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MRI Findings Show Posterior Disc Bulges At L5-S1 And L4-5 Levels. Suggestions

Posted on Mon, 16 Dec 2013

Question: Name :XXXXX Age:43 MRI: Aug:2011 Taking Medicine : Necob Plus(D/N), Duvanta Np20(N),Daxid50(N),Selzic150(N)(By Neurology Surgeon) Olive Oil message(light) Problem having pain in back travelling to back of legs though the pain more when standing more then 10 min's , but is irritating. Dr. also say having some fybermylogia problem for which some time take Neugalin 75. MRI of the lumbosacral spine was performed and high resolution T1 and T2 The study reveals evidence of obliteration of normal lumbar curvature. End plate degenerative changes are present. Otherwise vertebral bodies are normal in size , shape ,alignment and signal intensity. Neural arches are normal.Facet joints are congruent. No ossesous destruction is seen. Intervertebral discs show early degenerative changes seen as partial loss of normal bright signal intensity of the nucleus pulposus on T2 weighted image. Diffuse posterior disc bulges are seen at L4-5 and L5-S1 levels indenting the thecal sac. Remaining intervertebral discs are normal in height and show no posterior projection. No evidence of stenosis. Lower end of the spinal cord, conus meullaris and nerve roots of the cauda equina are normal.The thecal sac is normal and CSF demonstrates normal signal intensity. No intraspinal mass or pre/paravertebral collection seen. MR findings are suggestive posterior disc bulges at L5-S1 and L4-5 levels.

Answered by Dr. Dr. Praveen Tayal (48 minutes later)

Brief Answer: Due to disc prolapse. Detailed Answer: Hello, Thanks for posting your query. The pain in the lower back travelling down the legs on standing is due to a disc prolapse at L4-L5 and L5-S1. Since the MRI was done almost two years ago, the degenerative changes are likely to be progressed causing a mild nerve root compression at these levels. These are age related degenerative changes of the spine. The treatment is done according to the severity of symptoms. If you have only one symptom- back pain shooting to the legs with no nerve related symptoms like limb weakness, numbness, urinary incontinence, etc then medicines along with bed rest are the first line treatment along with physiotherapy. Regular physiotherapy helps in preventing further progression of the problem. You need to get some good muscle relaxants like Thiocolchicoside prescribed in combination with a potent pain killer for releif. Doing back strengthening exercises and lumbar traction will also help in reducing the symptoms. Do consult with your neurologist and get a latest MRI scan done for proper evaluation. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.Wishing you good health. Regards. Dr. Praveen Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Praveen Tayal (1 hour later)

advice name of spasm medicine along with pain killer medicine name available in market

Answered by Dr. Dr. Praveen Tayal (39 hours later)

Brief Answer: Improving the posture will also help. Detailed Answer: Hello. Thanks for writing again. You can use Mahagesic MR 4mg or Thiospas 4mg twice in a day after meals. Be sure to have a bed rest st the time of acute pain and do a hot fomentation at least twice daily. Hope my answer is helpful. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Praveen Tayal (7 hours later)

dr as per your advice I visited my neuro dr. he advice me to have skelbenze 15mg evening duvanta np20 night is some other medicine as per your advice to be taken regards

Answered by Dr. Dr. Praveen Tayal (16 hours later)

Brief Answer: None. Detailed Answer: Hello. Skelbenze is a muscle relaxant and Duvanta is methylcobalamin supplement. These two should provide you adequate relief in 5-7 days. No other medicine is needed. You are on the right treatment. Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar