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  • d.aaron
    Member
    Post count: 4

    I just had an MRI yesterday and the results showed “mild disc bulging and an area of mild to moderate pinching of the nerve [for my] left leg”. Is this indicative of a herniated disc, where the disc is bulging and impinging on my nerves?

    Would you also suggest obtaining a copy of the MRI images for myself? I can do so, and get them on a CD.

    My question is, with conservative therapies such as simple stretching as has been suggested, will the bulging disc repair itself? Will that prevent future flare-ups of major back pain? So far I’ve had 4 episodes in the past 3 months, this latest resulting in 2 weeks of missed work, dr. note and 3 different medications to control the issue.

    All I want to know is if this can get better more or less on it’s own as my provider (KP) suggests, or am I in for a lifetime of repeated episodes and pain?

    Your thoughts are appreciated.

    ~David – severely frustrated with these repeated episodes and time lost at work.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    “Mild disc bulging and an area of mild to moderate pinching of the nerve [for my] left leg” is a very unusual reading by a radiologist. Nerves become “compressed” and not “pinched”. A mild bulge will not compress a nerve. If there was a herniated disc, the radiologist should have noted this. Was this truly a board certified radiologist?

    Always obtain your own images on a CD and get two copies in case you need to send them off for a second opinion.

    Discs do not repair themselves. See anatomy of the lumbar spine and herniated discs on this website to understand the problem.

    You can improve over time with physical therapy and epidural steroid injections. After three months with little improvement however, consideration of surgery should be made if a microdiscectomy is the solution (as long as the pain is mainly in your buttocks and leg-not your back).

    Dr. Corenman

    d.aaron
    Member
    Post count: 4

    Regarding the reading, that was how my PCP conveyed the results to me. All I can say is I hope the radiologist running the MRI and interpreting the results was board certified…

    Since I have been dealing with back pain radiating to my legs with reported tingling, numbness and severe flare-ups like the one I am just getting to the other side of ( muscle spasms bad enough to make me cry out / scream in pain ), it sounds like from what you are saying is best to get an out of network ( away from my provider ) 2nd opinion. I’m working on getting the MRI results from them.

    They have a history of this issue going back to late 2008, and still harp on keeping with a conservative approach which so far has not had any longer term curative effect as i keep winding up throwing my back out at some point, from doilng little things like washing my hands; turning to pick up a bottle of shampoo in the shower etc.

    Thanks for your reply & advice. Any further advice eg how to get the provider past the conservative approach they seem stuck on would also be appreciated, but I understand if this a place you can’t go.

    ~Dave

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    For the life of me, I just don’t understand what the reluctance is for some family docs to refer to an up-to-date spine surgeon. Spine surgery now is generally safe and very effective, especially for surgery to remove a disc herniation. My success rate and satisfaction rate is higher for this surgery than my well esteemed partners for their scope procedures but there still is reluctance by some general practitioners to refer for this surgery. Maybe reluctance developed from the nightmares that occurred thirty years ago with non-specialized surgeons who would not understand the procedures or had poor results.

    Print out and show him or her this email. I would be happy to talk with them personally. Have them call 970 476-1100.

    Dr. Corenman

    d.aaron
    Member
    Post count: 4

    Thanks for your reply. I have my own ideas as to why Kaiser Permanente continues on their wholly conservative (a.k.a. least expensive to their for-profit company) approach, but I won’t go into that on your forum – it’s not the right venue for that methinks.

    Thanks for the suggestion, I will take it under advisement.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Ah- Kaiser. That explains the reluctance to refer. Kaiser is somewhat like the British Nation Health Service or the Canadian Health Service. Medical care is expensive and rationed.

    The best way to reduce costs if you manage the organization is to prevent referrals to an expensive specialist. With Kaiser, I have seen referrals if you complain hard enough. The squeaky wheel gets the grease! Good luck.

    Dr. Corenman

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