Help!

I have been suffering for quite some time with low back pain. April/09 I had and MRI wo contrast lumbar.

Results-Interval worsening of the disc herniation at L4-5 posteriorly, centrally, and paracentrally to the right. Mass effect over exiting right L4 nerve root and over traversing right L5- S1 nerve roots. Bilateral spondyloarthritis L4-L5 L5-S1 and L2-L3.

Does anyone know-is this bad? I am very uncomfortable but have opted not to take pain meds with the exception of OTC. I have had several Medrol Dose Packs and have done the series of three epidural pain/steroid injections with no relief.

I see my pcp tomorrow for a referral to a neuro surgeon. Does anyone have any idea of what the next step could possible be? Or possibly what a Neuro may opt to do? Any ideas would be appreciated! Thanks

Hi, and Welcome Hondo44,

Back pain is miserable pain. So sorry you're having to deal with the effects of all these MRI findings.

I'll try to help you understand some of the results. The radiologist is describing in great detail what he has found to be wrong with each physical level of your spine that he needs to report on. Those descriptive terms do have meaning to your doctors.

But the "IMPRESSION" part will tell you more directly what the diagnosis is going to be, thus maybe giving you an idea what direction to try for treatment.

(NOT a doctor)

First, a disc is soft tissue - the cushion between the vertebrae. Your vertebrae are bones/hard tissue. Your spine can articulate/move because of the way these bones and cushions are designed.

a "disc bulge" would be like a knot on a tire. (Certainly painful but not usually a surgical condition)

a "disc herniation" would be like a jelly doughnut with the inner jelly protruding out the doughnut ring, on a microscopic basis. (Often can be a surgical condition - may need more like a repair of this outer ring, so to say)


"Interval worsening of the disc herniation at L4-5 posteriorly, centrally, and paracentrally to the right."

I think the radiologist is describing just ONE "cushion" or "disc" that is between your L4 and your L5 vertebrae. This disc is herniated at the backside of this disc "posteriorly," AND in the middle "centrally," AND from the middle going around to the right side of this disc "paracentrally." So this disc is pretty involved with the degree of "opening" or "tear" or "rent" or "herniation." Just different words to describe "herniation." I hope that didn't confuse you.


"Mass effect over exiting right L4 nerve root and over traversing right L5- S1 nerve roots."

Well, I would think all the gelatenous material extruding out of the disc is "massing over" the outlets for the nerve roots. I would think that would cause a very painful condition. Probably very fixable. They are newer techniques in surgeries and options that maybe could like seal the tear, but then what to do with the "mass" extruded material, if that's confirmed what it is.

"Bilateral spondyloarthritis L4-L5 L5-S1 and L2-L3."

Sounds like ole arthur's got ya. anti-inflammatories may help that/ Arthritis Tylenol, heating pad for comfort. heat causes swelling on a microscopic basis. swelling causes pain.

Of course, age, past injuries, smoking and drinking, genetics, work history, diet can predispose us to some things and would have a bearing on our health.

Here's some links to get you started.

http://medical-dictionary.thefreedic...ndyloarthritis

Back Pain forum:

http://neurotalk.psychcentral.com/forum22.html

You may get by with some PT, home exercises and Lidoderm 5% patches, or the newer Flector patches (both nonnarcotic).

If you're in a lot of pain, you need to break the pain cycle. I didn't like have to concede to a mild narcotic, Darvon 65, but it helped me a lot.

Sometimes if it's a surgical condition, surgery is the only way. Do your research on the doctor, follow-up care and pray. Most are benefited by surgery.

Ask us any questions you want. We're here to try to help you understand.

i have a bad disc in my back also with some compression. back pain, pain bending etc. i've also had 4 series of injections with no help, or very short term help.

my neurosurgeon mentioned a procedure called X-STOP. it's considered to be a minor procedure that takes about 30 min's. i wonder if your dr might mention it. with discs i think they take into consideration the mri results and your symptoms. plus your neuro exam.

please let us know how your appt goes.

Hello,

Sorry you are in so much pain. I am very familiar with back pain. I have a fusion at C6 &
C7 (neck). I have disk problems up and down my spine. I have a wonderful chiropractor who understands back pain. He has 2 herniated disks.

My advice find a good chiropractor. If the nuro wants to operate think hard about it, once they start operating the spine is never the same.

I hope you find relief soon!!!
Take care,
Sherrie

First off I wanted to say to Neuro Talk!!! I'm with you on the back problems. I just celebrated my one year date since my 5th back surgery.

Back to you...I am posting after your doc visit...I would ask him what can or should be done...my honey asked my doc if his wife had the problems I have what would he do...he said surgery...I'm very pleased with the results!

Just ask tons of questions!!!

Welcome to NeuroTalk. Great to see you have come to be with our loving group. There are a number of friends will to assist as we can. Just let us know how we can be of any help. We are all here to assist each other as possible.

Again welcome, looking forward to seeing you around.

Darlene

Hi HONDO, and welcome to NT! You will find a great bunch of people here.

I had a fusion at C3-4 and C4-5 about 20 years ago. It helped the problems I was having at the time, but over the years I've developed pain up and down my spine off and on. I've found that Yoga and stretching exercises help me. Wine's good, too.

I hope you can find relief. Pain becomes a focus and it becomes hard to think of anything else at times.