Herniated Disc Questions and Answers Archive 2010 Part 8

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-I have not been too happy with my doctor these days. He just doesn't have any more than 3 min per office visit. I recently had a mri for my back. I somehow injured my back last December and have had pain ever since. I believe it is more serious than he says. All along he has said that I have sciatica.Prior to my injury I was able to participate in fitness, weight lifting & yoga 4 to 5 days a week. I just turned 44 a few weeks ago. Grade 1 spond @L5-S1 w/ bi-lateral L% spond. Straightening of the normal lumbar related to spasm. Preservation of normal fatty marrow throughout. Also @ L5-s1 superimpose on the spond large broad disk bilge w/ small central herniated disc as facet & ligamentous hypertrophy leading to moderate r & L foraminal stenoses based on images. At L4-5 a large broad disc w facet & ligamentous hypertrophy without evidence of significant central canal or foraminal stenosis. At L3-4 sm broad disc bulge w/ r lateral herniated disc deviating the right L# nerve root posterolatetally but without central canal or foraminal stenosis @ this level. the L1-2 & L2-3 disc space is unremarkable. What does all of this mean? Many thanks, Sincerely, Paul

Q: Hi, I was not able to see my doctor for another week but I received my MRI report and I don't know what most of this means. I hope you can help.. Heres the conclusion section of the report...1. L4-5 leftward HNP effacing the descending L5 nerve roots and contributing to mild central stenosis. Mild rightward endplate reactive edema. 2. L5-S1 broad bulge and a small focal HNP right paracentrally effacing the descending S1 nerve roots. Right sided. Minimal facet disease. Moderate central stenosis due to short pedicles. Thanks for any feedback you can give me.. My symptoms are horrible.. My daily life miserable.. I can't walk very far at all without bending over for relief. My entire left leg goes numb and tingly then burns like boiling water being poured over it.. My muscles in that leg are weak and I'm falling often when I have to stand too long.. I'm really scared.. Thank you, Renee

Q: hi i recently had an mri of lumber spine after a car accident 2 yrs ago.results were as follows.findings.on sagittal imaging. there is degenerative change with disc space narrowing and disc dehydration at L4/5. NO sinister bony lesion identified. conus terminates normally at L1. on Axial imaging; at L3/4 no narrowing of the canal or nerve root compression. at L4/5 there is a small diffuse disc bulge which is indenting the theco and touching the descending L5 nerve root in the lateral recess on the right. no convincing compression of the descending or exiting nerve roots. AT L5/S1 NO COMPRESSION OF THE DESCENDING OR EXITING NERVE ROOTS. IMPRESSION DISC DEGENERATION AT L4/5. can you simplify this and explain it to me and will this heal or will it be ongoing as i am in sever pain and sometimes drop to the ground when it hits the nerve.as i work as a barber i can now only work 1 to 2 days a week and would it be wise for me to stay at my job as standing all day makes it worse. thank you paddy

Q: My name is chandramol. I am from Moradabad. i have back pain in the body. treatment or medicine.GOOD AFTERNOON

Q: Small posterior central disc herniation at L4/5 along with a central annular tear at L5/S1 with no significant neural compression. Yet am suffering a burning pain along all my back though anti-inflammatory tablets are taken. Why such pain and what are possible remedies. Thanks, Kursheed

Q: Hello. Maybe you can help. I am 34 year old health male who has worked out for years. About a month ago I woke up with very bad neck pain that went into shoulder and upper arm I missed 3 weeks of work because of it. I had a MRI which read central and larger right foraminal disc protrusion c5 c6 with impingement upon exiting right c6 nerve root. There is mild cord compression at this level. I am in physical therapy and had a epidural injection last Friday the 24th. I'm still having pain but the majority of pain is when I get up In the morning. It hurts really bad in shoulder and arm. It will taper off a little during the day. The doctor said the shot takes about 5 to 7 days to take effect fully. Will this eventually resolve it self or will I always have this pain. Just very frustrated Any info would help. Thanks Scott

