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Lumbar spine MRI with mild facet hypertrophy and disc bulging

Dear Ask The Doctor:
I need help with interpretating my MRI results, Can you help? At L3-4 there is a fairly mild disk bulge along with facet hypertrophy. there is no significant spinal canal narrowing. Bilateral foraminal narrowing can be seen, mild in degree. At L4-5, there is a fairly mild disk bulge along with facet hypertrophy. Mild spinal canal narrowing can be seen. Bilateral foraminal narrowing can be seen, mild in degree. There appears to be a very small superimposed right central protrusion at this level,as well. At L5-S1, there is a left foraminal posterolateral protrusion superimposed upon a disk bulge. Facet hypertrophy is present. There is mild right and mild to moderate left foraminal narrowing can be seen.


Thank you for writing to AskTheDoctor.com

According to the MRI report you are having at the present time  a mild lumbar disc bulging that apparently is not causing an important narrowing of the spinal canal to produce a lumbar nerve compression. For your information, some of the major causes of acute and chronic low back pain (LBP) are associated with radiculopathy (nerve compression).

However, radiculopathy is not a cause of back pain; rather, nerve root impingement, disc herniation (bulging), facet arthropathy (which you have also, but  apparently is not causing problems at the moment), and other conditions are causes of back pain. In the future, you may have a chance to develop a  lumbosacral radiculopathy, if the disc bulging and the facet hypertrophy become more pronounced giving as a result nerve root impingement and/or inflammation that may progress enough to cause neurologic symptoms in the areas that are supplied by the affected nerve root.

Basically the conservative treatment of the Lumbar Facet Arthropathy, when gets symptomatic, meaning: low back pain: is Physical Therapy aimed to recondition and stabilize the lumbar spine by re-educating and teaching you a daily stretching routine for the lumbar area, strengthening of abdominal muscles, and other important general recommendations as follows: sleeping with a pillow between the knees lying on the side, avoid activities that place additional strain on the lumbar spine (example: weight lifting). All of the above, with the objective to keep you as far as possible from episodes of acute low back pain, and also to preserve your quality of life.

Hope this helps you.

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