STENOSIS AT L4-L5 . So as Army man and sportsman i feel so disappointment to my self and thinking always about my problem. So please you are request to give me some solution what should i do for complete relief from back ache. thank you Ganesh

Q: Hello, could you please advise me... I was involved in a automobile accidents last year on June 03, 2009 and it left me with severe neck and back spinal injuries. I'm in severe pain everyday of my life and my doctor have me on pain meds and muscle relaxer. About 5 months ago my pain got worse and now it continues to radiates down both my arms and my right hand, I have problem with my nerves in my wrist and below my thumb and now my index finger feel like someone is poking needles in it and it hurts alot. I can't even write my name without my hand and thumb hurting me. My primary care physician has referred me to see a Neurologists on the 17th. Below I have my Cervical MRI results for you to view if you have the time. (I really would appreciate your opinion.) My Question is, when I go to see the Neurologist on the 17th, should he perform a emg nerve conduction test on me instead of a regular consultation? I'm no doctor, but doesn't my MRI result shows that I pinched nerves too? I get so depressed living in all this pain everyday. Thanks, I look forward to get a response from you soon. Here's my 2nd Cervical MRI Report results:

MAGNETIC RESONANCE IMAGING OF THE CERVICAL SPINE WITHOUT CONTRAST. Comparison is made with the prior study date 06/19/09. There is straightening of the normal cervical lordosis. There are no marrow replacing lesions or fractions. C2-3: The disc lever remains unremarkable. C3-4: A shallow right paracentral disc herniation/protrusion continues to abut the cord. This is stable. The neural foramina are patent. C4-5: A central/right paracentral disc herniation is stable and mildly abuts the ventral cord. The neural foramina are patent. C5-6: A broad disc bulge is unchanged. The central canal and neural foramina are patent. C6-7: A small central disc herniation is unchanged. C7-T1: The disc level is unremarkable. IMPRESSION: 1. NO SIGNIFICAN INTERVAL CHANGE FROM 06/19/09. STABLE RIGHT PARACENTRAL AND CENTRAL DISC HERNIATIONS AT C3-4, C4-5, C5-6 AND C6-7 AS DESCRIBED. Mary

Comment: 42 year old with a silly low back injury while coughing that pinched my sciatic nerve running down my right leg and into my right foot. Tried chiropractic for a few weeks with no improvement. Had an MRI this am and this is what the report said " disc space narrowing at the L5-S1 level and disc desiccation with a moderate to large central and right sided disc extrusion. Disc material is extruded into the spinal canal and right lateral recess and right sided neural foramen. This would appear to cause mass-effect on the right L5 and S1 nerve roots. Dee

Q: I am in so much pain and just about willing to try anything to make it stop. I take medicine, but the meds don't even help and they make e so tired. I have multiple bulging discs, i have spinal stenosis, i have scoliosis, i have degenerative disc disease. I am really suffering and would like some advice. What do you recommend? Terri

Q: Hi, I recently injured my back by lifting something and went to chiropractor who just made my symptoms worse. I have pain on my right side that runs from my buttock down to right leg and have some tingling and numbness in my foot. I had an MRI done and went to a Ortho and he is recommending surgery, but i prefer to try conservative treatment before surgery. Please see my MRI report below: Scans show a large right sequestered herniated disc at L4-L5. There is a large sequestered fragment posterior to the body of L5 which compresses the thecal sac and compresses the right L5 and sacral nerve roots. There is a sacralized L5 vertebra. The L5-S11 disc space shows disc dessication, disc space narrowing and bulge. The L1-L2 L2-L3 disc spaces are preserved. The facet joints are unremarkable and there is no acquired lumber stenosis. The conus medullaris and cauda equina show no intrinsic abnormality. The paraspinal soft tissues are unremarkable. There are no medullary bone lesions. Laila

Q: Hi, I have DDD. I am 51 yr old male. I had a 3 level Cervical fusion in '08. IN '09 I herniated L-5. I had a micro'd on it and was somewhat better,as the left leg pain was alleviated. IN Jan 2010.I fell on ice and re-herniated L-5. My neurosurgeon says I'm a good candidate for fusion (L-5 S-1). I'm seeing him the 17th of this month and am going to get a date for the surgery.I read what u say about fusions,am i making a mistake? I am in chronic pain. Both legs,hips and back. Thanks Paul

