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Can anyone help provide insight into my recurring back / sciatic pain & MRI Results?

I originally had a bulging disk at L4-L5 at age 15. I completed PT, it bothered me for a bit again at 18, then was practically fine (with a little nagging here and there) for 10 years.

About 8 months ago the pain came back worse than ever. I got an MRI, I've been through two rounds of cortisone injections and physical therapy, which helped up until a month ago. I just started acupuncture, am seeing a chiropractor this week and will be starting up PT again. However, I think at this point it would be helpful for me to understand what exactly these MRI Results mean...

Impression:
At L4-L5 there is a bulging disc with a left paracentral disc protrusion and degenerative facet changes causing mild spinal canal stenosis with narrowing of the lateral recesses, worse on the left. Impingement of the traversing left L5 nerve root. Mild bilateral foramina stenosis is also noted.
2. At L5-S1 there is a small right foramina extra foramina disc protrusion with degenerative facet changes causing mild narrowing of the right lateral recess and mild right foramina stenosis.

I was told that the bulging disc at L4-L5 is what's causing my sciatic pain (through my glutes and down to my calf) but there seems to be a lot more going on - and I'd like to be able to better understand these MRI results so that I can take the appropriate routes to care.

Any help is greatly appreciated.

Thank you!
1 Responses
Avatar universal
I recieved a very similar not result at 22. I'm 33 now, I've tried physically therapy, epidural injection, nerve ablation s, and 3 years of pain meds. My father is a physical medicine and rehab doctor, so I've been well versed in medical terms. Pretty much, you have hernatiated discs that a bulging out. Visualize a disc, as a jelly donut. When you hernatiate or have disc protrusions, imagine the jelly is coming out of the donut pressing on nerves. Stenonis and degenerative refer to injuries that are progressive and incurable. Your spine will continue to marrow and you will not have adequate support for your spine. I was diagnosed at 22 with degenerative disc disease and similar mri findings. Unfortunately for me, i will suffer from chronic pain for the rest of my life. Its been 7 years since I considered returning for help. I've been told, you will have pain the rest of your life, and you should come to terms with that.
Some people are considering surgical canidates. Because of my young age, know one is willing.
Some people find relief through epidural, steroid, nerve ablations, and physically therapy. I have not.
I plan to return to pain management, and be put on pain meds despite how that my make me look to others. My quality of life. Insomnia, and depression have become too much to bear.
I assume some doctor ordered the mri.and the should have explained it. My right leg had nerve damage at 22, I cant imagine what it is now.
If you have not seen a physiatrist (physical medicine and rehabilitation) thats were you should go first. They should run a test called an emg...electromyagraphy. This is a test send electric impulses through you leg to check nerve activity. They can prescribe physical therapy.
If they believe you are a canidate for surgery, you will be referred to an othopedist.
You may be referred, or can take your mri to a pain management specialist. They offer procedures and meds, if pain is a significant issue for you.

Good luck! I advise you seek treatment immediately, and continue to seek help of symptoms persist and worsen over the years.
Take it from me, I've be untreated for 7 years, thinking I could do it all on my own, and I'm suffering the consequences and about to restart the entire process.
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