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    Suggest treatment for lumbar spine injury and back pain

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Posted on Wed, 16 Aug 2017 in X-ray, Lab tests and Scans
Question: My back pain was diagnosed on 14/11/2014. The report say a “small disc bulge at L5/S1 level”. But I do not know the reason of my lumbar spine damage/injury.
I have a hazardous cleaning work history since February 2013 to November 2013 where I have (combinedly) performed daily 300 to 350 times repetitive bending (forward), lifting. Twisting, Working in awkward position and carrying of weights such as machine tools and equipment for work.
My GP has advised that according to CT report my Lumbar condition was diagnosed at initial stage that the above physical movement has contributed my L5/S1 lumbar damage. He also advised me that the above physical movement are medically known causal of lumbar damage/injury.

I have had no previous history of back pain or lumbar injury, however, Could you advised me that my-

1.     Whether my Lumbar injury has been diagnosed at the beginning or initial stage or late stage?
2.     Do you believe the above reasons/ physical movement is the cause of my lumbar injury
doctor
Answered by Dr. Vivek Chail 3 hours later
Brief Answer:
I need to see the images to confirm accurately

Detailed Answer:
Hi,
Thanks for writing in to us.

My observations are the following

1. If your MRI scan shows and your doctor has said then it must be a small disc bulge which is usually the initial stage. CT scan are less accurate and MRI scans show details of lumbar disc conditions. I am not sure if you only got a CT scan of the lower back or also have got a MRI scan done.

If you want me to have a look at your scan then please send me your images by uploading the CD or DVD on a file sharing site like dropbox or google drive and I will have a detailed look on my work station and confirm your thoughts on whether you have an intital or late stage of the condition.

2. At your age of 47 years, some amount of disc degenerative changes is acceptable. If you have done a lot of bending at work then the degenerative process might have been hastened during the time you used to do bending forwards 200 times daily, which is surely a lot of stress on the spine.

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Vivek Chail 1 hour later
thank you for your reply.
i have no CD with me however i believe i can collect it from the radiologist who did CT scan. as i out line my first CT was done-
(1) first in 14/11/2014 -shows small disc bulge at L5/S1
after first diagnosed i further engage the same work but within 6 days i develop severe back pain and the next diagnose show the below
( 2.) second time in 20/05/2015 shows mild board base disc bulge at L5/S1, with L5 nerve root compression.
(3) third in 27/07/2015 show posterior disc bulge at L5/S1 to L/3/4 with L5 nerve root compression.
(4)4th time 22/12/2016, shows posterior disc bulge at L5/S1 to L/3/4 with L5 nerve root compression and disc height loss at L5/S1.
doctor
Answered by Dr. Vivek Chail 52 minutes later
Brief Answer:
Any spinal canal stenosis might suggest moderate to severe disc bulge

Detailed Answer:
Hi,
Thanks for writing back with an update.

Going by the information from the 4 scans done from 14-11-2014 to 22-12-2016, there seems to be a progression of the disc bulge. When it was first diagnosed, you had a disc bulge only at L5-S1 disc level and in the scan done in 2014 we find that levels L3-L4 to L5-S1 show disc bulges and this can mean that you have disc bulges at L3-L4, L4-L5 and L5-S1 disc levels for now.

Considering your 1st and 4th scan, this might suggest something more than an initial stage at the moment, which requires a detailed review of the 2016 scan.

An important point which I would like to know, in addition to what you have mentioned earlier is whether any spinal canal stenosis is mentioned in your reports. Any spinal canal stenosis will mean a that the disc bulge is moderate to severe.

I will be happy to review your images in detail once you have access to the CDs from your doctors.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vivek Chail 39 minutes later
yes, it is now progressive, but when it was first diagnosed , there was only small disc bulge at L5/S1. i will Try to collect CD, bu i can send you all the report just now if you provide me a mail id. i mostly need to know whether the first diagnosed was the first stage or not
i need a report form an expert regarding the stage of my first diaginsed
doctor
Answered by Dr. Vivek Chail 7 hours later
Brief Answer:
Please send me the download link of your images

Detailed Answer:
Hi,
Thanks for writing back with an update.

Please send me the download link of your images to YYYY@YYYY and send me a follow up query.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6707 Questions

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