Q: Had an MRI done for C5-6 pain. Results are Mild posterior herniation of disc material centrally and to the right of midline at the C5-6 level with compromise of the exiting right C5-6 nerve root sleeve. What does that mean? I had a fusion at C6-7. Also, states Loss of the mormal lordotic curvature of the cervical spine is noted. What all does that mean and why did I lose the lordotic curvature? Michelle

Q: I am a 47 year old avid swimmer who has been having increasing right scapular pain, which radiates through my shoulder and down my right arm for the better part of a year now. MRI results states, "There is advanced left-sided uncovertebral joint hypertrophy markedly encroaching on the left lateral recess and creating a moderate left sided neural forminal stenosis. Left sided neural foraminal narrowing is compounded by the asymmetric degenerative facet arthopathy. There is anterior thecal sac effacement. There is mild central canal stenosis at the midline due to the uncovertebral joint hypertrophy. Right neural foramen is patent." Is it possible, even though report states problem area is left-sided at C3-C4, to present pain on the right? Dale

Q: I went to the doctor for pain and weakness in my right index finger.At times right shoulder is in much pain and arm is weak. Dr ordered a mri and impression was mild degenerative change to cervical spine, most pronounced in C5-6 and C6-7 with a subligamentous disk herniation at C5-6 and small central disk at C6-7 without signifigant spinal stenosis. I am wondering if this is something that will go away or be an ongoing problem and possible treatments. Thanks, Heidi

Followup: Hi Again, My report for my MRI says C5-6 there is a broad based subligamentous disk herniation. This does abut against the anterior margin of the spinal cord but does not appear to result in any significant spinal stenosis. The exiting nerve roots do not appear effaced. C6-7 There is minimal central disk however this does not efface the spinal cord nor narrow the nerve root exits. C7-T1 intervertebral disk is normal. I am a very busy mother of 3 and i have bouts of sciatic pain that makes it very hard to get around. pain goes in both buttocks and runs down legs. Pain runs through right shoulder blade and up back of neck. Thank You for your time Heidi

Q: Can you please tell me what all this means. At L5-S1, there is moderate disc space narrowing, diffuse dehydration, mild spondylosis and type II Modic endplate marrow changes to the left side of the disc interval. A small broad based posterior spondylitic disc bulge is eccentric to the left of midline slightly. It produces mild flattening of the thecal sac with slight narrowing of the spinal canal and lateral recesses as well as mild narrowing of the left foramen inferiorly. There is no evidence of left L5 nerve root impingement. The bulging disc does appear to contact both of the S1 nerve roots in the lateral recesses although neither is displaced from its normal position and neither appears significantly compressed. Impression: L5-S1 Discogenic disease with small posterior spondylitic disk bulge. This is my new MRI. Had auto accident 10 years ago. Had a baby a year ago, when they did the epidural they hit a nerve 4 times. I've always had pain, but it's been severe after the baby. Christina

Q: I went for a MRI today after several years of pain in the L2 and L4 region which was somewhat mitigated for a while by biokinetics. I received a call from my specialist this evening saying that the MRI ha shown a severe rupture between L4 and L5 with a large amount of material in the spinal canal. He went on to say that he's surprised I can still walk with the location and extent of the problem. He recommends surgery - he'll discuss options with me tomorrow. From what I've read, I suspect he will be recommending some form of discectomy. Let me say at the outset that I selected this particular surgeon based on both his reputation for excellence and his advocacy of conservative treatment. Is there an obvious alternative, or is this the best course of action? I am permanently in pain, even when on anti inflammatories and opioid painkillers. I have trouble walking for most of the day, and have taken lately (past few days) to using a walking stick. Age: 42. Reasonably fit. 6ft 2in, 95kg (209 lb) Andy

Follow up Q: Subsequent to my previous post, I now have more information. My neurosurgeon says I have a "sequestrated disc". MRI reads as follows: At the L4/L5 level extensive broad based disc herniation and extrusion is noted severely compromising the spinal canal, especially so on the right side. Postero-lateral extension is also noted into the exit foramina on both sides which are further complicated by end plate changes. The paravertebral joints showed some tropism and fluid is noted in the paravertebral joints but no significant synovial cyst is seen. The L4 nerve roots are posteriorly and superiorly displaced on both sides.

