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Back Problems Message Board


Back Problems Board Index


Welcome to the board.

The discs are comprised of something like 85% "moisture" and as such, are subject to drying out as we age. This degenerative process is called "dessication." It results in a weakening of the disc, or in some cases, the disc becomes pancaked so that the adjoining vertebrae actually touch.

At the disc located between the lumbar 4 and lumbar 5 vertebrae the disc is reported to be protruding. A disc protrusion is a type of disc herniation --it means the disc contents is protruding out beyond the normal confines of the intervertebral disc.

Think of a water balloon. When you push on one side of it, the displaced water causes there to be a bulge out the other side. This is similar to what happens with the disc. In your case the protrusion is described as small, but it is still pushing into the thecal sac, which is a thick membrane that contains the spinal nerves in the central canal. This puts pressure into the side of the thecal sac, which can result in nerve pain.

At the next level, L5-Sacral 1, the disc is also dessicating. It too is pushing into the thecal sac, "indenting" it. There are some signs of degenerative change located in the facet joints at this level.

The facets are synovial joints that are located at each level and connect one vertebra to the next. They, along with the discs and connecting ligaments are what allow the spine to bend, twist and flex. They are subject to arthritis just like other synovial joints like the ankle, knee, hip, etc. This facet arthropathy is a very common source of lower back pain.

Sometimes the joint enlarges which causes stenosis of the foramen. The foramen are openings through which the spinal nerves pass from the spine out into the body. When the enlarged facet takes up more than its own space, it causes the foramen to narrow...which puts pressure on the spinal nerve. This can result in nerve compression or irritation. All of this is described as "mild" in your report...meaning that it is noticed but it has a long ways to go before it would require a surgical procedure of some type.

The disc at this level is drying out and it has an annular tear as well. This is a tear in the outer circumferance of the disc...which may or may not be causing pain.

Since the described issues are "mild," I would imagine that the spine specialist would recommend treatment with conservative modalities such as a course of physical therapy to strengthen the core and back muscles, oral medication for pain and inflammation and perhaps a series of epidural steroid injections to relieve inflammation and help the tissue to heal.

You will want to be very careful to avoid any activity that involves bending or twisting at the waist, pushing, pulling, reaching up overhead or to the side, and you should not lift more than a small amount of weight...with a herniated disc people are restricted to about 10 pounds until they are healed.

Just to ease your mind...many doctors will look at your MRI and probably say things look pretty good. Radiologists use a series of adjectives that serve as a ranking system: minimal, mild, moderate and severe.

The human spine begins the aging process in our 20s...so most people beyond that age show a bit of "wear and tear" in their spine, especially with the discs and facet joints.

Where do you feel your pain? Do you have pain or numbness in legs or feet?





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