Lower back pain

Patient

Q: Hello my name is robert i had a upright mri done yesterday i been have lower back pain for 3 years the mri shows c5-6 and c6-7 small disks bulge could this be why i am have lower back pain from my neck down?

Doctor

A:    The back pain might be due to a  nerve compression. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The same described before for the cervical spine applies to the lower back in terms of cause of pain and numbness in the legs, same causes, different spinal level. The treatment strategy usually includes: a physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory medication (Aleve, Motrin), also a re-education of your habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. If the condition fails to improve with a comprehensive rehabilitation program and selective injections, you might be presented with a surgical evaluation. Often, a progressive improvement is shown over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.

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