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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Back Injury. X-ray Showed Facet Joint Syndrome. MRI Shows Dessication Of Invertebral Discs. Psychological Pain?

Hi! I am a 38 year old female. I had a back injury in 2003 at the L5 and L4. I have had pain in my lower back and right leg ever since. This January I was finally able to get a doctor to take me seriously. An xray showed Facet Joint Syndrome at the L5 level. My Physio Therapist “pulled” on my right leg and it finally feels like it is the same length as the left. She has stated that part of my right hip and L5 that were injured were directly related. She has said that my right hip had rotated forward, there are issues with the S1, S2, Siatica. I just received the results for my MRI yesterday and it states “there is a slight desiccataion of the intervertebral discs at the L4-5 and L5-S1 Levels with minimal broad based disc bulging at the L4-5 level. There is a small annulus fissure at the same level. My doctor has stated that this is not due to my previous injury and that “God made a bad design when he made the back” and basically the results are what you would find in any MRI even someone who did not even feel back pain . I do not understand why I feel pain continuously and at different levels some times just like a small ache to excruciating pain. Is this pain I feel just psychological? Are these “minor issues” and would they be related to my original injury?
Mon, 13 Aug 2012
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Orthopaedic Surgeon, Joint Replacement 's  Response
finding of disc bulge alone on mri means very little . if suspected nerve root injury clinically suspected is not found on mri it means nothing at all.
occasional backache without nerve injury quiet often is due to microinstability.
to put in medical terms you are passing through phase of instablity due to disc dysfunction which becomes aggravated when there is some weakness of abdominal muscle activation and multifidus muscle of back activation .
what we can do is go for a sensible core stabilisation programme with highlighting use of proper ergonomics for normal day to day activity.follow back care instruction while travel and work.
what works well is disciplined approach to problems of back .it may hurt but never damage .pain will become ok as you progress in muscle activation and may take upto a year of hardwork to get over the problem
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Had Back Injury. X-ray Showed Facet Joint Syndrome. MRI Shows Dessication Of Invertebral Discs. Psychological Pain?

finding of disc bulge alone on mri means very little . if suspected nerve root injury clinically suspected is not found on mri it means nothing at all. occasional backache without nerve injury quiet often is due to microinstability. to put in medical terms you are passing through phase of instablity due to disc dysfunction which becomes aggravated when there is some weakness of abdominal muscle activation and multifidus muscle of back activation . what we can do is go for a sensible core stabilisation programme with highlighting use of proper ergonomics for normal day to day activity.follow back care instruction while travel and work. what works well is disciplined approach to problems of back .it may hurt but never damage .pain will become ok as you progress in muscle activation and may take upto a year of hardwork to get over the problem