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Diffuse disc bulge
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Diffuse disc bulge

Hello Doctor,
My husband is suffering from upper back pain. The MRI reports of the spine say:
--Diffuse disc bulge at c5-6 level with mild compression on thecal sac. no nerve root compression.
--Diffuse disc bulge at L5-S1 level with central disc protrusion causing moderate compression on thecal sac and both
   intervertebral foramina. no significant nerve root compression.
--Mild Annular disc bulges at L3-4 and L4-5 levels with mild compression on thecal sac. no nerve root compression.

Is it the cause of pain. the pain is in the upper back right side of the spine a parallel column running.
the collar bones & the right shoulder also pain.

what treatment can be given?

Thank you.
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6 Comments Post a Comment
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Avatar_dr_m_tn
Conservative treatment for his back. Ergonomics is very important from now on, his bed, his chair, his seating positions, and also his foot wear. Change everything to proper ones and also he has to exercise to strengthen his back muscles. For pain he has to take anti inflmaatory drugs occasionally. Hot fomentation of his back will give him relief. Take care!
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Avatar_n_tn
Thank you Dr. Vinod. :)
We will take care of these things.

I had a question:
Can a diffuse disc bulge can cause continuous pain for over a month?
Like we need not fear anything else?

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Avatar_n_tn
And is disc herniation connected to disc bulges? if yes, in what way?
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Avatar_dr_m_tn
Any pressure on your vertebral column bones/spine will give disc bulge and disc herniation. It is related to weight, posture and continuos pressure problems and injuries. The pain is due to the compression of the nerves. You have to understand that there are spinal nerves which supply your arms and legs and most part of your body and with spine problems you have these symptoms. Conservative treatment at this stage is very important. Take care!
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Avatar_f_tn
I had a trauma fall in 2005(50), injurying my  neck, back, and shoulder.  I have had 4 neck surgeries, last surgery Aug 2010 posterior 6 level fusion(metal plate in back) and 1st, 2nd and 3rd resulted in anterior fusions from C3 through C7.  I have significant limited movement in my neck due to a fused neck front and back.  2006 carpel tunnel surgery, 2007 thumb reconstruction, 2008 2nd neck surgery, 2009 3rd neck surgery and Aug 2010 4 neck surgery.
In 2006,(51 years old) I had an MRI of the back and I had advanced mid and lower facet degeneration.  L-3 through S1 Advanced facet arthropathy within a year after my fall.  I had an X-ray in 2000 due to acute onset of muscular back pain which revealed views of lumbosacral spine show moderate advanced focal DDD at T-11-12, but below T12 disk space are well maintained thorught the lumbar spine. I see no acute findings. I see no significant facet joint arthritis.  There is no evidence of spondylolysis or spodylolisthesis.  I was given motrin and quicky recovered.  I have been ambulated for 2 years due to balance issues resulting in 3 subsequent falls. These fall and balance issues all occured before my spinal cord compression in the cervical spine.  I had an MRI of the lumbar spine again in 2009 due to radiating, shocking  leg pain; hip, calves, buttocks, knee front and in back of knee where leg bends, ankle swolling and big toe on the left side.  MRI revealed: Multi level lumbar spondylosis  and DDD Worst at T-10-11 moderate central canal and moderate right neurofpraminal narrowing secondary to diffuse disc bulge with superimposed right paracentral disc extrusion and moderate bilateral facet hypertrophy causing mild central canal  moderate right and mild left neurforminal narrowing.  The posterior right paracentral disc extrusions effaces the right subarticular recess and perhaps impinges the right traversing L4 nerve root.  A recent MRI was done on 7-20-11  L3-L4 Mild diffuse annular bulge indenting the ventral apsect of thecal sac, moderate bilateral facet hyperthrophy, L4-5 moderate diffuse posterior and severe bilatral facet hypertrophu left worst(And that is where I told my Dr. all the pain is at.  I can barely walkor sit for any lenght of time without getting shocking pain in my whole leg down to my feet and numbness in my toes. L5-S1There is a small diffuse posterior bulge that indents the ventral aspect of the thecal sac, moderate to severe biliteral facet hypertrophy without significant central canal stenosis or neuroforaminal narrowing.  What do they mean without significant.  Is that greater than moderate, but not significant.  Impression multi level lumbar spondylosis and facet arthrosis with mild central canl stenois form L2-3 through L4-5.  Diffuse posteior disc buldge from L3-4--L5-S1, mild right L3-4 and bilateral L4-5 neuroforaminal narrowing.  Enhancement in the region of the facet joints reflect active inflammation, facet arthropathy is worst at L4-L5.  Again noted is a posterior diffuse disk bulge at L4-5 and prominent epidural fat.  The conus terminates at terminates at level L1-2 (what does this mean)  No other bone marrow abnormality is identified. What does this mean.
My doctor read the impression and said that I have athritis from old age.  I am 56 years old.  At the time I fell I was 50.  And at the time this whole night mare began I was 46 years old.  I am very depressed.  Should I get a second opinion.  I can not bare to go through any more failed surgeries.  All of my neck surgeries failed.  I have reoccuring bladder infections, no sex drive and images are not accurate when taken on me.  I had severe spinal cord compression which was significantly compressed and it state thecal sac was attenuated and in contact with cord.  My doctor still did not want to do surgery.  I was eating pain med like candy, i could not sleep I was in so much pain and now history is repeating itself with my back.  What should I do.  Please help me.  
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1768519_tn?1313818075
My MRI results for lumbar FINDINGS..... Alignment and bony structures. There  fatty intensity focus at L3 consistent with hemangioma.   Fairly well defined non fatty lesion at T12 to left reaching the end-plate and roughly 17mm in diameter..   Vertebral heights are maintained with intravertebral end plate herniation's T11 through L5...   IMPRESSION.... Disc space narrowing at each level T3 through L3 with intravertebral end plate herniation's and desiccation. T12 lesion does not show fatty features this could be atypical herniation's or a variety of vertebral body lesions. Acet arthropathy  mild at L5 S1.. There are several renal hyperintensities.. T11-12moderate to advance lossof disc hieght with anterior ostephyte and minor disc buldge .. T12-L4 same as above L5-S1 mild facet arthropathy with mild hypertrophy. There are several renal hyperintensities THIS IS JUST THE LUMBAR Cervical reads...straightening of the cervical column with mild anterior osteophytes C3 tru C7 mostly at C5-6 C6-7 C3-4 mild anterior osteophyte and minor uncinate hypertrophy bilaterally  C5-6 narrow disc shallow broad disc/spur complex and slight   uncinate hypertrophy with foraminal narrowing  C6-7 disc space narrowing  minor left central disc/spur complex
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