MRI: L4-L5 root nerve impingement

Patient

Q: What does a L45 there is limited disc dehydration bony disc protusion extrusion complex posteriorly central and inferior with sligh early impingement of the left extrathecal L5 root what does it mean and what will they do

Doctor

A:    Basically, what this result tells you, is that you have a herniated (protrusion) disk , this occurs when all or part of a spinal disk is forced through a weakened part of the disk. This places pressure on nearby nerves. This impingement can cause low back pain that can vary widely. It may feel like a mild tingling, dull ache, or a burning or pulsating sensation. In some cases, the pain is severe enough that you are unable to move. You may also have numbness. The pain most often occurs on one side of the body, with a lumbar (lower back L4-L5) herniated disk, you may have sharp pain in one part of the leg, hip, or buttocks and numbness in other parts. You may also feel the sensations on the back of the calf or sole of the foot. The affected leg may feel weak. The pain often starts slowly. It may get worse: After standing or sitting, at night, when sneezing, coughing, or laughing, when bending backwards or walking more than a few yards, especially if it is caused by spinal stenosis (narrowing of the spinal canal). The pain, numbness, or weakness often will go away or improve a lot over a period of weeks to months. 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 in overweight patients .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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