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MRI showed disc bulge and large central disc herniation causing significant spinal stenosis. Meaning?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10363 Questions
I have back problems since I was a teenager. On my resent MRI it says, "At L4-5 there is disc bulge and relatively large central disc herniation causing significant spinal stenosis. There is impingement of the descending left and possibly right L5 nerve roots. There is mild to moderate bilateral neural foraminal stenosis. At L5-S1, there is minimal right foraminal disc protrusion with mild right neural foraminal stenosis". What does this mean and will it progress as I get older because I'm only 36yrs old and there are days that I can't walk because of the pain.
Posted Mon, 29 Apr 2013 in X-ray, Lab tests and Scans
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
You are suffering from PIVD at lumbar region. Due to this Disc bulge pressure occurs on nerve roots & radiation of pain and numbness occurs in that dermatotome. This happens due to a progressive degenerative change in the lumbar spine. The problem can aggravate further as you age but the progression can be significantly retarded with regular physiotherapy. Physiotherapy like intermittent lumbar traction , back strengthening exercise reduces pressure of disc bulge for some time & gives relief.

The following measures will help with the pain
• Lie on a hard bed.
• Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( dont repeat a dose before 6 hours) with food.
• Avoid forward bending.
• Correct your posture while sitting
• Avoid prolonged sitting
• Avoid strenuous activity & lifting heavy weights.
• Apply diclofenac gel on the affected area. Warm compresses will also help.

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.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: MRI showed disc bulge and large central disc herniation causing significant spinal stenosis. Meaning? 14 hours later
My chiropractor told me that in 20 years I will be incapacitated. That in his line of work he has seen this.. Is this true and is there anything I can do to prevent it?
Answered by Dr. Praveen Tayal 9 hours later
Thanks for writing again.
If no active treatment is done then this could happen. But regular physiotherapy sessions will help in improvement of the symptoms and the disease progression will be retarded.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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