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  • help
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    Post count: 4

    HELLO DOCTOR ,I M FACING SEVER BACK PROBLEMS FROM ALMOST 30-35DAYS N THE PAIN GOES DONE TO MY LEGS,ESPECIALLY MY LEFT LEG,I VISITED DOCTORS WHO HAVE TOLD ME TO REST AND GIVEN SUM PAIN KILLERS ,I GOT MY MRI DONE THE STUDY REVELS THE FOLLOWING:
    1)BROAD BASED POSTERIOR DISC BULGE WITH POSTEROCENTRAL DISC EXTRUSION IS SEEN AT L4-L5 level causing severe lumbar canal stenosis with indentation upon the bilateral budding L5 nerve roots.
    2)The T11-T12 INTERVERTEBRAL DISC IS REDUCED IN HEIGHT AND EXHIBITS DIFFUSE POSTERIOR BULGE WITH LEFT POSTERO LATERAL DISC HERNIATION WITHOUT ANY NERVE ROOT COMPRESSION.
    3)MILD POSTERIOR DISC BULGE IS SENN AT L1-L2 LEVEL WITHOU ANY NERVE ROOT COMPARESSION.
    4)MILD OLD WEDGING OF T11&T12 VERTEBRAL BODIES IS SEEN…

    PLEASE EXPLAIN ME EACH POINTS ABOVE…AND SLOUTION FOR THE SAME…

    DOCTOR I m 28yrs old FROM LAST 2MONTHS MY CAREER IS ON FULL STOP,,,MY Back PAIN IS LESS AS DOCTOR TOLD ME THE INTENSITY OF THE PAIN IS LESS N NERVES R FUNCTIONING FINE but pain is coming n goin,,HE SHOWED ME THT L4-L5 DISC IS BECOME FULL BLACK N PRESSIN THE NERVE,,HE HAS GIVEN ME PAIN KILLER MEDICINES,,how can I make my spine more strong,,,I WANT YOUR HELP AND ADVICE HOW I CN BE FIT N FINE,,WHT PRECAUTIONS SHOULD I TAKE,,HOW CAN I FIGHT WITH THIS PROBLEM N GET INTO MY NORMAL ROUTINE,,NOW M TAKIN MEDICINES SUCH AS PAIN KILLER N HIGH ON CALCIUM MEDICINE..LAST 3-4 DAYS EVEN MY NECK N SHOULDERS R ALSO PAININ WHICH WAS NOT THER BEFORE…WHAT MEASURES SHOULD I TAKE AS I HVE GR8 SUPPORT FROM MY FAMILY,SO PLEASE LET ME KNOW I WIL BE VERY THANK FULL TO YOU..DOCTOR I ASLO WANT TO KNOW HOW TO AVOID THE BULGING OF OTHER DISC….AWAITING FOR YOUR REPLY…THANK YOU…………

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Thank you for your information. You describe your MRI well but do not describe your symptoms with enough detail. “Severe back problems” and pain in both legs needs to be further explored. First, do you have any motor weakness in your legs or bowel/bladder changes? Is the pain worse in your lower back or in your legs? What is the ratio? Is it 50/50, 60/40, 70/30 or the reverse (legs more painful than lower back) 30/70 etc. What makes the pain worse? Is the pain worse with walking and standing or increased with sitting, bending or????

    The herniation in your lower back according to the report is significant. “Severe lumbar canal stenosis” generally means a very large herniation causing significant compression. Generally, these very large herniations can be associated with motor weakness or cauda equina syndrome (see website). If either of these are present, in my opinion, decompression surgery needs to be performed.

    If the pain is significant and you cannot ambulate, again, surgery would be recommended to gain the fastest recovery.

    The T11-L1 degeneration/deformity is probably old Scheuermann’s disease and has been present for quite a while. Most likely, this is not causing the current symptoms.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    help
    Member
    Post count: 4

    Hello doctor,Thanks for your previous reply..
    SYMTOMS ARE AS FOLLOWS:LOWER BACK PAIN IS MORE THAN LEGS (RATIO LOWER BACK TO LEG IS 85:15),FEEL SENSATION IS PERFECTLY FINE IN MY LEGS,NO BLADDER CHANGE,NO MOTOR WEAKNESS (KINDLY ONCE AGAIN CLARIFY THE MEANING OF MOTOR WEAKNESS),AS I M THIS DAYS ABLE TO MOVE N WALK QUITE A GOOD DISTANCE..ITS JUST THAT THE PAIN COMES N GOES IN WEEKS TIME ..
    PAIN USUALY HAPPENS WHILE SITTING AND THIS DAYS TOSUM EXTENT WHILE SLEEPIN ON MY BACK,
    dOCTOR I WAS ALSO FEELIN PAIN IN MY UPPER BACK JUST BEHIND THE CHEST ON LEFT SIDE USUALY.
    I RECENTLY AGAIN WAS ADVICED TO DO X RAY FOR LUMBAR SACRAL SPINE AP & LAT
    AND ALSO DORSO LUMBAR SPINE AT& LAT ON 29TH SEPT.AS I HAD GONE TO NEW DOCTOR AS ALL OF THE SUDDEN THE PAIN HAD INCREASED.
    REPORTS SAYS:ALL NORMAL EXCEPT PARTIAL COLLAPSE OF D12 VERTEBRAE.
    SO KINDLY LET ME KNOW IS MY BACK SHOWIN IMPROVEMENT AS NOTHING RELATED TO L4-L5 DISC WAS MENTIONED.
    ALSO LET ME KNOW WHT MEASURES SHOULD I TAKE WHICH WIL HELP ME TO RECOVER QUICK,
    DOCTOR MY WEIGHT IS 100KGS N I M AWARE THT I HAVE TO REDUCE THE SAME.
    ALSO WANTED TO KNOW WHEATER YOGA N WALKS WILL BE HELPFULL.
    DOCTOR YOU HAD EARLY MENTIONED ABOUT SUM OLD SCHEURMANNS DISEASE WHT IS THAT EXACTLY AND HOW DOES IT OCCUR AND WHAT IS THE TREATMENT FOR THE SAME AS NONE OF MY REPORTS HAD MENTIONED THIS WORD ANY WHER.