Q: Hi, could you please explain the following in terms I can understand. I struggle with constant back pain, not debilitating, worse at some times than others. The spinal alignment is normal. Vertebral body heights are maintained. There is a mild disc desiccation which is a normal variant. A mild uniform L2-3 disc herniation is present. There is central posterior bulge or subligamentous herniation of the L3-4 disc. Noe definite nerve root compromise is identified. There is minimal bulging of the L4-5 and L5-S1 discs. Miled multilevel degenerative changes of the lumbar spine with mild disc bulging from L2-L5-S1. Small disc bulge or central subligamentous disc herniation at the L3-4 disc may be present. No definite nerve root compromise identified. No spinal stenosis at any level. This was from my last MRI that was 5 years ago. Sam

Q: How do I find doctors who perform the epidural for herniated disks? (In New York City, especially.) Most doctors have I spoken to will do this. Emily

Q: Hi..5 weeks ago I was diagnosed with a herniated disc at L3-L4 with the herniation abutting a nerve. Most severe symptoms are weakness and numbness in my left leg - especially around the knee and nearby inner thigh can top-front calf. I've been have physical therapy for 4 weeks including traction. I'm a little stronger now and the radiculating pain is not as severe as 3-4 weeks ago, however the leg weakness and continuing radiculating pain can stop me in my tracks when I try to walk very far. I am walking assisted with a cane but slowly and not more than a few minutes at a time. Especially in public it's not long before I get radiculating pain in my buttock and left leg when walking. I can only work remotely due to my immobility and I still take pain med however I've cut back on it. Since I am still semi-immobile with continuing pain my ortho surgeon recommended epidural spinal injections (3 of them 2-weeks apart) - I had my first one earlier today. Am I at the point to just wait this out to see if the injections provide less pain so my physical therapy may help the herniation resolve on its own - buying me more time so to speak in extending the time to heal? I must admit I'm fearful with my level of incapacitation at this point in being able to once again regain strength in my left leg and be able to walk on my own and go in to work. Thank you very much for any advice, and with the care and concern for pain sufferers you exude on your website. Alan

Q: Hello. I have 2 bulging discs at L4/L5 and L5/S1. One on the left, the other on the right. Symptoms mainly on right side. I stumbled onto your site by accident, when researching acupuncture as a back pain remedy. I was surprised that your story mimics mine - I too injured myself through martial arts. I developed symptoms in November last year, through overextending myself through karate. I am at the stage now when nothing helps long term. I've spent a lot of money trying to fix the condition, but I keep getting the same symptoms - muscle spasm, pain across the back, weakness and heaviness in leg. Some days I can hardly walk. Even worse, some days it's better than others, and I don't know why. I REALLY want to get back into karate. I was told I could go back gradually. But I can't judge it. Example: I just spent 2 weeks in Japan training, carefully, 5 days a week, and I was fine. Yes, there was pain, but it dissipated over time. By the end of the training I could bend and walk normally!!! Now I'm back, doing similar training, and I'm getting terrible pain again. If you could offer some advice, I would be most grateful. As I feel I can't do anything, and have no hope of getting back into the martial art I love. Juliet

Q: Hi, MRI results show an extruded disc in the left L5-S1 level that is suspicious for a sequestered disc fragment, which appears to be embedded in the left lateral recess & extending into the left neural foramen. This is contributing to severe nerve root encroachment. Fragment measures at least 1.2 cm. I saw a neurosurgeon but he suggested no surgery and that he didn't think there was a fragment, the thing is I am now having some of the same symptoms on my right side as I had on the left such as butt& leg pain. It's been 5 weeks since I saw this surgeon & 2.5 months since I was diagnosed. What are the chances that this fragment will absorb? My pain level hasn't changed at all since seeing the surgeon. I wear an ice pack most of the time at work. I'm afraid if I wait too long for surgery I will have permanent nerve damage, could this happen since the mri stated that the fragment is embedded? Thank you, Mary

