Can anyone please educate after review.I'm 30 yrs Old, Male.


STATEMENT
Back Pain , no known trauma

IMPRESSION

At L3/4 , there is a central disc protrusion containing a small annular tear adjacent to the superior endplate of L4.The disc Protrusion approx 3mm.
There is mild narrowing of the right lateral recess at this level secondary to the disc protrusion and lingamentum flavum hypertrophy.The disc gently abuts teh exiting L3 nerve root on teh right with mild right neuroforaminal narrowing.The left neuroforamen is unremarkable.

At L4/5 , there is a broad -based disc bulge with a superimposed central disc protrusion, resulting in moderate central canal stenosis and narrowing the lateral recesses bilaterally. impinging on the L5 nerve roots bilaterally.There is mild narrowing of the neuroforamen bilaterally as well.


I am getting lower back pain, numbeness, tingling in my right leg(thigh and below knee), arm and occasionally in left leg.This is very embarrassing to me.And even can't get hard erections during sex drive.

I was in very deep depression and frustrated after got MRI, Please anyone help me out.

- Can Physiotherapy is the right choice to get rid of from my numbeness,tingling ?
- Can i get back hard erections ? Is the lumber stenosis disease decrease the sex drive?

Thanks in advance


thes

Hi Thes,

I wanted to offer support and share with you some of my history if it can help. There are lots of options for you, so please don't get too depressed, they can do lots with back problems these day. I waited 8 years to have surgery until they developed the right technique! I'm also 30, like you.

I had herniations at L4-L5 to the right and L5-S1 to the left since I was 18. I had several epidural steriod injections through the years that worked very well for me. But, in 2007 I had bad right leg pain and hip pain because of the L4-L5 herniation. I was on several medications and had physical therapy, which lessened the pain a little but not much. I ended up having a microdiskectomy, where the surgeon used an endoscope and just removed the herniated part of the disk. I had 100% pain relief and had post-surgical aqua therapy (water, waaaaaaay better) and was back to 100%. My L5-S1 herniation to the left did not cause me any problems at that time.

After I had my son, I started having left leg pain/sciatica. I developed numbness and tingling and off/on hot/cold feelings. I had another microdiskectomy at L5-S1 with complete pain relief. As it turns out, the disk had fragmented, so I do have a drop foot from it, but thats because my jerk of a primary care doctor refused to the do the referral for me to see my surgeon when I insisted and I had to switch doctors to get my referral, so the time lapse led to bad swelling in my spinal canal.

There are lots of options for you before things get too bad. I'd say (and I'm not a doctor or anything, this will be up to a spinal specialist, which you should see ASAP) that if you are already at the numbness stage and from those MRI results, that PT will probably not help much to relieve your symptoms. It can help push a bulging disk back in, but once it's herniated and abutting the nerve root, it wont solve the problem. It can't hurt and it good to help strengthen your core muscles to support your back, especially if you might have to have surgery down the line.

A spine doctor will probably recommend starting with epidural steriod injections to help reduce the swelling and thus, the pain and maybe the other symptoms you are having. It's kind of a temporary fix, but mine lasted years before I ended up needing surgery. Both my surgeries were same day procedures (in and out of hospital same day) and done with microinstruments through a tiny opening and I didn't even have stitches. My pain was relieved almost immediately and (aside from the drop foot) all functions returned to normal right away.

Did the doctor say he thinks your erection issue is related to your back? I would ask that the doctor check your testosterone and prolactin levels to make sure it's not an unrelated issue. Stenosis just means the space is narrowed, probably because the herniation is in there. It could be from the nerves being irritated by the herniation, but I'm not sure there is a real way to test for that. The depression you are experiencing about your back problems and pain could be producing that as sort of a side effect.

I think you need to see a spinal specialist to talk about your options as soon as you can. Where are you from? If you are anywhere near Philadelphia, PA or South NJ- I highly recommend The Rothman Institute.

Best of luck to you!

Carly