    KINDLY REPLY.

    THANKS :)

    help
    Member
    Post count: 4

    doctor the pain these days is more on right side it keeps moving from centre to left -right but no pain in the right leg when the pain is on the right side and when the pain is on the left side its mild pain in left leg when i get up from my bed,this pain in left leg is from quite long time before this back problem was detected and it use to happen only when in the morning i use to get up from the bed n use to go away in few seconds its jus these days i happens whn pain is on the left side of my back…PAIN IS MORE ONLY WHILE SITTING.DOCTOR I WOULD LIKE TO AVOID OPERATION SO WHAT MEASURES SHOULD I TAKE AS I HAVE GOT FEEDBACK THAT SPINE OPERATIONS ARE DANGEROUS AND CAN HAVE ADVERSE EFFECT IN LATER STAGE OF LIFE AND ARE NOT SUCCESFUL MANYTIMES.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Most of your pain is lower back in origin. You have very little leg pain and no weakness or bowel/bladder involvement. It sounds like that if your lower back pain improves, your overall picture will improve.

    X-rays being reported as “normal” in the lumbar spine are obviously incorrect as you have a previously reported large herniation of the L4-5 disc. The x-ray probably has subtle signs of changes (narrowing of the L4-5 disc) and X-rays will not identify a herniation.

    Sitting pain that improves with standing is the most common identifying symptom factor in most disc herniations. However, most pain generated from a lumbar herniation is extremity or leg pain as the nerve root compression is the most painful problem. Your problem with majority lower back pain from a disc herniation is not typical. None the less, epidural injections along with a good physical therapy program is the initial treatment recommendation. If you fail that program, a surgical discussion would be called for.

    The fact that most pain is lower back and not leg pain makes a surgical decision somewhat more difficult. Most patients with majority lower back pain that have failed conservative measures should be worked up to look for a fusion possibility. However, according to your report, you have a massive disc herniation filling the spinal canal. Based upon your complaints and the large disc herniation, a simple microdiscectomy has a greater than 50% chance of relieving a reasonable portion of your back pain. If you do fail a simple decompression, a fusion discussion can still be on the table.

    You do not need to look for a surgical discussion if you have no inclination for surgery as it sound like you have pain but no neurological compromise.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    help
    Member
    Post count: 4

    Hello Doctor,

    This conversation is in regards to my back problem which had aroused 2 years back.
    Doctor on 16th of Sept 2013,i was feeling back pain and it was this time in thoraic region so i was advised to do MRI report which i did again after 2 years,Request you to read my previous conversation which has the details of my previous MRI along with this time MRI.

    I was suggested to do Lumbo Sacral Spine with screening of whole spine and observations are as follows:
    1)Mild Loss of Lumbar Lordosis.(Request you to explain the cause and measurements to improve).

    2)L4-L5 disc is dessicated slightly reduced in height and exhibits diffuse posterior disc bulge ,abutting the thecal sac and bilateral traversing L5 nerve roots.Encroachment of bilateral neural foramina is noted without significant nerve root compression.

    3)T11-T12 disc is mildly dessicated ,reduced in height and exhibits mild diffuse posterior bulge without significant thecal sac or nerve root compression.

    4)L1-L2 mildly dessicated ,reduced in height and exhibits diffuse posterior bulge with extrusion of the disc material migrating right paracentrally and superior upto the lower 1/3rd of the L1 vertebral body and indenting the thecal sac.(Please Explain as last time it was not mentioned in detailed manner).

    5)Screening of the cervical spine reveals :Loss of Cervical Lordosis.No other significant abnormality is seen.

    Screening of dorsal spine does not reveal any significant abnormality.

    Symptoms :

    Back Pain upper and lower,by god grace i think its much much lesser than which was 2 years back also less leg pain as i had taken a break from my work.

    I wanted to ask you what should i do to improve my health.If u can suggest any excerise for the above mentioned problems which can actually improve my health.Can my spine become normal like it never had any problem like before.

    Precautions which i should take care during my life cycle so that the problem does not worsen.

    Awaiting for your reply.

    Thank you!!!

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