At the L5/S1 level loss of disc height and signal is seen. Generalized disc extrusion is noted with a large central annular tear, compromising mainly the central aspect of the spinal canal. Mild poster- lateral extension, however, is also noted into the exit Foramina. The paravertebral joints showed some tropism and degenerative changes, especially so on the left side. The L5 nerve roots are posteriorly and superiorly displaced on both sides. The S1 nerve roots are in contact with the disc, which may irritate them. The spinal cord ends opposite T12 and no intradural pathology is seen. CONCLUSION

1. At the L4/5 level a severe functional spinal stenosis is noted due to a massive disc extrusion and broad based herniation, severely compromising the spinal canal, especially so on the right side. The L4 nerve roots are posteriorly and superiorly displaced. 2. At the L5/S1 level an extradural defect is noted compromising the central aspect of the spinal canal, where it is in contact with the S1 nerve roots on both sides, which it might irritate. The L5 nerve roots are posteriorly and superiorly displaced. My question - the neurosurgeon has advocated a discectomy to be performed next week. Would conservative therapy be off the cards? Also, would a microdiscectpmy or endoscopic discectomy be contra-indicated with my condition? Lastly, would anti-TNF therapy be of any value? Thanks in advance for your help. Andy

Q: I was wondering if you could help me understand my MRI results. I will just tell you the conclusions of everything. 1. Central/right paracentral disc protrusion at L4-L5 resulting in thecal-sac effacement. There is a mild, multifactorial central canal narrowing at L4-L5. 2. Shallow annular bulging with annular tear L3-L4. 3. Broad-based disc/osteophyte complex at L5-S1, without central canal stenosis or gross neural impingement. 4. Degenerative change, greatest at C5-6. There is a shallow broadbased disc-osteophyte complex, which effaces the ventral CSF, although does not result in cord compression or central canal stenosis. No foraminal stenosis is identified. I am only 32 and was also recently diagnosed with Fibromyalgia. No other disease has shown up in bloodwork, and I have had no major injury. I don't know why I would have what sounds like so much spinal issues. Please help me understand what is going on with these results. I am in constant pain and have difficulty walking and also a large amount of pain in my right shoulder, right shoulder blade, and the right side of my neck. Nicole

Q: Could you please explain to me the terms in English what this diagnosis of my MRI result is?, thank you. Findings: The height of the disc spaces are well-maintained except for some straightening of the cervical spine probably secondary to muscle spasm. There is a disc osteophyte complex at level C5-C6 causing slight compression of the thecal sac. However, the neuroforamina are intact. I do not see any evidence of compression of the nerve roots. Impression: Disc osteophyte complex centrally causing slight compression of thecal sac at level C5-C6. This is a result of an auto accident a year ago and I still have no progress with my family doctor, no examination, though I did get one referral to a neurosurgeon and he said he was a brain surgeon and he offered cortisone shots. I extended my 3 months of physical therapy and I think I need to see the type of doctor that will actually examine and assess my neck and I have shoulder pain as well, I just really would appreciate some answers or advice, thanks a lot, Genelle.

Comment: My age is 36. I have a very hectic lifestyle. According to my MRI report the effective midsagital diameter of spinal canal at various disc levels are as follows: L1-L2: 19mms L2-L3: 19mms L3-L4: 13mms L4-L5: 06mms L5-S1: 9.5mms IMPRESSIONSLumbar Spondylosis, Degenerative spinal canal stenosis at L4-L5 and L5-S1(L4-L5>L5-S1). Degenerative Disc disease in L3-L4,L4-L5 and L5-S1. Mild facetal arthropathy at L4-L5 and L5-S1. Jayanta

