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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are Circumferential Disc Bulge, Bilateral Facet Hypertrophy And Bilateral Neural Foraminal Narrowing A Concern?

I have circumferential disc bulge, bilateral facet hypertrophy, bilateral neural foraminal narrowing in the L4-L5 area Posterior disc bulge, bilateral facet hypertrophy L5-S1 area I m in so much pain from this. The dr said it shouldn t hurt. Is this true
Mon, 25 Mar 2019
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Radiologist 's  Response
Hi,

Disc bulging is very common in population. Theoretically it is not hernia (protrusion on extrusion) but it can cause a hernia by the time. Bulging means disc had pressure from top and bottom so it overflows to posterior.

Generally it is not a big problem and can be solved by physical therapy. But if there is severe bulging with facet hypertrophy, it can cause neural foraminal narrowing (which is probably your case) and that can cause serious pain and neural problems.

Even if there is neural foraminal narrowing surgery can be delayed. If there is no serious neural problems, pain can be reduces by painkillers and physical therapy can help.

But after 3-6 months physical therapy if the patient still has a serious pain or neural problems (like low foot or incontinence) than surgery must be considered.

Hope I have answered your query. Let me know if I can assist you further.
     
Regards,
Hamza Eren Guzel,
Radiologist
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Are Circumferential Disc Bulge, Bilateral Facet Hypertrophy And Bilateral Neural Foraminal Narrowing A Concern?

Hi, Disc bulging is very common in population. Theoretically it is not hernia (protrusion on extrusion) but it can cause a hernia by the time. Bulging means disc had pressure from top and bottom so it overflows to posterior. Generally it is not a big problem and can be solved by physical therapy. But if there is severe bulging with facet hypertrophy, it can cause neural foraminal narrowing (which is probably your case) and that can cause serious pain and neural problems. Even if there is neural foraminal narrowing surgery can be delayed. If there is no serious neural problems, pain can be reduces by painkillers and physical therapy can help. But after 3-6 months physical therapy if the patient still has a serious pain or neural problems (like low foot or incontinence) than surgery must be considered. Hope I have answered your query. Let me know if I can assist you further. Regards, Hamza Eren Guzel, Radiologist