Bulging disc between L4 and L5

///Bulging disc between L4 and L5
Bulging disc between L4 and L5
Viewing 6 posts - 1 through 6 (of 12 total)
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  • AvatarWeldon
    Participant
    Post count: 6

    I have experienced the SI joint slipping out of alignment five times over 18 months. Three times in the last five weeks of which the last time the pain was excruciating. My neighbor is a PT, PhD at an out-patient clinic attached to a hospital and is helping me with an exercise program. After several days of the last instance, he and my P.A. suggested an MRI, which I had a week ago.

    Here are the results,
    Exam: Xray lumbar spine minimum four views (72110)
    History: Sciatica
    Technique: 5 views of the spine
    Comparison: None
    Findings: There is no fracture or aggressive lesion. There is a trace degenerative anterolisthesis at L4-5. There is moderate lower lumbar degenerative disc disease and facet arthropathy. There is no soft tissue abnormality.
    Impression: No acute osseous abnormality. Moderate lower lumbar spondylosis.

    I am 71 years old and been active all my life. After two weeks and diligent exercising, I still have pain in my upper left glute, sometimes down the outside left thigh and then to the lower part of my left shin to the ankle (like shin splints). Pain level is about a 3-4 when not hurting too much but is 6-7 when really aching. It is affecting my gait and sometimes I can barely walk. Hard to sleep and lucky to get 4-5 hours per night. The pain percentage varies between 70 – 30%, thigh to ankle but sometimes flips to more ankle than glute.

    I am from southern Arkansas and both neurosurgeons I know have retired and moved. My questions is: Can this be improved by exercise with the PT supervision or might I need some type of surgical intervention?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6840

    The most common disorder that causes pain in the sacroiliac joint is a nerve compression syndrome like a disc herniation or a foraminal collapse. See https://neckandback.com/conditions/herniated-disc-lumbar-spine/ and https://neckandback.com/conditions/lumbar-foraminal-stenosis-collapse/.

    The x-ray is a good test for alignment and stability but will not give information regarding nerve compression. You would need an MRI for that. Once the disorder is diagnosed, surgery is only one of the treatments for these disorders.

    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.
    AvatarWeldon
    Participant
    Post count: 6

    Dr. Corenman,
    Thank you for the fast response. I had the Xray 30 days ago and the report was “You have some arthritis in the lumbar area.” After further problems arose, I had an MRI August 2nd. My post included the only results from the one page result. From researching the MRI medical terms in the report through your website and a couple of others, it appears that my problem is related to arthritis and aging.

    I hope that I can mitigate further damage and maybe make improvements with diligent physical therapy. If this were you, would you try that options first? In addition, I read on your site about nerve damage and its symptoms. Last night and this morning,I started to get numbness in the tip of my left big toe, which was a symptom pointed out on the site.
    Thanks for you help and for your efforts in helping others!
    Weldon

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6840

    If you have no motor weakness (https://neckandback.com/conditions/home-testing-for-leg-weakness/) then you can continue with PT and hopefully gain some relief.

    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.
    AvatarWeldon
    Participant
    Post count: 6

    Dr. Corenman,

    Again, thank you for your help, especially over a weekend. You have a passion for helping people!

    I read through the link on leg weakness twice. My first thought is that the problem is the L5 Nerve Root. That is because I had noticed I could not control my toes on the left foot from “slapping” the ground as soon as my heel hit. This seemed to match your “foot drop” description. So, I tried to do the “duck walk” and could not keep my toes from hitting the ground. Would this mean that I may need more than PT? Should I share this home test with my PT?
    Thanks you again for the help!
    Weldon

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6840

    You have weakness of the tibialis anterior muscle, probably a direct result of compression of the L5 nerve root. In my opinion, you need an MRI and surgery if the MRI notes a herniated disc causing compression of the nerve root. The nerve may not recover if you wait. See https://neckandback.com/conditions/how-muscles-recover-from-nerve-injuries/

    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.
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