Lower Back Pain

[syncmaster]

I hurt my back in 1999 while wrestling. An MRI revealed the following:

Findings: There is a central and left-sided broad based disc protrusion at L4-5. There is a moderate central and left-sided canal narrowing,left lateral recess stenois inferior o the disc space and probable compression of the L5 nerve root. There is moderate facet degeneration at the same level, further narrowing the canal.

At L5-S-1 there is a diffuse disc bulge with facet degeneration. No significant central or foraminal narrowing seen. Minimal degenerative change seen at L1-2, L2-3, and L3-4.

Impression: Broad based central and left-sided disc protusion at L4-5. Mid moderate to moderate severe central and left-sided canal narrowing. Probable compression of the left L5 root as it enters the lateral recess inferior to the disc space.

Doc,
When I hurt my back, I had really bad pain. After about one year, the pain subsided. Based upon what the MRI report stated, can my condition self heal? Although I am not in pain, sometimes I wake up with a stiff back which relaxes after several hours.

Thanks

[CCF-Neuro-M.D.-PW]

I cannot give you a formal clinical diagnosis over the internet, as this site is purely educational.

Disc protrusion in the back can produce a wide variety of symptoms from no symptoms at all to compression of nerve roots and spinal cord. Although I cannot comment on the MRI without seeing the scans, if there is compression of the L5 nerve root, this could cause pain that radiates down the outside of the leg to the foot, possible weakness in the muscles that flex the foot up. It seems fortunate that you do not have these symptoms. Even if these symptoms do occur, they are treated conservatively, and they usually resolve.

I cannot predict if your condition will change. Probably you will continue to have some disc bulges on MRI. Whether these will remain asymptomatic I don't know. If you develop symptoms such as inability to walk, stiffness in both legs or inability to pass urine this may mean that there is some compression of the spinal cord and you should be re-imaged. While this can occur it is realtively uncommon.

Good luck

[gene123]

Hi all,
i had acdf on jan 11,2006 on c5,c6, my problem is that i'm still in pain, neck and neck spasm's, and back pain. i am taking 6 percocet a day and valium. My surgeon said he is surprised i'm not doing better at this point. i told him that is why i'm calling him. also have disc protrusion l4,l5 told me he can't do anything surgical for that and has now refered me to pain management. When i told him about the med's he said that is a heavy dose and that we will talk about this week when i see him. I don't feel i'm ready to go back to work in two weeks, and that i need to get refill on med's i'm worried he will not do this. I am on heating pad 3 times a day. i need to tell him i need at least another two weeks off work. I'm stressing about that. back is always sore, but seems to go in cycles regards amount of pain. the med's i'm on just takes the edge off, should i ask him to try different med's. i have been on these since last august. any suggestiond would help.regards pain meds and time off. Thanks
Gene

[Cinham]

I have had two surgeries for cervical disc fusions - two fused in 2001 and one fused in 2005.  The latest surgery is not fusing after nine months.  I have been wearing a bone growth stimulator for the past six months.  Some days the pain in my neck is almost unbearable.  Other days I hardly notice it at all.  I have also had increased headaches and several migraines a month since surgery.  I have gone to physical therapy twice, taken muscle relaxers, and pain medication when I just can't get any other relief.  I was putting heat on my neck, soaking in a hot tub, and using light/heat therapy.  An orthopedic surgeon told me that if my neck is inflamed, the heat may relieve the pain for a while, but it causes blood flow to increase to the area where heat is being applied.  He said that cold packs are much more effective for inflamation (inflammation).  I have been using cold, instead of heat, for the past week and have noticed a significant difference in how much longer the pain stays away.