Q: I was wondering if you could explain the findings on my ct scan and maybe suggest your opinion as to whats going on. In Jan of 09 I had a micro discectomy on L3-4. It reherniated and had another one in March of 09. Continued pain in back with bilateral leg and foot pain. Had mri showed disk had collasped and was bone on bone. Fusion recommended to stabilize spine and fix this area. Had fusion in January of 2010. Now almost 7 months post op with continued bilateral pain in back, hips, and down both legs. Worse on left side.CT scan w/o contrast findings:Status-post discectomy and posterior lumbar fusion at the L3-4 level. Disc space graft pedicle screws and fixation rods show good position and alignment. The spinal canal appears widely patent throughout the post operative region. The remainder of the vertebral bodies show normal height and alignment. Small broad-based disc bulge at the L2-3,without significant spinal stenosis or neural foraminal narrowing. Small to medium broad-based disc bulge/protrusion at the L4-5 level which together with mild facet and ligamentous hypertrophy produces a mild degree of spinal stenosis. Mild narrowing of the inferior aspects of the neural foramina are noted without definite compression of the exiting nerve rootlets. Small central disc protrusion at the L5-S1 level, without significant stenosis. Neural foramina appear patent. I am a 48 year old female. Thanks for you input. Connie

Q: Yes, Hello... I've been suffering on and off with a herniated disc (finally diagnosed this past fall with MRI) for over a year now. There are flare ups. Everything will be fine until I begin some form of impact sport like running, skipping or any type of hopping. The pain is into my toes...not terrible in my low back but more in my legs and feet. Are you saying that these flare ups are caused by my mind??? Even after medical diagnosis has shown an L4/L5 herniation? Julie

Q: Hello, i'm Hoping u can help me to understand the results of my lumbar MRI. 1. Central disc protrusion at L3-4 of 3-3.5mm 2. Central and right-sided disc protrusion at L4-5 of 5mm. I was diagnosed with sciatica and to confirm this i went to have an MRI done. Symptoms started suddenly and within a few days i was unable to walk with out pain, i was bed rested for about a week and i slowly began walking but not with out pain. Pain began on my right lower back but now (a month later) the pain is slowly shifting to the left lower back. My pain level is at a 2-3 and it comes and goes. Pain seems to increase when i bend to get something off the floor or when i sit for too long. I'm 27yrs old, male and i've never had any surgeries done nor i've had problems in the past. I consider my self to be a fairly healthy person. I'm concerned because i'm worried of what kind of impact this type of injury will have in my health and daily activities, specially now that my wife and i are expecting our first child. The MRI also says that "at L4-5, there's a central and right-sided disc protrusion of up to 5mm with focal prolapse extending behind the endplate of L5 and into the subarticular recess. This results in thecal sac impingement, central stenosis, and right-sided subarticular recess stenosis, perhaps with mild compression of the right L5 root."Hope u can help understand these results, how is this treatable or is this a permanent injury? And have u seen similar cases? If u have whats their outcome with treatment? I appreciate the time your taking to help me out with this. Thank u, Evan

Q: I was in an accident and was rear ended. I been having pain in my neck, back and numbness to right arm. I had an mri done and got my report back.It states in report central and left paracentral spur and disc complex versus disc herniation is identified. Impression:C5-6 central left paracentral posterior spur and disc complex versus disc protrusion, otherwise negative. What does this really mean is wrong? I been just searching on the web for meanings of it. Ray

Q: Hi Sensei, 3 years ago I attended a local gym over a 3 - 5 week period. The young instructor subjected me to hamstring stretches put pressure on my low spine. Regrettably after about the 3rd week I realized he had injured my low back and I couldn't stand stationery without discomfort at the L5/s1 area of my spine. I have never resolved this and also now have pain on waking in that area. Osteopaths told me there were signs of wear and tear. I went to a Chiro who made it worse and now sitting has become a problem. Last week I decided to pay for an MRI and the report from the radiographer claimed my bacl looked " normal "!! I suspect the loss of disc space now means the associated facet joint is also being compressed which is why I get the pressured feeling just above the sacrum. To the right of my low spine I have get a very sore bony area which can be extremely painful. Basically, my question is: Is there anything I can do to resolve this or at least improve things? Many thanks, Tim

Q: Can you give your input on these results (mri). Symptoms are severe neck pain and reduced range of motion which started eight months ago as upper back pain slightly above midline a bit to the left of center. Upper mid back is still painful but not as severe as neck. When holding a telephone, my hand and thumb/index finger will go numb - whichever hand is holding the phone. When holding things in front of me, such as a book, often my hand, pinky/ring finger will go numb. When driving, arms become very tired and I find I have to switch from one are to the other on the wheel while resting the other in a downward position. When doing a lot of bending/landscaping, driving, or sitting, I will get pain in top/outside of thigh which will travel down leg and to top of foot. I have been advised by one dr. to seek an orthopedic surgery consult. I have been trying physical therapy first. I have had six PT sessions and so far, no improvement. Pain is still pretty intense. Thank you.

