MRI results: disc bulge at L4-L5 and L5-S1 with neuroforaminal narrowing on left!


Question:

MRI results: disc bulge at L4-L5 and L5-S1 with neuroforaminal narrowing on left side. What does this mean?

I have a burning sensation that goes down the back of my leg to my ankle and then to my little toe. Most of the time my left foot goes numb. My pain level is about a 7 all the time. It's very hard to walk and I limp around to avoid more pain. I have done 2 months of physical therapy ( no help), had 3 rounds of back injections, and on pain killers and muscle relaxers. I don't know what I need to do now. I am getting no where with my doctors. I have seen 3. An Orthopedic doctor, an Orthopedic Surgeon, and a Neurosurgeon. All of them have either said that they couldn't help me or I was having muscle spasms. I don't think so when having burning sensations, numbness, tingling, and pins and needles feeling.

One doctor said that I was using this as a way to get out of the army and that I had emotional and financial stress causing my back pain and that there was nothing he could fix. He was a Orthopedic Surgeon in Huntsville, AL where I am stationed. Please someone help me out.


Answers:

This means that the space where the nerve exits the spinal column is narrow...called stenosis. What it doesn't clarify is if it is narrow due to a build up of osteophytes or disc degeneration, or if the disc is narrowing the space. If it is the latter, it might be able to be helped with physical therapy, but it really requires a special approach. You first need a mechanical assessment from a PT trained in the MDT approach...this will help clarify if the pain is from stenosis or is of discal origin. People with degnerative type of stenosis will always have pain when they walk and it will always go away when the sit or lie down with the knees flexed. Pain from a displaced disc, however, can linger and even be worsened in the sitting position, it might go away at times, or can be truely constant.

Some considerations for you are:
1. If the pain is truely due to a degenerative stenosis, conservative care will only bring temporary results...whether it is PT, chiro or spinal decompression...it's like a pebble in your shoe...you can move it around for awhile, but the irritation will always be there unless you remove the physical obstruction.
2. If it is discal in origin and you have been in PT without success, consider a PT with MDT experience (go to http://www.mckenziemdt.org), or you may require a manipulation or spinal decompression (but be prepared to shell out $4,000 out of pocket unless your ins covers it)
3. If the surgeons are insisting it will not help you and if their reason is because "it's too mild" I would follow up with a standing MRI...the structures in our spine can change considerable from lying to standing and what might not be appearing in a lying MRI, might manifest in a standing MRI.
4. Do your behaviors follow that of someone with your type of back problem, or are you having unusual or bizzare symptoms?...the more of the latter you have, the more likely it could be having a psychosomatic reaction...this would definetely require psychological intervention.

Good luck...I highly recommend following up with a PT with MDT experience.




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