Managing Chronic Back Pain


Q: Could you help me understand these results? current doctor failed to. I am in constant pain that effects daily routine. Have tried pt and injections. There is straightening of the lumbar curve. The alignment of the vertebrae is normal. The vertebral bodies are normal in height and show discogenic changes at L4-L5. Loss of T2 hyperintensity suggestive of disc desiccation is seen at L4-L5 level. Decreased disc height is seen at L4-L5. L4-L5 disc shows bilateral posterolateral disc protrusion causing bilateral neural foramen impingement more on right. L5-S1 discs show mild right posterolateral disc protrusion causing mild impingement on neural foramen. Rest of disc are normal. The pre and the paravertebral soft tissues appear unremarkable


A:   In my clinical practice, I often am asked for a re-interpretation of results or for a second opinion.  When experiencing pain, it can be difficult to absorb all the information in one medical visit.
Generally, you are experiencing back pain on a chronic basis and the source of your pain seems to related to deterioration of parts of your spinal cord.  This deterioration could have been a results of genetics, excess weight, smoking, inactive lifestyle or acute trauma.  I assume other causes of back pain have been excluded by your doctor.
Some individuals find relief in a diagnose, some individuals experience remorse. Regardless of your initial reaction, it is important to recognize that your focus must shift from curing the pain to managing the pain. You will have good days and bad days but there are many things you can do to ensure the bad days are few and far between. These include:

Maintaining a healthy weight via a healthy diet
Regular strength and stretching of your core muscle groups
Enjoying an active lifestyle with balanced rest
Eliminating smoking
Manging your psychological stresses
Creating a trusting therapeutic relationship with your health providers to guide you as your condition changes over time


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