Does Nerve impingement mean probable surgery?

[tracy62401]

I am a 43 y.o woman.  Just told yesterday based upon MRI due to severe pain in R hip, buttock and hamstring, that I have a nerve impingement in lumbar L5 which is causing my pain.  I can barely stand on my leg and have trouble with the pain even on NSAIDS.

My "impressions" on the MRI report read:
1. Potential right L5 nerve root impingement within the neural foramen secondary to facet degeneration and foraminal bulging disc.  Asymmetric right sided facet degeneration is seen at this level.
2. mild disc bulging at L4-5
3. Left foraminal and far lateral disc bulging at L3-4.  Correlate clinically for left L3 radiculopathy.

Can anyone please put this into plain english for me?  What is my prognosis probably? Am I probably facing surgery?  How bad should my pain be right now if you can put that into words?

Thank you for your help!!!!

TGF

[Aimc]

Re: above MRI results 11-21-13.
I am a 45 year old woman.

[Aimc]

Hi,

Back pain for 4 weeks.!My symptoms started severe, constant back pain, moving into severe constant cramping and visible spasms upper anterior left thigh, numbness and loss of sensation anterior, medial and lateral from just above knee to ankle.

Little to no relief with anti-inflammatory med, narcotic, muscle relaxer, stretching, and chiro care for 3-4 weeks.

Pain with sitting, standing, walking, using stairs, bending, driving. Pain disrupts sleep.

My job includes: bending, pushing, lifting, pushing, pulling, twisting. I am currently not working as of a week ago.

MRI conclusion:
As of 11-21-13, since previous MRI in May 2013: there is new focal left sided disc extrusion that impinges the exiting left L3 nerve at L3-L4. There is also superimposed broad-based posterior left sided disc protrusion.

Unchanged: right sided disc protrusion at L3-L4 that impinges exiting right L2 nerve.

Unchanged: small left sided disc protrusion at L4-L5 that encroaches the exiting L4 nerve.

I am seeing Pain Mgmt , pending next course of action due to MRI results.

What do you recommend?

Thank you.

[Abhijeet Deshmukh, MD]

Hi.

The vertebrae sit one above the other. They make the spinal column. They come into contact with each other at the facet joint and at the intervertebral disc.

Between the arms of two adjacent vertebrae, there is an intervertebral foramen for the exit of the nerve root.

Your MRI suggests there is disc bulging at the level of Lumbar 4 (L4) and L5 vertebrae. The discs support the vertebral column and act as shock absorbers. If the disc bulges out, the distance between the two vertebrae decreases, pressing the exiting nerve at the foramen.

Radiculopathy is a term used for nerve root problem. You have L4 and L3 radiculopathy which are responsible for your symptoms.

You will need surgery. There are certain non surgical treatments which can be tried first. If they do not work, surgery is the option. Some surgeons prefer surgery as the first option. Prognosis improves with a prompt surgery.

Looking at the MRI picture, your symptoms may fall into the Moderate to severe category.

Please discuss the treatment options with your doctor.

Regards