Q: I'm 36 years old. TYPE/EXAM LUMBAR SPINE WITHOUT GADO. CLINICAL INFORMATION: L4- L5 right leg sciatica TECHNIQUE: Sagittal T1, sagittal T2 performed on the lumbar spine and axial T2-weighted images performed on the disc spaces. L1-L4: No focal disc protrusion, spinal canal stenosis or significant neuroforaminal stenosis. L4-L5: There is a small to moderate-sized right lateral disc protrusion at the neuroforaminal level and extending slightly beyond with a small annular tear and a small right posterolateral osteophyte causing mild to moderate right neuroforaminal stenosis. No left neuroforaminal stenosis. No spinal canal stenosis. Minimal loss of disc space height and hydration. L5-S1: No focal disc protrusion, spinal canal stenosis or significant neuroforaminal stenosis. No focal disc protrusion, spinal canal stenosis or significant neuroforaminal stenosis of the other levels imaged in the field of view.CONCLUSION: Small to moderate-sized right lateral disc protrusion and small right posterolateral osteophyte at the L4-L5 level causing mild to moderate narrowing of the right neuroforamina. I've had the pain for about 9 months now. I've tried various treatments (anti-inflamatories), physio, etc. Unfortunately I probably keep doing things to aggravate it.My GP has scheduled to appointment to see a neurosurgeon in a couple months...in the mean time I will continue with physio, exercise, ultra-sound, weight loss. Do you think I should be able to avoid surgery ? Any other thoughts would be appreciated. Jeff

Q: I AM IN PAIN AT ALL TIMES MY M.R.I SAID C6-C7 a mild based subligamentous herniation with a right foraminal small protrusion is present disk material flattens the thecal sac anteriorly with moderate central canal narrowing with the AP diameter of the central canal at 9=mm and moderate foraminal encroachment right side greater than left due to additional facet joint and uncoverteral joint hypertrophy. Debra

Q: Hi, great site and service that you offer. Can you tell me what this means: At L5-S1 there is broad right posterolateral disk bulge which encroaches into the neural foramina bilaterally. Moderate central spinal canal and mild to mod. right greater than left foraminal narrowing.Bilateral foraminal stenosis at L3-4 and L4-5 due to a small psoterior spondylitic disk bulges and facet arthropathy. I am 26 have bad back pain that is now radiating to my upper back and shoulder area. Please advise. Barbara

Q: I am a Multiple sclerosis patient since 5 years. I am 45 yrs old. Recently i underwent a surgery for inguinal hernia. After the surgery, I experienced very severe pain in my abdomen and low back with shooting pains on both my legs. I underwent an MRI and the results show Diffuse bulge with broad based left posterolateral protrusion of L4-5 disc causing mild bilateral foraminal narrowing (left > right) with indentation on Left L5 nerve root. Mild bulge of L2-3 and L3-4 disc without canal or foraminal narrowing. Mild bulge of C4-5 and C5-6 discs. Few focal hyperintense in bilateral cerebral white matter with splenium of corpus callosum most likely suggest plaque of demyelination. Shobana

Q: I am a 30yr old female that has suffered from lower left side back pain that radiates down my left leg, both legs hurt but its more painful on the left side. My ankle are so painful I find it hard to walk and normally drag my left leg. I also have some groin, butt and saddle pain. In march I was diagnosed with neurogenic bladder, with no cause to the source. In August I had another urodynamatics done that revealed that not only was I having bladder spasms but now having colon spasms. I take oxbutynin, flomax and recently had bladder sling procedure done to help with the incontinence. MS, Arthritis, lupus have all been ruled out. Then this friday my new doctor suggest a mri of my spine... here is the report. Can you tell me what it means and could it be the cause of incontinence? REPORT (EXAM OF THE LUMBER SPINE W/O CONTRAST) THERE IS NORMAL SAGITTAL ALIGNMENT. NO PARS DEFECTS IDENTIFIED. VERTEBRAL BODY AD DISC SPACE HEIGHTS OVERALL APPEAR MAINTAINED. FIVE PRESUMED NON RIB BEARING LUMBER TYPE VERTEBRAL BODIES. THERE ARE MINOR GENERALIZED DISC BULGES AT L4-5 AND L5-S1. TINY SUPERIMPOSED FOCAL CENTRAL DISC PROTRUSION PRESENT AT L4-5. HOWEVER THERE IS NO FORAMINAL OR CENTRAL CANAL STENOSIS. THE CONUS IS NORMAL IN APPEARANCE. Shannon

