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Having back pain. MRI showed lumbar disc degeneration with prolapsed intervertebral disc. Prognosis?

DOCTOR OF THE MONTH - Feb 2014
Feb 2014
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Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5931 Questions
Question
Hi. I got an MRI done pursuant to lower back pain. It was less intensity earlier, and suddenly on bending forward to wash my face I felt sharp pain. THe MRI report says:

OPINION

MR Findings suggestive of spondylotic and disc degenerative disease with minial retrolisthesis of L5 over S1 vertebra with:
- Mild diffuse disc bulge with mild broad based posterior disc protrusion at L4-L5 level
- Diffuse disc bulge with moderate broad based posterior protrusion at L5-S1 level

DETAILS

1 Straightening of the lumbar lordotic curvature with minial retrolisthesis of L5 over S1 vertebra

2. Evidence of prominent marginal osteophytes at multiple levels.
3. Vertebral bodies are otherwise normal in size, shape and signal intensity

4. Degenerative disc desiccation is noted at multiple levels
5. Mild diffuse disc bulge with mild broad posterior disc protrusion at L4-L5 level effacing the ventral epidural fat plane and mild impression on ventral nerve roots and encroaching upon inferior aspect of bilateral neural foramina with consequential compressive radiculopathy
6. diffuse disc bulge with moderate broad based posterior protrusion at L5-S1 level, compressing the ventral thecal sac attenuating lateral recess and neural foramina with consequential compressive radiculopathy
7. no significant disc bulge/protrusion is noted at any other level
8. primary bony canal is adequate with no evidence of stenosis. lower dorsal cord and conus medullaris are normal. Thecal sac shows a normal CSF signal intesity. No significant intraspinal mass or pre/paravertebral collection is seen.
9. both sacroiliac joints are normal
Posted Tue, 26 Mar 2013 in Back Pain
 
 
Answered by Dr. Saurabh Gupta 51 minutes later
Hi and welcome to XXXXXXX
Thanks for posting your query.

I understand you have back pain . Your MRI reports are suggestive of lumbar disc degeneration with prolapsed intervertebral disc( PIVD) where the nerves get compressed by the protruded disc.

There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.

The medications will relieve pain and help muscles to relax. Physiotherapy shall also help a lot, especially exercises that strengthen your back. I would suggest you to try swimming as this will help most in back conditions. Adequate rest and proper nutrition is equally important. Drink lots of fluids since dehydration affects the disc.

I advice you to follow these measures-
• Lie on a hard bed.
• Anti -inflammatory drugs like Tablet ibuprofen 1 tablet as and when required
• Avoid forward bending.
• Avoid strenuous activity & lifting heavy weights.
• Apply diclofenac gel on the affected area. Warm compresses will also help.If you dont get better with these treatment , surgery is a good option, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms.

Hope this will help you. Please do write back if you have any additional concerns.

Wishing you good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
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