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What Does My MRI Scan Test Report Indicate?
Question: 59 yr old male, 5'9" ,160lbs, active. MRI results: Lg left posterolateral disc protrusion L3L4 with significant neural foraminal encroachment on lft. protrusion aprox 1 cm beyond vertebral body margine, mild facet joint changes. L4L5 minimal bilateral neural formainal encroachment. L5S1 marked disc height loss no evidence of stenosis or encroachment. what type of treatment do you suggest?
Brief Answer:
Treatment should be guided by symptoms severity and duration.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
MRI findings are more consistent with degenative and herniated disc disease of the lumbar column.
There is left foraminal encroachment at L3/L4 level with probable nerve compression.
If the disc protruding at this level is located posterior (or towards spinal cord) then there is stenosis at this level.
If the disc is protruded anterior, it is not cause of concern.
Other changes seem to be minimal with slight effects on neural structures, however, treatment in such case is guided by symptoms too, besides imaging studies findings.
There is need also for correlation between MRI findings and neurologic symptoms distribution such pain and sensory changes distribution, group muscles affected, if any.
If mild symptoms ( pain, pins and needles ) and no other issues such difficulty walking, or standing for a long time, treatment should be conservative.
In such case treatment consists on few days rest, avoiding lifting weights, avoiding excessive bending over, NSAID drugs, or painkillers and physical therapy with the aim of strengthening back muscles, reducing joint loading.
If moderate to severe pain, difficulty in everyday activities, symptoms persistent more than two months, surgery should be considered.
Hope you found the answer helpful.
Let me know if I can assist you further.
Take care.
Treatment should be guided by symptoms severity and duration.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
MRI findings are more consistent with degenative and herniated disc disease of the lumbar column.
There is left foraminal encroachment at L3/L4 level with probable nerve compression.
If the disc protruding at this level is located posterior (or towards spinal cord) then there is stenosis at this level.
If the disc is protruded anterior, it is not cause of concern.
Other changes seem to be minimal with slight effects on neural structures, however, treatment in such case is guided by symptoms too, besides imaging studies findings.
There is need also for correlation between MRI findings and neurologic symptoms distribution such pain and sensory changes distribution, group muscles affected, if any.
If mild symptoms ( pain, pins and needles ) and no other issues such difficulty walking, or standing for a long time, treatment should be conservative.
In such case treatment consists on few days rest, avoiding lifting weights, avoiding excessive bending over, NSAID drugs, or painkillers and physical therapy with the aim of strengthening back muscles, reducing joint loading.
If moderate to severe pain, difficulty in everyday activities, symptoms persistent more than two months, surgery should be considered.
Hope you found the answer helpful.
Let me know if I can assist you further.
Take care.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
DEFINITE COMPRESSION OF NERVE, CONSTENT PAIN LOW BACK, LEFT BUTTOCKS, HIP, FRONT OF THIGH, AROUND TO GROIN, TO KNEE. BEFORE HAVING THE EPIDERAL INJ I WASN'T ABLE TO WALK MORE THAN A FEW STEPS UNTIL THE PAIN CAUSED MY KNEE TO FEEL LIKE IT WAS GOING TO EXPLODE. THE INJECTION HAS HELPED GREATLY, I'M ABLE TO WALK WITHOUT INCREASING PAIN, STILL CAN'T SIT WITHOUT PAIN IN LOW BACK AND BUTTOCKS. NIGHT TIME PAIN STILL GETS STRONG IN HIP AREA, IT SEEMS TO COME IN WAVES RATHER THAN CONSTENT. THE BEGINING SYMPTOMS CAME ON GRADUALLY BECOMING SEVER AFTER A COUPLE WEEKS. I AM A TRUCK DRIVER HAULING HEAVY EQUIPMENT, SITTING LONG PERIODS, LIFTING 30 LB CHAINS FREQUENTLY. HAD THE SAME PROBLEM A YEAR AGO AND NEVER COMPLETELY RECOVERED.
Brief Answer:
Injections could be repeated.
Detailed Answer:
Welcome back.
First of all, you should avoid lifting weights.
Since the epidural injections helped, they can be used two more times within a time period of one month from another.
You can use lumbar brace support for a couple of weeks and, since pain improved, you should have physical therapy done.
All these issues should be discussed with your treating Doctor.
Hope I helped you.
Best regards.
Injections could be repeated.
Detailed Answer:
Welcome back.
First of all, you should avoid lifting weights.
Since the epidural injections helped, they can be used two more times within a time period of one month from another.
You can use lumbar brace support for a couple of weeks and, since pain improved, you should have physical therapy done.
All these issues should be discussed with your treating Doctor.
Hope I helped you.
Best regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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