Disc bulge L3-L4 and L5-S1 level

[santhi804]

i had back pain since three months, last week i went one hospital and they prescribe to take MRI and in the report Diffuse disc bulge causing mild narrowing of bilateral neural formina at L3-L4 and L5-S1 level.

Diffuse disc bulge causing nea total oblitertation of bilateral neural foramina at L4-L5 level.

please suggest

[drpramod]

tab tramadol tab valium 5 tab medrol tab dynapar and complete bed rest required the recovery ll b xpected in next couple of weeks if u sincerly  follow the instruction

[caregiver222]

ggreg has provided an informative and comprehensive explanation of your situation.

The very first thing to do is to avoid heavy lifting and especially inappropriate lifting, which will agravate the situation. Avoid riding in a car without an inflatable cushion under your butt.

The second is to get a referral to a specialist in rehabilitive physical therapy, who, in conjunction with your physician, will give you a protocol to follow that will redsuce pressure on the nerve. Whether or not this is covered by insurance, it will be the best money you have ever spent. Count on several sessions. You cannot learn these exercises from the internet. Muscle relaxants are contraindicated. They decrease muscle tone. Opiates don't work. A TENS device is very helpful to eliminate pain. Ask your physician. Consider surgery only as a last resort.

[Dr. A. Srivastava]

Thank you for your question. Although without being able to examine you I can not offer you the specific advice on diagnosis and treatment that you need, but I would try to provide you some relevant information about your health concern.

In slipped disc or disc prolapse conditions symptoms may originate due to nerve root pressure, pressure on the spinal cord and pressure on the tail bone. Common symptoms could be back pain, paralysis of muscles, pain radiating to the arms or legs, leg pain and numbness, tingling, or weakness. Warning symptoms can include loss of control of the bladder function, numbness & pain at genital areas, paralysis with spasticity of both the legs. In addition, if you are suffering continuous weakness and notice reduced strength of muscle bulk in legs, please arrange an appointment with a neurologist right away. Further referral to a physiotherapist for spinal exercises could be beneficial and may produce relief of symptoms. Hope this helps. Take Care & Stay Healthy!!!

[ggreg]

Drives me crazy when an MRI report is sent directly to the patient and not to a neurologist who can go over the results with you.  Oh, well, what it means is the neural foramina is the nerve opening for the nerves that go from the spinal cord, thru the openings in the vertebral bodies (spinal bone structures), and then onto the rest of the body, which for you would be the legs.

The disk is the cushion part between the vertebral bodies, and sometimes either because of an accident or arthritic aging process, the bones push down on that cushion so hard that it bulges out.  In your case, at the L3-4 and L-5-S-1 level, there has been some narrowing of that opening for the nerves, caused by the bulging disk material.  And at the L4-5 level, there has been a "near total obliteration" of that opening.  That means that the nerves at that level are likely not working at all because disk material has filled that opening.

What this all means is, the nerves that service your body that come thru the L-4-5 vertebrae on both sides (bilaterally) are being choked out completely by a bulging disk, causing those nerves not to work at all, and at the other places in your lower back, there has been a mild narrowing of the space where those nerves go through, probably causing milder symptoms at times.  Symptoms would be pain, weakness, numbness and tingling, that sort of thing.

You need to sit down with a neurosurgeon and discuss the findings of your report.  He will decide whether moderate treatment, rest, medicine, perhaps physical therapy, will make the bulging disks get better, or whether he needs to do some sort of surgery to repair the bulging disks.  I would say that the finding that the nerve openings being completely closed by the bulging disk at L-4-5 is significant.  Could be the doc might want to do surgery to get that disk out of there, as well as repair the other disks, perhaps replace the L-4-5 disk or go for fusion of those bones in your lower back at that spot.  There are also some new techniques where surgery is minimally invasive to repair the disk.  Once they get the several nerve foamina cleared out, especially the one at the L-4-5 level, you should find relief from your back pain.