CERVICAL MRI RESULT: Mild degenerative change C6-C7 with superimposed right posterolateral to foraminal C6-C7 disc protrusion. Straightening and slight reversal of normal cervical lordotic curvature. Mild narrowing of right C6-C7 foramen at the junction of the lateral recess and entry of the right neural foramen. THORACIC MRI RESULT: Small non compressive T2-T3, T3-T4 and small to moderate T6-T7 annular bulges noted. At T9-T10 there is a moderate sized superiorly extruded left paracentral to posterolateral disc herniation observed. This effaces the CSF space along the left anterolateral aspect of the thoracic cord without compression. LUMBAR MRI RESULT: Transitional vertebral body at L1 with articulated prominent transverse processes versus atrophic twelfth ribs. This places a small rudimentary disc at the level of S1-S2, and the conus terminates at the level of L2 vertebral body. L5-S1 mild disc narrowing and desiccation with broad posterior disc protrusion. Small central disc extrusion with disc material extending slightly inferiorly at this level 1 to 2 mm. Moderate facet and ligamentum flavum hypertrophy to cause moderate central canal and lateral recess stenosis. Disc material and facet hypertrophy abuts but does not clearly impinge the S1 nerve root bilaterally at the level of lateral recesses. Mild left and mild to moderate right mixed spondylitic foraminal narrowing. Gail

Q: I've been having alot of pain lately and finally was able to have an MRI and the findings are confusing to me since my doctor is one that believes the medicaid patients do not deserve the same type of care that other 'better' insured patients deserve. These were the printed findings that I am praying you can help me with.... Broad annular bulge with small volume left paracentral disc protrusion at L4-5 resulting in left lateral recess stenosis and effacing the descending left L5 root sleeve. There are multilevel annular bulges most prominently at the L4-5 level. T11-12 demonstrates ligamentum flavum hypertrophy and mild lateral facet arthropathy. L4-5 level demonstrates broad annular bulge with small volume left paracentral disc protrusion resulting in left lateral recess stenosis and mild effacement of the anterior thecal sac. Please, help me understand this. I strongly feel that with some understanding, I can better my chances of improving not only my pain level (which I only take OTC for) but to help me from further injuring myself. Your help is deeply appreciated. Thank you sincerely, Beverly

Q: i have recently just come out of hospital with severe pain pain, the xrayed me and found i have narrowing of T12/l1 what is this, i get numbness in legs and arms sharp pains in chest, the pain was so intense i couldn't move at one point, they have given me pain killers for pain, it helps but doesn't get rid of all the pain, what can i do, i have been referred to orthopedic team, but will acupuncture help me? thanks Lisa

Q: My MRI states "multilevel osteoarthritis/neural foraminal narrowing. Most notably, there is SEVERE right neural foraminal narrowing at L4/5." In ordinary English I assume this means the nerve is severely compressed. Can this cause severe unrelenting constipation? If not (and I am of the opinion this IS the cause of my constipation) then what does it cause? Bruce

Q: After an auto accident I have significant lower back pain and tingling / numbness in legs. I had disc issues before but without the pain and was not hindered in doing 14 plus hours of landscape activity weekly, now I can do nothing... other than PT exercises and minimal pool exercises. What is wrong with me? This is greek to me. How could a minor car accident (hit from rear with seat belt on) cause this much havoc? Mild left convexity scoliosis. Disc bulge and osteophytes at L2-L3 and L3-L4. Disc space narrowing, disc bulge, osteophytes with endplate changes, and facet hypertrophy at the level of L4-L5. there is a poterior disc herniation with anterior impression on the thecal sac. Disc space narrowing , disc bulge, osteophytes, endplate changes, and facet posterior disc herniation with anterior impression on the thecal sac. There is moderate bilateral neural foraminal stenosis. There is a 0.5 cm left facet joint cyst which abuts the exiting left L5 nerve root. There is mild anterolisthesis at this level measuring 0.2 cm. Tarlov Cysts at the level of S2 Biggest concern is this somatic pain or real? thanks for any help. Beth