Q: Hi, i have an l5-s1 herniation with annular tear. the disc is partially hydrated. I have Just a few quick questions. Does the annulus eventually heal itself? can or does the herniated portion become reabsorbed by the body? Is mild pain ion the front of the thigh sciatica? mine seems to at time radiate to that area. Stress seems to really make the pain worse and i am stressed and anxious all the time over this. I wonder if it can be TMS since all forms of conservative treatments do not really work including a non xray guided epidural done by a neurosurgeon which makes no sense to me at all. My pain level is thankfully no worse than a 3 out of 10 but i am not sure what my next move should be. I did chiropractic, ortho, PT and IDD therapy. what else is there? Tony

Q: I have been suffering pain and aches on the left side of my neck , shoulder and some mild impingement on my fingers. Its a dull ache most of the time and it has stop me with my normal activity at the gym. Its very frustrating and the aching sensation seems not to end. I have been taking pain killers , naproxen, dosulupine for nerve pain,. The anti depressant dosulupine seems to be working for 2 months but unfortunately the pain came back and it making my life a misery. Please see report for my cervical Spine MRI Scan. Can you please advice and assist as exercises, stretches and conservative treatment does not seem to be working and physiotherapy as well seems not to be helping. Date of exam: Monday 23 November, 2009 Area imaged: Cervical Spine Contrast -Dose: Radiologist Report History:Pain in both shoulders going down to both hands. Neck pain with headache. Report: The alignment, bone marrow signal and spinal cord appear normal. There are mildly dehydrated disc at C5/6 and C7/T1. There are minor discal bars at C4/5 and C5/6 but thesedo not cause any significant neural compression or spinal canal stenosis. No significant narrowing the neural exit foramina and the vertebral body heights are preserved. The spinalcanal is capacious throughout the cervical spine.Conclusion: No significant disc protrusion or neural compression is evident. No spinal canal stenosis. Thank you, Dan

Q: I am 54 years old and have never experienced any back/sciatic problems before. Eight months ago I experienced acute lower back pain which responded to 800 mg of ibuprofen 3-4 times daily. The localized low back pain subsided in a couple of days; however, since then I have been plagued with "tail bone" pain, left leg/buttock pain, tingling, etc. Nothing seems to help - mornings are the worse, sitting's very uncomfortable, so I do alot of pacing. I don't have medical insurance so I've self-medicated with 3-4 800 mg. of ibuprofen daily and it barely helps. I was able to get a MRI at a discount and am hoping you can give me some insight as to treatment, etc. I will type just the impression: #1) L2/3 and L3/4: Mild disc bulge without stenosis and mild right facet hypertrophy. #2) L4/5: Asymmetric bulge to the left containing a left posterolateral annular tear, slight ligamentum flavum thickening, and mild to moderate bilateral facet hypertrophy. There is mild bilateral lateral recess and mild left neural foraminal stenosis. #3) L5/S1: There is a large broad-based central to left lateral recess disc protrusion which projects 12 mm posteriorly in maximal AP dimension. It abuts the right S1 nerve root sheath origin causing flattening. It abuts, posterior displaces, and completely effaces the left S1 nerve root sheath origin. Thanks in advance for your thoughts. Laura

Q: I hurt my lower back in 2005 deadlifting.Went to see the doc, he took some x rays, told me it was a muscle contraction and gave me meds. He also requested I stop weight training for 2 weeks. I ended u not working out for almost 2 years. then he said it was a pain that I'd have to live with for the rest of my life. I came to grips with it and went back to the gym. everything was good for like 2 years. after I had to move and stopped working out. I have pain shooting down the back of my leg. From the top of my glutes down my harmstring. this pain comes and goes sometimes lasting up to 2 months. Also, the pain switches from the right leg to the left adn it barely happens at the same time. this also causes weakness on the affected leg, which impedes me from walking and getting out of bed sometimes. I finally got an MRI in june 2010. the summary of the study is as is : the study realized shows intervertebral disk presence at the level of L5-S1 and L4-L5 with compromised caliber of the corresponding lateral recesses. it also states theres is a degenerative process that compromises the lumbar intervertebral disks located between L4-L5 and L5-S1, characterized by presenting dehydration ansd those also show to be prominent, compromise the dural sac, decrease the caliber of the lateral recesses on both sides of these levels. the vertebral lumbar bodies and its posterior arcs, present themselves without change in their signal density that suggest inflammatory or tumoral compromise. the signal intensity of the medular cone, and the nervous roots of the equina cauda do not show alterations. my question is what can I do to alleviate the pain in order to maintain somewhat active? Erich

