Can someone help me I am very scared
 

First off I want to say that I am so glad I found this forum! Thanks to Alffe for pointing me here to the right place :D

I injured my back last month and have been having horrible pain and numbness. My doctor ordered a MRI and I got the report back but I just can't understand it. It looks like it might be pretty serious but I am not sure can any one please help me I am very scared.

Here is what the MRI report said.

Findings:

The caudal most lumbar type vertebra is labeled L5.

Vertebral body heights, alignment and marrow signal are normal. Degenerative discogenic changes are noted at the L5-S1 level.The conus terminates at the L1 level. The cauda equina is normal in morphology. The paraspinal muscles are symmetric.

L1-L2: No disc herniation,neural forminal stenosis or spinal stenosis.

L2-L3: No disc herniation,neural forminal stenosis or spinal stenosis.

L3-L4: No disc herniation,neural forminal stenosis or spinal stenosis.

L4-L5: Note is made of concentric annular bulge without significant neural formanil or spinal stenosis.

L5-S1: Note is made of a broad-based central disc protrusion causing moderate left and mild right subarticular stenosis. Disc protrusion contacts the descending left S1 nerve root. Neural formina are patent. No significant central spinal stenosis.

IMPRESSION:

1. Central disc protrusion at the L5-S1 level causing moderate left subarticular stenosis. Disc protrusion contacts the descending left S1 nerve root.

Thank you!

First, I am not a doctor nor do I have a radiology background, so am only giving information from my own knowledge base. Your doctor should explain your scan results to you in detail.

Basically it says your back is fine down to the base of your lumbar area/top of your tail-bone area, but at this level you have what some call a 'slipped-disk'.

Each of our vertebrae have their own name and number according to their area in the spine. For example, L1 means the first spinal bone in the lumbar region.

When the numbers quoted are between two vertebrae. eg. L1/L2, it's actually the space between the bones, or the disks that are being discussed.

L5/S1 refers to the disk between the last (or 5th) Lumbar vertebrae and the first Sacral one.

Between each bone in our back (vertebra) we have thick disks filled with gel which act as shock-absorbers, and those disks in turn are covered with a thick material called the annulus (annulus means 'around the outside').

Over the years these disks start to wear out and flatten, or possibly bulge out (like squashing a marshmallow) which is what has happened to you in your L5/S1 area.

With conditions of this type you'd probably find physio beneficial in easing the low back pain that I'm sure you have.

I hope that's helped and if you need any further information, there are some good web sites that help you understand your own reports.

Here's one I found fairly easy to follow..
http://www.radiologyassistant.nl/en/4556dea65db62

Thank you very much!

My doctor didn't explain any of it to me I was just told I had a herniated disc. I was finally able to get into another doctor yesterday and they are sending me to a surgeon so I have my fingers crossed that all goes well.

These are permanent conditions unfortunately no matter what MD says
 

If your in serious pain that is not improving, see a pain specialist. Stick with low dose opiates without acetomenophin and also look in to an antispasm medication such as flexeril in conjuction. STAY WITHTHE LOWEST DOSE. I became addicted (dependent) thinking that more is better. Now I'm stuck at very high doses of opiates to get any slight improvement in levels of pain.
Also if your numb you may act in ways that will cause more permanent damage. I went surfing and now have permanent pain and Im only 30; this wouldnt have happened had I just taken 6 months off and dedicated myself to physical therapy 100%. Hope that helps.

Back in 1987 I had an 8mm L5 herniation without much numbness in my legs and didn't have surgery. Its was very tough but mine got better. I took a year off work. My faith helped me. I am now facing a 3 level fusion but thats another story. Steroids can help. Have your doctors talked about an injection or other conservative treatments first before surgery?

Always, always, ALWAYS go conservative first. Spinal surgery is risky.

Go to a pain specialist. There are many treatments they can do first.

I have two disc bulges at L1/L2 and L2/L3 caused by two slip and falls 15 years ago. They deteriorated over the years, now I have arthritic changes on the facet surfaces.

When aggravated by a fall that broke my left leg, I had to have separate treatment on my back. First was phisio. Then epidural injections with low dose opiates to manage the pain. Gradually the compression wouldn't go away.

Eventually I had a procedure called a Radio Frequency Ablation where they sever the nerves that send the pain signal to the brain. One for each vertebrae. It is minimally invasive and works. No pain.

Not sure if this is the prescription for your injury, but pain specialists have many options.

I would put surgery last on the list. Best of luck.

First let me tell you I have had much experience with herniated discs , on 3 separate occasions in 1975, 1983, and again in 2006. 2 out of the 3 times I healed on my own, and had surgery for the one in 1983 because I was Teaching and couldn't deal with the pain when trying to teach. You have a "slight" herniation of a lumbar disc, with some "stenosis" which is nothing more than a "narrowed opening" at the spine where the sciatic nerve emerges and goes into the leg. It is one of the longest nerves in the body, and when you have a "herniation" of a disc, the outer sheath of the disc is weakened and allows the inner portion to slip out, and this in turn puts pressure on the nerve root at the spinal area, but in so doing, the sciatic nerve carries the pain all the way down to your toes, if it's real bad, but it looks to me that with "aspirin", if your stomach can tolerate it, will be enough to relieve the problem, and it will heal on its own given a few months of proper sitting, and sleeping positions. You dont need surgery, only rest, aspirin for pain, and a "straight-back" rocker to sit on. You can take 2 aspirin every 4 hrs as needed without doing you any harm, and it will ease the pain. One thing for sure is that it will take about 2-4 mos to get back to normal, but don't rush into "surgery", as I doubt very much that you need it.

Medicine not always the answer
 

From personal experience I believe that you do have to be very careful any time you have a protusion in contact with the nerve. Since I was in the military, the first thing I did when I contracted serious back pain was try to gut it out with the over the counter pain meds from the drugstore. When the pain became so bad that I could not walk more than ten steps, I went to the doctor who had me visit a neurosurgeon who took the first MRI. The insurance company insisted on physical therapy to see if they could avoid paying for a surgery. Finally, 29 days after the excruciating pain began, I was placed in surgery where the disc was removed. The surgeon said it had exploded into pieces. One piece was really pressing into the nerve. Well, that was 1990. Four months later, I deployed to Desert Shield/Desert Storm as a soldier. But, almost twenty years later, my left leg and foot still give me all sorts of trouble with ache, weakness and poor response to nerve tests. limp constantly. I'm pretty sure the lingering affects are due to the piece of disc protuding into the nerve for so long.

It is probably little help, but it does seem to me that individual histories, with apparently similar causes, are very variable. My own experience dating back to the early 90's was of fairly mild NP until suddenly in the space of two weeks in 2006, everything went wrong and I lost much control of my lower body. Spinal decompression surgery was then the only option, and then only to prevent further worsening. The spinal nerve had been damaged (myelomalacia) and now little or no chance of improvement so I am left with poor control over my lower limbs and ever-present NP.