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What Causes Mild Generalized Disc Bulge And Uncovering Of The Disc?

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Posted on Tue, 24 Mar 2015
Question: L4-L5: Mild disc height loss. Mild generalized disc bulge and uncovering of the disc. Severe bilateral facet arthrosis and ligmentum flavum thickening. Synovial cyst, protrudes into the epidural space from the left facet measuring 6.2.12 mm. Moderate right and severe left subarticular recess narrowing secondary to ligamentum flavum thickening and the synovial. cyst. Moderate left neural foraminal narring is unchanged. Impression: Lumbar spondylosis with new left L4-L5 facet synovial cyst protruding into the epidural space and severely narrowing the left subarticular recess, impinging on the descending left L5 nerve root. Remainder unchanged.
doctor
Answered by Dr. Olsi Taka (58 minutes later)
Brief Answer:
Nerve root compression.

Detailed Answer:
Hello! Thank you for coming to HealthCareMagic for your health related questions.

I read that report carefully. It speaks of some degenerative changes of the lumbar spine which to a point is found in many people with age, a common cause of back pain. What should be causing the more troublesome symptoms though is at the site between your fourth and fifth vertebrae. At this level these degenerative changes are prominent and on the right due to the addition of the effect of a cyst it markedly narrows the space where the nerve passes to leave the spine and compresses the nerve root, the right L5 nerve root.
It would have been helpful if you had said something more on your symptoms. Judging from that report you should have back pain with pain and numbness radiating into your right limb up to the dorsum of your foot and the big toe, muscle weakness into this distribution causing difficulty into raising your foot. Not all the symptoms are always present simultaneously.
Treatment initially is attempted with physical therapy and over the counter painkillers like Ibuprofen. If your symptoms are limited to back pain it usually is limited into that type of management. If you have nerve compression symptoms and that doesn't work, local injections with corticosteroids and anesthetics may be tried. Lastly comes surgery to relieve the compression on the nerve root. If the symptoms are severe especially weakness at times surgery is done earlier without attempting those first steps.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (5 minutes later)
TY...I have tingling up and down legs and numbness in feet at times. I also have hip pain on the right side. Burning sensation down buttocks and go to the bathroom alot. Would this be caused by this
Also would seeing a chiropractor help this condition
doctor
Answered by Dr. Olsi Taka (16 minutes later)
Brief Answer:
Read below

Detailed Answer:
Thank you for providing some more info.

First of all let me make a small correction to what I said, it was the left not the right nerve root which is more compressed.

The symptoms could be caused by nerve root compression. However since from the way you describe them the tingling and numbness seems to be on both sides other causes might be considered like peripheral neuropathy so if symptoms don't improve with physical therapy and pain killers, testing with nerve conduction studies might be useful to confirm it's the nerve roots on both sides affected and not peripheral nerves.
As for the frequent urination, it is not characteristic for that report, it is usually present only when there is narrowing of the spinal canal with compression of the lower nerve roots and such a thing is not described in the report. Perhaps a urine analysis would be recommended to look for possible bladder infection which is common in women and causes frequent urination.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (20 minutes later)
Would it be in my best interest to see a chiropractor.
doctor
Answered by Dr. Olsi Taka (9 minutes later)
Brief Answer:
Physical therapist is more appropriate.

Detailed Answer:
Physical therapist would be more appropriate in my opinion and of a more proven effect.
Efficacy of chiropractics is debatable and not proven by studies in general (although it has shown to be of some benefit in back pain) but physiotherapy is safer and effective.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Causes Mild Generalized Disc Bulge And Uncovering Of The Disc?

Brief Answer: Nerve root compression. Detailed Answer: Hello! Thank you for coming to HealthCareMagic for your health related questions. I read that report carefully. It speaks of some degenerative changes of the lumbar spine which to a point is found in many people with age, a common cause of back pain. What should be causing the more troublesome symptoms though is at the site between your fourth and fifth vertebrae. At this level these degenerative changes are prominent and on the right due to the addition of the effect of a cyst it markedly narrows the space where the nerve passes to leave the spine and compresses the nerve root, the right L5 nerve root. It would have been helpful if you had said something more on your symptoms. Judging from that report you should have back pain with pain and numbness radiating into your right limb up to the dorsum of your foot and the big toe, muscle weakness into this distribution causing difficulty into raising your foot. Not all the symptoms are always present simultaneously. Treatment initially is attempted with physical therapy and over the counter painkillers like Ibuprofen. If your symptoms are limited to back pain it usually is limited into that type of management. If you have nerve compression symptoms and that doesn't work, local injections with corticosteroids and anesthetics may be tried. Lastly comes surgery to relieve the compression on the nerve root. If the symptoms are severe especially weakness at times surgery is done earlier without attempting those first steps. I hope to have been of help.