Q: I have had spinal surgery, cervical and lumbar. I now have a new MRI which shows at L5/S1 left post-lateral disc herniation, moderate narrowing of L5 foramen and disc material abutting exiting nerve root causing compression on the exiting nerve. I have terrible pain and weakness in my right leg..pain runs from top of thigh down outside to the knee and then across to top of foot. It hurts severely on lying down, weakness and pain in both feet on walking and severe pain in right leg and right lower back when walking and pain in lower back and radiating into both feet when sitting. I don't want more surgery and can I get other help. Shirley

Q: Hi Sensei,I am a 30 year old male and I have been in a lot of discomfort and pain for the last four years which I am finding harder and harder to deal with. I have had a CT of the spine, and an xray of the lumber area which apparently did not show anything significant. CT SPINE Results: In upper thoracic spine there are degenerative disc changes. In the cervical spine the disc heights and end plates appear better preserved although there are small disc protrusions.At C4-5 level there is mild broad based protrusion with mild central stenosis. C5-6 level there is mild broad based protrusion with mild central stenosis. C6-7 level there is disc osteophyte bar with mild central stenosis. The exit canals remain widely patent. XRAY LUMBER SPINE Results: There is a slight rotation of the upper lumbar levels to the right. There are transitional vertabrae at the thoracolumbar and lumbosacral junctions, the former nominated as T12 and the latter as L5. There is sacralisation of the L5 transverse processes. The L5/S1 disk is rudimentary. There is reduction in height of the L4/5 disk space posteriorly. There is a small neural arch defect of L5. The SIJs are normal. I have recently been to a specialist who said there's not much that can be done, and that it might be genetic. He thinks the only direction for me to take is just pain management. Do you have any other advice as to which direction I should take? I don't think I can deal with this for much longer. regards, Aiva

Q: Hello, Could you please explain how bad my condition is and also will I need surgery. I am going on a mission trip at the end of August so I will not be able to see a specialist until after I get back. MRI results: There is a central protrusion of L5-S1. The base of the protrusion is 9mm, AP dimension 5mm. Appears to abut both the right and left S1 nerve roots. No appreciable neural foraminal stenosis. There is loss of intervertebral disc space height at this level consistent with degenerative disc disease. L1-L5 intervertebral disc space levels are unremarkable. No additional areas....... Christine

Q: I have had pain in my left shoulder and down my left arm for months and it has gotten alot worse so I went for a MRI on Friday and it turns out c5-c6 and c6-c7 are ruptured and a fragment is pushing on my cervical cord and dislocating it. Do you know what the normal procedure is for something like this? Page

Q: Thank you so much for this amazing material. 3 months ago I began having severe back/hip pain and sciatica. The start of the pain was coincident with an emotional/ethical situation I involved myself with. Looking back, I recognized the coincidence and, being familiar with the mind/body relationship through having read Dianetics, concluded that the pain must be psychosomatic in origin, though there were/are serious injuries in my past and even radiological irregularities (probable hip arthritis). What I did not realize, however, is the oxygen aspect. Shortly after reading your material, I found myself in a casino and experiencing very little discomfort for a change. I then learned that oxygen is often pumped in there to keep people alert and spending. This pretty much heralded the end of my disability. Tonight I purposely hyperventilated and my extreme discomfort is now gone! I am in your debt. My career as a software technician/programmer may not actually be over, I may not need surgery, etc. I may be able to live, in other words! I will be reading everything I can about this while enjoying my new-found comfort. With tears of gratitude, Tom

