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You mention that your symptoms are arm related and do not mention neck pain. This is very good because degenerative disc disease causes both neck pain and arm symptoms. The fact you have no neck pain means this degenerative disc disease should give you no neck trouble other than some stiffness.

In regards to your arm symptoms, it would be unusual to have weakness associated with mild foraminal stenosis. Arm paresthesias (pins and needles) and “numbness” can occur but if foraminal stenosis is present, the symptoms should become more intense with bending the head backwards or to the side of the symptoms. If that is not the case, then have your physician look for something called “thoracic outlet syndrome” or a peripheral nerve entrapment.

Chiropractic for degenerative disc disease works well in general. For nerve irritability, it can work well as long as the nerve is not aggravated. Acupuncture can be effective for temporary relief but generally doesn’t yield long term relief of symptoms. Traction can be effective for significant nerve compression but for your neck will probably not be as effective. The eye twitching most likely was not directly related to the traction. If the numbness in your arm is related to compression of the nerve root or even irritability, an epidural can be effective also.

Without any cord compression, your leg symptoms are not related to your neck.

Dr. Corenman

Just getting an MRI scan for back pain that is “not serious” without other significant symptoms doesn’t make sense. There must be more going on to require an MRI. Is the pain severe? Are you impaired with your activities or work? Do you have weakness or bowel and bladder symptoms? Has the pain persisted for more than three months without relief from physical therapy, chiropractic or medications?

You mention contrast injection with the MRI. Contrast (Gadolinium) enhances blood vessels and is useful if you have had a prior surgery or are suspected of having an inflammatory condition but is normally never used on the first MRI if either of those are not present.

The term “slipped disc” is a poor one for a diagnosis. The disc cannot “slip” as it is firmly attached to the bone of the vertebra. The top vertebra can slip on the bottom one but this is easily seen on an X-ray and can be made more apparent on flexion-extension X-rays. The doctor may think you have a disc herniation.

Ask your doctor why you need an MRI. He will probably be able to give you the indications for this imaging study. Ask why you need contrast also. Make sure the MRI machine is at least 1.5 Tesla strength. There are “open” MRIs that have much lower strength (0.3 Tesla) and many times, the imaging is poor and will need to be repeated.

Dr. Corenman

Your symptoms are consistent with a disc herniation compressing the nerve root. When you bend forward to tie your shoes, you flex your hip. This tensions the sciatic nerve which causes more compression of the nerve root. It does sound like you need a microdiscectomy. There is one study that indicates that patients who undergo surgery performed within six months of the herniation do better than ones who wait. Nonetheless- I think you should be happy with the results of surgery. Could there be some residual symptoms after surgery? Possibly- but don’t hesitate to undergo surgery.

The only worry I have is your lower back pain. Normally, a disc herniation compressing the nerve root will cause buttocks, thigh and leg pain. Lower back pain is generated by the disc or facet. If your percentage of low back pain is equal or greater than your leg pain, low back pain may not completely go away with a microdiscectomy.

Dr. Corenman