Q: MRI report NOV 17 2007 finding: Straightening of cervical. Alignment otherwise appropriate. Mild disc space narrowing at C 5-6 remainder of disc spaces are maintained. Vertebral body heights are maintained. Cord signal is normal. Cerebellar tonsils are in appropriate location. C3-4 broadbased disc bulge that does not impress on cervical cord lateral aspects of disc bulge extends into neural foramen causing mild bilateral neural foraminal stenosis,right greaer than left. no centra canal stenosis. c4-5 broadbased disc bulge that does not impress on cervical cord lateral aspects of disc bulge extends into neural foramen. No significant neural foraminal. central canal and neural foramen are maintained C5-6 broadbased disc bulge that abuts cervical cord anteriorly.lateral aspects of disc extends into neural foramen causing a mild to moderate degree of bilateral neural foraminal stensis, central canal is maintained C6-7 broadbased disc bulge that does not impress on cervical cord lateral aspects of disc bulge extends into neural foramen bilateral,left greater than right causing moderate left neural foraminal stensis. no central canal or right neural foraminal stensis. had a C5-6 fusion on march 2008. after fusion still had mild and not all the time pin & needles in fingers numbness in hands pain in shoulder areas the doc said this mybe nerve damage thing will get better went back to work things just got worse to the point i could not work they said it was in my head got a new doctor after years of bitching to the doctor a got a mri done they have booked a fusion for C6-7 the big Q is what the difference between the mri and is this connected to the first problem

MRI REPORT june 10 2010 FindingsC3-4 C4-5 levels, no spinal stosis with osteophyes contributing to mild foraminal stenosis bilaterally at these levels C5-6 level demonstrates solid anterior fusion across disc space with no spinal or foraminals stensis C6-7 level demonstrates mild to moderate posterior bar osteophyte formation and minimal thicking to ligamentum flavum -these degenertive changes superimposed upon cervical spinel canal that is developmentally mildly narrow in caliber has produced near complete effacement of csf about cord at yhis level, how ever , with no cord flattening or sigl change. osteophytes produce moderate to marked foraminal stenosis bilaterally at this level. nigel

Comment: I've just discovered your site, read what I believed I needed, then read your "My Story". I figured I'd let you know that I, and I'm sure, many like myself, are grateful for your work on this subject of back pain. It has been a very helpful thing and a great learning experience. Thanks for all you have done for us. Mike

Q: I am a work comp patient with a anterior herniated disc at C3-C4 with indentation on the spinal cord. I have right arm/hand weakness, pain that radiates in my neck, sometimes in my rt. arm and hand if I try to lift anything 5 or more lbs. I used to lift 60 to 80 lbs daily as a vendor. I am depressed, gaining weight and now one of the doctors is trying to say its age related or genetics. I used to unload plants, palms, citrus etc. I don't want to give too much info due to litigation. I haven't ever felt this kind of pain before and I am tough. I was in excellent condition before this. I was told by my primary care doctor that I needed surgery, as well as the work comp. primary care doctor, then sent to a neurosurgeon who said I was old and anyone in there 40's can expect to loose the fluid in their neck and then it will herniate. I don't believe this, and at times have severe pain in my right wrist and numbness tingling at times that will come and go now I am starting to wake up with numbness and tingling in my left hand and arm. Does this mean it is getting worse. My 2nd opinion doctor agreed I need surgery and feels just like my primary care doctors that this is work related and wants to do surgery but they are trying to claim it is degenerative changes. I don't know too many people out there that are females that could keep up with me before my injury. I did manual hard labor, constant bending, lifting over head, pulling objects that weighed over 100 lbs. If this was degenerative tell me how I was able to do my job pain free up until the over head lifting and then a sharp pain and this is where I am at now. They have me going for a IME, I could understand if I wasn't in good shape before or if I was trying to get out of work, but I loved my job!!!! All I want to do is get the surgery or what ever it takes to stop the pain and get back to work. I heard that it is all about the doctor's opinion, so why don't they talk to the doctor that has seen me for years. If I had a prior herniated, bulging or disc issue she would know and really could I have done the hard labor in the heat 5 days a week, I would come home so exhausted and go right back the next day without any issues. I don't have a genetic factor and I don't know what to do any more. How can I make someone believe or am I wrong? I just feel that if it was degenerative that I would have lost it sooner. any advise please and is there any other option for me other then disc fusion with bone and plate? Therapy helped but when they said no more my symptoms came back and they seem to be getting worse. Stacy