Q: Hi. I found your blog online and would like your help in understanding my MRI of my Cervical Spine, please. I sustained some cervical/lumbar injuries during a lifting accident while conducting patient care as an EMT approximately 5 yrs ago. I'm 41yrs old in great physical shape. I will follow-up at a later date with my lumbar MRI results. TECHNIQUE: An MRI exam of the c-spine using sagittal T1 and FSE long TR double echo, and oblique axial T2 sequences. Findings: At the C5-C6 there is a broad based posterior disc herniation with some accompanying osteophytes larger to the left of midline resulting in stenosis of the canal and mild impingement of the adjacent spinal cord. There are hypertrophic changes about the right uncovertebral joint at this level narrowing the right C5-C6 neural foramen. Posterior disc bulges are noted at the remaining levels from C3-C4 through C6-C7 deforming the thecal sac. IMPRESSION: Posterior disc herniation with accompanying osteophytes noted at C5-C6 resulting in stenosis of the canal and impingement of the adjacent spinal cord. Hypertrophic changes of the unconvertebral joints are noted at this level narrowing the right C5-C6 neural foramen. Posterior disc bulges are noted at the remaining levels from C3-C4 through C6-C7. The remainder is withing normal limits and with no additional abnormalities.

Since my accident I have experienced slight to severe pain to my cranium, bi/lat shoulders, forearms, wrists, hands, fingers with accompanying numbness and tingling and weakness/clumsiness. I also experience daily/nightly moderate neck pain along with limited range of motion. My questions are many but foremost I am deeply concerned about my spinal cord and danger associated with my current cervical condition. Please help me understand. Thanks a billion! Norma

Q: I have been in a nightmare for the past 7 months...I have mri results and have no idea how to decipher them and was hoping you may be able to help me? I had a complete upright mri in may after being hospitalized in january of this year for multiple back problems...i ended up in the hospital almost a month...was in the worst pain i have ever experienced. i was incontinent, pain in my hips, down my leg and my hands and arms would burn like crazy and go numb...the findings on the mri are as follows? Cervical spine with contrast...straitening of normal lordosis there is diffuse desiccation with invertebral disc space narrowing at the C-5 C-6 level. type 2 degenerative end plate changes are noted involving the inferior endplate ofC-5 and superior endplate of C-6. C4-C5 there is a small generalized disc bulge and uncovertebral hypertrophy causing mild left neuroforaminal narrowing. C5-C6 there is central disc osteophyte complex with left paracentral component which is causing impression on the ventral aspect of thecal sac and causing mild spinal canal stenosis. there is bilateral uncovertebral hypertrophy resulting in moderate to severe left and moderate right sided neuroforaminal narrowing. C6-C7 there is a generalized disc bulge and bilateral uncovertebral hypertrophy causing mild to moderate bilateral neuoforaminal narrowing. Christine

Q: I am inspired by your story. I have been experiencing back pain for almost 4 years. For most of that time, I have treated it according to TMS theory, and continued pushing through pain in my yoga practice (I am an instructor). That is until this winter, when I had such severe muscle spasm I could no longer work through it. I have since seen doctors and gone a more traditional route that treats it as an injury. To that end, I have totally altered my life; still, I am still in crazy pain. Otherwise, I am a healthy 32-year old woman (not without anxiety though). While I used to have conviction in the TMS diagnosis and program, I am really in a fearful and distressed place right now, unsure whether to recommit to TMS or leave it behind. To make matters more confusing, I recently flew out and saw Dr. Schubiner, convinced by the literature and my intuition my pain is really about the fear and stress in my life. However, and despite my profile fitting TMS perfectly, the MRI showed a couple bulges and one very large herniation. He said based on the size (6mm, I think), that that could be causing my pain and that while TMS is likely contributing to some of my pain, the herniation could be, too. We then discussed the possibility of surgery, and now I am in this gray zone--I cannot continue with the TMS program because I'm not confident about the diagnosis, but when I don't get better and am afraid of every pain sensation in my back, as now it really may be contributing to my injury and the reason why this pain hasn't ebbed! I'm in a gray zone and unsure how to proceed. I'd appreciate any insight or advice based on your experience. Really, all I want to do is practice yoga--I miss it so much, but each time I step on my mat my back goes into spasm. I used to think it was conditioning, but now after rounds with real docs, I am afraid it might actually be from the disc. Thanks again and any bit of advice would be appreciated. Best, Brooke

