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MRI of back pain showed annular fissure and foraminal stenosis. What can be done?

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I received an MRI for a Five month back pain.....shows broad based posterior disk bulge with a central disc protrusion containing small annular fissure intervertebral disk bulge in close proximity to exiting L5 nerve root. No evidence of foraminal stenosis.....I am curious if this could be the cause of my pain ...I have had two bouts of PT and am considering a third, will sitting exasperate this condition? What is average recovery time?
Posted Wed, 3 Jul 2013 in General Health
Answered by Dr. Michelle Gibson James 52 minutes later
Hi, thanks for using healthcare magic

The above results would definitely contribute to any back pain that you may be experiencing.

There are discs between each of the vertebra.
These discs are composed of an outside ring called the annulos fibrosis and an inner aspect called the nucleus pulposus.
The annulus functions to distribute the pressure and force on the bones and provide strength.
The nucleus functions to carry the body's load and receive any shocks associated with walking, running, jumping etc

The ability of the nucleus to retain water decreases with age and it starts to deteriorate.
Due to decrease in stiffness of the disc the annulus starts to bulge resulting in decrease space between the vertebra.

These discs have nerves and blood vessels at their edge that contribute to the pain.
In addition the deterioration of your disc and the loss of space may mean that there is increase pressure now being placed on another part of the vertebra.

The foramin is the space that the spinal cord passes through, they state that it appears normal, no narrowing (stenosis).

Physiotherapy is recommended and you can consider another round.

Surgery is only considered only if there is weakness , loss or disturbance in sensation.

The disc may or may not return completely to normal though some correct with time, but the exercises are important in maintaining mobility and reducing discomfort and disability.
It can sometimes take 6 mths to 1 yr of therapy for improvements.

the use of pain medication and muscle relaxants may be helpful.

I hope this helps, feel free to ask any other questions
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Follow-up: MRI of back pain showed annular fissure and foraminal stenosis. What can be done? 25 hours later
Thank ou so much. Would extended sitting exasperate this diagnosis? I AMA bookkeeper and have been unable to sit or twist without pain. If it doesn't recover am I at risk for rupture or is this already a rupture or herniation? Thank you so much
Answered by Dr. Michelle Gibson James 6 hours later

At this point , there is no rupture , there is a tear in the annulus (the outer ring) with bulging of the disc (mild herniation). Herniation is a protrusion via a space the disc is bulging slightly out of its space.

Extended sitting or standing may aggravate the pain that you feel but would not necessarily worsen the rupture

There can be resorption of the disc back into the space however as mentioned it can take a long time. If physiotherapy is continued it is unlikely that it would progress but would take time to improve.

Please feel free to ask any other questions
Above answer was peer-reviewed by
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