MRI report showing Facet arthropathy and L5 compression


Q: What is L4-5 moderate disc space narrowing,disc desiccation and shallow endplate erosions.Facet arthropathy,ligamentous hypertrophy and a 4.5mm broad right eccentric disc protrusion with annular tear produce mild central stenosis and sever compression of the right L5 nerve root,within the lateral recess.The left lateral recess is mildly narrowed.There is moderate right foraminal stenosis and mild left foraminal stenosis?


A:   According to the MRI report you are having at the present time a L4-L5 problem that is compressing the L5 nerve root at his exit of the lumbar spine by the “foramen” or outlet. 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 or protrusion), facet arthropathy (which you have also), 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 or protruding 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.

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