Posted By DTC on May 09, 1999 at 09:23:20
Was involved in an accident approximatley 5 months ago....since then, no unbearable pain just vague tingling without numbness in hands and feet....decided to have an MRI done of neck and lumbar spine. Results are as follows: C-Spine=negative L-Spine=mild central disc bulge at L3-4 and L5-S1 and Marked central to right paracentral bulge at L4-L5. I have unusual feeling (as if someone has put a TENS unit) in my left lower lumbar spine. No really unbearable pain, just occasional tightness in my lower back with no radiation. Went to a neurologist, i basically wasnt impressed with his comments. He told me that bulging discs will stay this way. He also told me that he isnt sure if my discs are causing the unusual "TENS" feeling or if my discs are causing it. I had a neurological exam which came out 100% normal. He was perplexed. He ordered NSAIDS and physical therapy. Okay questions--Do bulging discs ever shrink in size? What type of prognosis do i have? Also, I am 26 year old white male who is in excellent shape and an avid runner. Can i still run? Thanks for your valued and professional answer.
Posted By CCF MD mdf on May 09, 1999 at 12:48:36
Bulging discs are common, though typically more common with increasing age. They are basically a sign of wear and tear. Bulging is not the same as herniated, which implies more extensive injury.
The bulge never really gets put back where it originally was, but there is plenty of the rest of the disc between the vertebrae anyway. There is also a lot of room in the space where the spinal cord and roots live. There is a lot of built-in margin in this system, such that most of go our entire life with gradually more wear and tear but no serious damage to any structures within (specifically the spinal cord and nerve roots). However, pain is pretty common. I see many people who have pain or even sometimes tingling and numbness in certain patterns, whose neurologic exam is normal.
The normal exam does not negate the pain - it just tells the doctor and you that there is no permanent damage.
Good conservative treatment includes NSAIDs and physical therapy - it's what I prescribe most of the time.
Prognosis - for details, you must consult your doctor. It varies all over the map from resolution of pain/tingling to continued chronic pain - but usually people get relief with treatment mentioned.
For advice on whether you can still run, see your doctor. He/she is likely to tell you to avoid impact exercise for a while and then gradually resume, but details must come from the person who has evaluated you.
I hope this helps. CCF MD mdf.
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