Q: I got a cervical spine MRI w/o contrast, because I am having right shoulder arm weakness and pain radiating from neck to fingertips (pointer & middle), migraines/headaches, neck and back pains after sitting or standing for any length of time. Resting on my back gives some relief and I take Tramadol to block the pain signal. The cervical spine MRI is as follows: FINDINGS: There is grossly normal alignment without subluxation. There is no fracture or acute osseous change identified. Osseous marrow signal demonstrates no focal suspicious lesions. There is a hyperintense area within the T3 vertebral body that probably represents a small hemangioma. The cervicomedullary junction and visualized portions of the posterior fossa are unremarkable. The cord is grossly normal in size and signal. There is degenerative disc disease with disc desiccation, disc height loss multilevel with mild disc bulging and spondylosis. At the C2-3 level there is no central spinal stenosis or neural foraminal narrowing or focal disc protrusion identified. At the C3-4 level there is diffuse disc bulging with more focal disc protrusion and spondylosis on the left with mild to moderate left neural foraminal narrowing. There is no central spinal stenosis or right neural foraminal narrowing. At the C4-5 level there is diffuse disc bulging with uncovertebral hypertrophic change, the findings have led to mild bilateral neural foraminal narrowing. At the C5-6 level there is diffuse disc bulging without spinal stenosis. Uncovertebral hypertrophic changes have led to moderate to severe right and mild left neural foraminal narrowing. At the C6-7 level there is mild disc bulging without spinal stenosis. There is uncovertebral hypertrophic change that has led to moderate bilateral neural foraminal narrowing. At the C7-T1 level there is no spinal canal or neural foraminal narrowing or focal disc protrusion identified. CONCLUSION: 1. Degenerative disc and uncovertebral joint disease multilevel. The findings have led to disc bulging but no spinal stenosis. 2. Multilevel neural foraminal narrowing most pronounced on the right at the C5-6 level where it is moderate to severe with moderate left neural foraminal narrowing at this level and moderate bilaterally at the C6-7 level. Mild neural foraminal narrowing is evident at other levels. 3. No acute cervical spine findings otherwise.

I saw my neurologist last Wednesday for a neck to right arm nerve conduction. She said that the mod. to severe narrowing at c5 to c6, is probably causing the pain going down my spine and out to my right shoulder. The nerve conduction on my right arm, shoulder and neck showed severe carpal tunnel on my right wrist, moderate CT on my left, mod. to severe irritation in arm, shoulder and neck and some damage in the lower neck area. She is working on getting authorized carpal tunnel surgery on right wrist with a possibility to also do CT surgery on the left too; 1 to 3 cortisone shots injected in my lower neck, and physical therapy for my back, neck and shoulder, though depending if PT will do further damage or will help is still not known. She said that neck surgery could be a possibility though both her and I do not think that would be the best, as it is very risking surgery. After the nerve conduction on Wed. afternoon, my neck and back starting really hurting with pain and I had weakness having a hard time holding my own weight walking and needed to hold onto something as I walked. But the next day it was back to the regular pain aching with no weakness. I also see a naturopath. She is helping me with heavy metal detoxification, strengthening my immune system and chronic Lyme's disease. I got a second case of Lyme's in 2006, was treated with 6 weeks of antibiotics, but stayed fatigued since then. Since 2006 I got diagnosed with glaucoma in both eyes, fibromyalgia, osteoarthritis, osteoporosis, narcolepsy, migraines, Bell's palsy, had right shoulder partial joint replacement surgery, had a small heart attack, LBBB, cognitive disorders and extreme fatigue. I feel like I have been falling apart the last few years and now the pain is getting unbearable. I would like to hear your input on my MRI, nerve conduction testing and my diagnoses and possible treatments. What would you consider doing in my case? Thank you very much for your time and answers. Susan

Q: Greetings Mr. Rostocki, I have been a back pain suffered since March, 2008. Since then I have had chronic back pain with consistent visits to the Chiropractor. I have as well been seeing a. nutritionist to try and solve my problem. I recently went to a neurosurgeon and was diagnosed with a herniated disc in L5-S1 and an abnormally strait lumbar (no curvature). The doctor told me that the main cause for the problem was structural since without lumbar curvature, the weight could not be properly distributed and the L5-S1 disc was taking all the punishment. His recommendation was spinal cage fusion. I do not want to have surgery done and risk making the issue worse. Can you please help? I need a cure I'm tired of being in constant pain and am willing to try anything other than going under the knife. Please help! Jason

