What does my MRI test report indicate?

Posted on Mon, 8 Jun 2015 in Back Pain
Question: MRI said central, left paracentral disc herniation at L5/S1 , shallow midline disc protrusion at L3/L4 with annular tear, shallow sics buldg at l2/L3 with posterior annular tear. age 65, female. any advice on treatments? have to do surgery?
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer:
Consider a conservative approach before surgery

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. As is with most disc herniation, annular tears and disc bulge cases the initial approach includes a conservative non-surgical one which includes:

+Physiotherapy: Which in my opinion is the most important approach in such cases. Results will be slow/gradual and take a few weeks to really establish their benefit

+Pain medications

+Mild exercises

+Limited rest

+Limited weight bearing

+Anti-inflammatory medications

I would give this about 6-8 weeks for actual benefit from the above mentioned regimen. Only if the pain does not alleviate, and is still significant present should surgery be considered.

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shoaib Khan 15 minutes later
physico therapy includes????

She is a visitor here and needs to take flight back to China on XXXXXXX 8. Any advice before she goes back? Or she has to stay here for treatment before she can fly? She barely can walk now and has severe pain.

any counter shelf anit inflmatory medications that you recommend?

thanks a lot!

Answered by Dr. Shoaib Khan 12 minutes later
Brief Answer:
All queries addressed sir/ma'am

Detailed Answer:
Hello once again.

Physiotherapy is a different department altogether and is found in most medical centres. She can start a few sessions where she is right now, and then continue once she travels to China. A specialist (physiotherapist) will conduct all the exercises for her, and she need not do anything on her own.

Advise before traveling would be the anti-inflammatory medications, pain medications, a brace if she really needs it to support the regions that have the annular tear, and no weight bearing.

She can fly, but should just be careful and not go about any swift movements and should not carry anything on her own. Better to transfer her through a wheel chair till the flight and then on to the seat, and then from there again using a wheelchair to her mode of transport (taxi or car) back home.

She can go about all her physiotherapy sessions with the same physiotherapy centre, which is preferred instead of going about visiting 2-3 centres.

I hope this helps. Please feel free to write back to me for any further clarifications, I am always here to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shoaib Khan 19 minutes later
i googled online and said maybe injection will help on her pain.. will you suggest that for her?

she is a visitor and has no insurance.. So far we have spent 2000 dollars on this. I dont know how much it will cost for the physicotherapy.

Can you give us some suggestions based on the finanical aspects as well?

Answered by Dr. Shoaib Khan 10 hours later
Brief Answer:
I completely understand

Detailed Answer:
Hello once again Lili.

I understand. The injections are steroid injections which will help relieve pain for a certain duration of time. But will inevitably have to be taken again. I would suggest getting her insurance if that is an option for you. Getting the injections once in a while or using pain relieving oral tablets will more or less sum up to the same amount, so it's your choice there entirely.

As for the physiotherapy, it will take at least 20 sessions or more with the physiotherapist. So what you can do is go for about 2-3 sessions and inform the physiotherapist during those sessions to teach you or her everything that needs to be done as you won't be able to come again due to personal reasons. Learn the exercises taught by the physiotherapist and religiously go about them on a daily basis, even twice daily.

Surgery will be expensive and at this point is not indicated as we have to try conservative management first. If surgery is required, I would recommend sorting her insurance first.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions


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