Question :

Mild disc protrusion L4-L5 and L5-S1 with facet hypertrophy

Dear Ask The Doctor:
I,ve had back problem n and off since my 3rd child, (7 years) i got my MRI results today stating,. "there is some straightening of the normal lumbar lordosis, aligement is otherwise preserved" " there is desiccation of the lower two lumbar intervertebral disks, at L4-L5, there is mild annular disk protrusion, which, in associationwith mild bilateral facet joint hypertrophy" is causing my pain. "at L5-S1 there is left-sided paracentral focal disk protrusion which is seen to contect the descending left S1nerve root with in the lateral recess" causeing my hip and leg pain "mild bilateral facet joint hypertrophy is also seen at this level" can someone please explain what this means in english and also give me an idea what opsions the sergan might give me when i see him, as GP was good and tried to expailn it to me but once i got home i forgot half what was said. and if at all posiable the pros and cons of the different treatments i might get offered, im 31 if that makes a difference with good health i think: :P thank you all for reading


Answer :

Dear Patient: 
 A herniated or protruded disc may produce a root nerve compression at a given level of the spine, in your case: L4-L5 and L5-S1, that causes an inflammation of the nerves and radiated pain to the  legs depending on the level of compression.Some times is not only the bulging disc but also coexist a facet hypertrophy that contributes to narrow the spinal space and compress more the root nerves. If this compression progresses, meaning, gets worse over the time, it can produce irreversible damage of the nerve root, then the discectomy is performed to decompress the nerve root involved so the neurological symptoms (numbness, tingling and pain local and radiated to the legs) improve and also avoid further damage to the nerve. The first treatment for a herniated disk is a short period of rest with pain and anti-inflammatory medications, followed by physical therapy. Most people who follow these treatments will recover and return to their normal activities. A small number of people need to have further treatment, which may include steroid injections or surgery. Changes in your lifestyle are a must, like diet and exercise are crucial to improving back pain by controlling weight .Physical therapy is important for nearly everyone with disk disease. Therapists will tell you how to properly lift, dress, walk, and perform other activities. They will work on strengthening the muscles that help support the spine. You will also learn flexibility of the spine and legs. Steroid injections into the back in the area of the herniated disk may help control pain for several months. Such injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done on an outpatient basis. Surgery may be an option for the few patients whose symptoms do not go away despite other treatments and time.


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