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Back pain, MRI shows mild diffuse disc bulge, mild narrowing of bilateral recess. Treatment?

Hi, My mothers aged around 56 is suffering from pain in lower back bone and pain in the upper side backbone (near sholders) the MRI report shows the following. Mild diffuse disc bulge at l4-l5 with indentation over thecal sac and causing mild narrowing of bilateral lateral recess/foramen. What is the best treatment she should under go?
Asked On : Sat, 27 Oct 2012
Answers:  2 Views:  458
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Diseases and Conditions
Spine Surgeon 's  Response

Initial treatment for this kind of problem is taking pain medications for few days and physiotherapy. After few days, pain meds should not be taken regularly because of their side effects and physiotherapy should be continued.
A lateral recess stenosis will cause compression on nerves and will in turn lead to leg pain, numbness and in extreme cases weakness. Not sure if your mother has any leg symptoms also or not?
This treatment should cause significant improvement in symptoms. In case of no relief, further treatment is recommended which usually consists of spinal injections or surgery.

Hope this helps,
Dr. Amit Sharma
Answered: Mon, 29 Oct 2012
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General & Family Physician Dr. A K M Wasim Rahman's  Response
Dear Shujaali,
L4 L5 is the Lumbar Vertebra. We have total 33 vertebra.
Cervical: 7 vertebrae (C1–C7)
Thoracic: 12 vertebrae (T1–T12)
Lumbar: 5 vertebrae (L1–L5)
Sacral: 5 (fused) vertebrae (S1–S5)
Coccygeal: 4 (3–5) (fused) vertebrae (Tailbone)
We have 31 left-right pairs of spinal nerves, each roughly corresponding to a segment of the vertebral column:
8 cervical spinal nerve pairs (C1-C8),
12 thoracic pairs (T1-T12),
5 lumbar pairs (L1-L5),
5 sacral pairs (S1-S5),
1 coccygeal pair.
So these nerves come out through the gap(foramen) in our vertebrae.
Now between two vertebrae there is a barrier(disc made of cartilage)
Your report is showing that one of those disc between L4/L5 is bulging and narrowing the space for nerveroot. Still it is in the initial stage and not compressing the nerve significantly.
If left untreated it may progress and compress the nerve which will result severe pain and function loss.
Thus consult a ORTHOPAEDIC SURGEON & PHYSIOTHERAPIST as early as possible.
Have a good health.
Answered: Sun, 28 Oct 2012
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