Q: I have a disc extrusion at L2, L3 with pain from the top of my right buttock, to my right hip down the front of my right thigh to my knee. The pain is awful and makes it difficult to walk when it is flaring up. I have been on Gabapentin and it helps to dull the pain in my thigh. My thigh is numb all the time and when anything rubs against it or presses on it it feels like pins and needles. Please advise, Surgery or PT? Lisa

Q: Hi, I'm 45 year old female. At 14 I had a laminectomy and fusion of L4-L5 after gymnastics accident. I've had a relatively normal life with bouts of back pain off and on which normally were relieved with medication, rest, and on occasion physical therapy. (Also in 2009 diagnosed with Hurthle cell thyroid cancer - small tumor without vascularization - rt thyroidectomy in Feb) Anyhow, last 6 months back pain more distracting. Constant lower back, hip area, thigh, calf and foot. Almost like hot knives and my calf feels like it is about to cramp. Also muscle weakness upon getting out of chair or after driving. I'm trying to "take it easy," I'm a desk jockey and spend 8 - 10 hours at a computer a day, but the pain seems to be getting worse. My recent MRI "Impression" is as follows: Mild degenerative disc disease at L3-L4 and L4-L5 with wall annular circumferential bulging at L4-L5 with left sided foraminal narrowing and nerve root compression: otherwise normal MRI of lumbar spine. No compression fractures or marrow infiltrative process.

Questions: (1) does this have any possibility of being related to my cancer? (2) will this get worse or can the changes be stopped or reversed? (3) Would you choose a chiropractor or orthopedic person to see after my family MD? I am NOT interested in surgery again and fear that is what an orthopedic SURGEON would say. (4) what should I expect by the way of treatment? If you could translate the MRI Impression into English and/or answer any of my questions I'd sure appreciate it. I've already had my fill of MDs and procedures given the past year. If I can do something at home to try to help myself alleviate the pain I'd like to go that route. Thanks for your time. Pia

Q: I was assaulted last year and have suffered chronic back pain since when standing or walking. A recent MRI scan showed the following result:Small disc bulges are present at C5/6 and C6/7 with moderate left-sided exit foraminal narrowing at C6/7. Non compressive disc bulges are present in the mid and lower thoracic spine. Please advise if this is the likely cause of my pain and is it likely to have been caused by the assault which was particularly violent causing brain injury and Grade 2 AC joint sprain? I also have loss of balance which has improved with neuro-physio but persists first thing in the morning, and I also double vision in the periphery field of vision for which I will see a consultant ophthalmologist in 2 weeks time. Val

Q: central disc herniation at the l4-l5 level with moderate to sever effacement of the thecal sac. central disc protrusion/diffuse disc bulge at l3-l4 with mild to moderate effacement of the thecal sac. also it says under findings.....mild degenerative disc signal l4-l5 and modic type II degenerative signal in the superior endplate of l5. what does all this mean? is it serious? Jerri

Q: I had herniated disc at L4, my MRI report says:Intervertebral disc dessication with fairly large postero-central disc extrusion showing caudal migration is seen at L4-5 level causing compression on the thecal sac. Associated bilateral lateral recess narrowing also seen at this level. MRI findings are suggestive of Lumbar Spondylosis seen as: 1. Straightening of lumbar spine 2. Postero-central disc extrusion with caudal migration at L4-5 level compressing the thecal sac and indenting on bilateral lateral recess. Please advise is conservative methods are possible for this case, if not, then for which surgery I need to go such as Nucleoplasty, Mild Lumbar Discectomy. Please guide. Please also send me your email address so that I can send you my MRI films and report. Sincerely, Manish.