Q: I have been experiencing a problem, although it does not appear to be causing any pain yet. When I lie on my right side predominately, I am able to shift my hips and can feel one of more vertebrae slipping in and out of place, I can be feel it and at times it is actually audible. I have had my wife place her fingers along my spine as it occurs but even she is unable to pinpoint the exact location. I have had back problems for years and recently had an MRI that showed several bulging discs. I do have a T11/T12 disc bulge. There is also a small partial tear in this area as well. At the L1/L2 level, there is posterior disc herniation extending from the right paramedian region to the left side of the canal. At the L2/L3 level, there is a circumferential disc bulging resulting in an anterior impression upon the thecal sac. At the L3/L4 level, there is circumferential bulging resulting in anterior impression upon the thecal sac. At the L4/L5 level, there is circumferential disc bulging resulting in anterior impression upon the thecal sac. There are also degenerative changes in the facets bilaterally. At the L5/S1 level, there are degenerative changes of the facets bilaterally. Now, here is the real kicker. In the conclusions statement, there is a note about a small focus of T1 and T2 weighted increased signal intensity within the T12 vertebral body and L1 vertebral body within which are small foci of decreased signal activity. These are believed to represent benign hemangiomas. What the heck does all of this mean? As I mentioned, I have had back problems for years. In 2003, the MRI results were about the same except the doctor who made the interpretation indicated a possible neoplasm. The Neurologist was actually looking for the cause of my neuropathy in my toes on both feet as I have Type II diabetes associated with Agent Orange exposure. Bob

Q: On April 14 2008 I had an accident & fell approx 10feet to a concrete floor, I have suffered severe hip & back pain since that date, as of now i have degenerative left lateral osteophytes at L3/4, L4/5, & L5/S1 on the left side,& there is degenerative disc disease at L5/S1 on the left side, could this have been caused by the accident? Keith

Q: I am a 26 yr old female and I was in a car accident on 2/13/10 and I began to feel acing in my lower back and soreness and stiffness in my upper back and neck. I began seeing a chiropractor (3x per week) and massage therapist (once a week)it seemed to help my upper back and neck but my lower back pain turned to a pinching within about 3 weeks. Then at the beginning of june the pain got very bad and I could not do anything. I feel pinching, stabbing feeling that starts in my low back and goes through my buttocks on the right side all the way to my calf. The pain is the most severe in the low back, buttocks and right calf and everywhere in between it is a little less severe. I started physical therapy and went twice a week for about 6 weeks with no relief at all. I finally had a mri done and this is what the report said:

Findings: There is advanced degenerative disk disease throughout the lumbar spine. No acute fracture or subluxation is seen. At the L5-S1 level there is a loss of disk space height and signal. Endplate changes are seen at L5 and S1 consistant with chronic degenerative disk disease. Mild facet disease noted bilaterally. The central canal is widely patent. There is some narrowing of both L5 exit formina from facet disease. At the L4-5 level, the disk space demonstrates loss of signal on T2 weighted images. There is a diffuse disk space protrusion. There is a central and right sided focal protrusion. There is marked compression of the right L5 nerve root centrally. The left L5 exit foramen and right L5 exit foramen are both patent. There is bilateral facet disease. At the L3-4 level, there is mild facet disease bilaterally. The disk demonstrates loss of signal. There is diffuse disk space protrusion without stenosis centrally or laterally. At the L2-3 level, There is a loss of signal from the disk space. There is a diffuse disk space protrusion with central nerve root compression. There is a tear in the annulus centrally. The L1-2 and T12-L1 disk spaces are normal. The conus ends normally at L1. No fluid collection or hematoma seen.

IMPRESSION: Multilevel degenerative disk disease with disk space protrusions causing nerve root compression at the L2-3, L4-5, and L5-S1 levels as above. At the L5-S1 level, there is primarily lateral nerve root compression. There is central and right sided disk space protrusion at the L4-5 level with focal disk space protrusion. At the L2-3 level, there is central nerve root compression. My questions are what is a protrusion is it like a herniation or a bulging disk? What does patent mean? What are my options? Why did I not feel any pain before the accident but the drs say that this has been there? The dr wants me do do an epidural steroid injection and if it doesn't work talk about surgery is this the right way to go? What other options do I have? Is it permanent? Thank you so much for your time and help. I am supposed to see the dr about the injections tomorrow. Thank you again for your opinion it is greatly needed and appreciated. Lindsay

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