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Back Problems Message Board

Back Problems Board Index

Welcome to the board. I would think the issues described in the MRI report are of small consequence. I think your doctors are most likely correct that the back pain you have experienced is due to the body compensating for the injured knee. It tend s to change the gait, throw off the body's alignment which causes changes in posture. This in turn causes different muscles and soft tissue that support the spine to work differently. Sometimes muscles will work hard to "guard" an injured area which can result in changes to the structural alignment.

I like to think of posture as a series of building blocks that begin with the feet. If the feet are not a firm foundation, correctly planted, it can throw the rest of the "blocks" off as you move up the body: ankles, knees, hips, shoulders, head. A pronation in the foot causes the ankles to lean in, which changes the position of the knee, changing the position of the hips. This can cause the pelvis to rotate...and on up the spine....

I trust you know your knee surgery is really needed and isn't an issue with the way you place your feet!

A few quick words about the MRI: the discs are the gelatinous, hockey puck-shaped "shock absorber" that separate the vertebrae of the spine. They, along with the facet joints, which link the vertebrae one to the next, are what allow us to bend and twist and have some movement in the back and neck. They are comprised of over 90% moisture. They are subject to drying out as we age, and stress them as we go about our daily living. It is common to have small bulges in discs as we age. Unfortunately, the aging process in the spine begins in our twenties!

Your discs indicate a small amount of degeneration. There are small bulges at both L4-5 and L5-S1. The one at L5-S1 has a small protrusion that is pressing beyond the disc space and pushing into the side of the thecal sac, which is the tough membrane that contains the cerebrospinal fluid (CSF) and the cauda equina nerves that extend out of the spinal cord. If this were badly indenting the thecal sac, it could create a narrowing of the spinal canal, which could result in nerve compression...and this would or could be a "big deal" but, good news! It is not doing that. It just abuts the thecal sac.

With conservative care to address the disc bulges you should be able to get back to something approaching "normal".

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