Q: Hello Adam, Thanks for sharing your expertise advise. I met an Auto accident from the back via a truck last year and has severe pain thereafter on neck and lower back.The pain now start going to inner thighs, knee and lower leg. After MRI report of the Lumber spine... Impression report- At the L5-S1 disc level, there is mild decrease in discal height and moderate desiccation of the disc material. The annular tear abuts without significantly deviating or compressing the central left S1 ROOT sleeve and could represent a source of chemical irritation of the left S1 root sleeve. 2. There is mild anterior wedging f the l4 vertebral body and a small limbus vertebrae along the anterior aspect of the superior endplate of L4. THese findings are compatible with remote trauma at the L4 VERTEBRAL BODY LEVEL. There is no evidence for osseous infection. Please advise as why my lower back pain is not going down and how severe is this effect. Should I have to go for surgery to fix this intensive pain which effecting my sleep, standing and playing any sports. Thanks again. Sanjeev

Q: Please help me understand what all this means. L5-S1, there is a small focal posterior disc extrusion which extends into the central aspects of the spinal canal. Disc material extends into the epidual fat but does not cause extrinsic pressure on the thecal sac. There is also no neural foraminal narrowing. Thank You. Christina

Q: small posterior central disc protrusion at c5-c6 level indenting thecal sac. This is my result of my MRI scan. Plz help me out what to do next. The doctor advised for an operation. But am not affordable to do operation now. kindly let me know the natural treatment methods Reegan

Q: I have done my MRI. Report Says:- Straightening of the normal mid lumbar lordosis. Intervertebral disc height loss at L5/S1 with dessication and mild retrolisthesis of L5 on S1. Remaining intervertebral discs of adequate height. L5/S1: Broad based central to left paracentral protrusion measures 26x11x9mm(MLxAPxS1) and compress emerging left S1 nerve root within its lateral recess and also posteriorly displaces the left S2 nerve root within the thecal sac. The protrusion contacts though does not displace the right S1 nerve root within its lateral recess. The above described findings results in moderate central canal stenosis. Neural exit foramina patent. Mild bilateral facet arthropathy. No pre or paravertebral soft tissue abnormality. So my questions are:- 1. What are the alternatives available to me? 2. Is surgery a must in my case? 3. What can be done to avoid the problem? Any exercise required? Thanks and Regards,Tarun

Q: I am having terrible symptoms. I have had headaches for years, almost daily. For this reason,I had a MRI a couple months ago. The results showed I have DDD, a herniated disc at C4-C5 that is pressing on the thecal sac. I have multiple bones spurs at C5-C6 on the thecal sac also. Besides headaches, I have the worst shoulder pain I've ever felt. My arm is tingly all the way to my finger tips. Terrible dull aching pain is constant on the top of my shoulder, like the muscle. My thumb aches and the sides of my wrist....all these symptoms are the the same side of my body, except for my headache pain, which is the opposite side. I have an appointment with a neurologist soon. Any advice? Misty

Q: Trying to figure out what my latest MRI means. I'm an Army Vet. Injured overseas. Have had some back and neck problems ever since. Impression: 1. Inveral worsening of anterolisthesis of L5 on S1, now grade 2, was grade 1, likely related to bilateral L5 spondylosis. There is no spinal stenosis or neural foramina narrowing at this level. 2. Right paracentral disc bulge at L2-L3 causing mild right sided neural foraminal narrowing is unchanged. Mild central disc bulge at L4-L5 ith no spinal canal stenosis or neural forminal narrowing. Seems I still have numbness in my right leg. Severe pain in my back. And still have muscle spasms. I'm on heavy pain meds and don't know what the VA is doing for me. Thanks for the help Sir, Steven

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