Back Problems

I am a 22 year old male with cronic (chronic) back problems.


At L1-2 There is no singnificant spondyloarthropathy.

At L2-3 there is mild degenerative disk disease. there is no central bony canal of foraminal stenosis.

At L3-4 there is a mild facet arthropathy. The central bony aand neural foramina are patent.

At L4-5 there is a circumferential disk buldg superimposed on a mild to moderate facet arthropathy. There is a mild to moderate degree of bilateral subarticular recess stenosis with potential compromise of the traversing L5 nerve roots. The central bony canal and neural foraminal stenosis.

At L5 - S1 there is no significant cenral canal or foraminal stenosis.

I need help figureing out what all this means. i think my Military doctor is giving me the run around and dont want to actually help me.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you too much more other than I know you have low back pain, which may or may not be related to your MRI findings. However I will try to provide you with some useful information.

The most obvious lesion on your MRI is likely at L4/5. Compression of the L5 nerve at this site may cause symptoms of pain in the lateral part of the calf that extends over into the big toe. You may have weakness of the lifting your ankle to the ceiling and perhaps inverting your ankle. In most people, the pain of a herniated disk (i.e., disc bulge) resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people ever require surgery. (Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain). With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.

However, if your pain is local (i.e., at the back only), it may be a result of irritation of or damage to structures of the spine (e.g., periosteum, ligament, dura, and joints).  The pain is usually exacerbated by activities that cause these structures to have increased pressure load (e.g., prolonged sitting or walking up steps). Prolonged irritation of these joints can cause muscle spasm described as a diffuse, burning pain.

One means of assessing whether or not you have nerve compression/damage is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers. It would be best for you to discuss this with your physician.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.