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Low back pain questions and MRI
9/26 8:39:02

I've been seeing a Chiropractor for over a year for lower back problems. Here are some of the results of my MRI:

*L3-L4:Reduced disk hydration with mild posterior disk space
narrowing. Minor annular bulging with minimal ventral endplate
spondylosis and minor facet arthrosis. Normal central canal and
lateral recesses with normal bilateral intervertebral neural
*L4-L5:Reduced disk hydration with mild disk space narrowing and
circumferential annular bulging with a large midline and left
paracentral disk herniation of the extrusion type measuring
approx. 7x12x18 mm in AP, transverse and cephalocaudal
dimensions, respectively, with cephalad migration in the anterior
epidural space posterior to the L4 vertebral body. Mild endplate  
spondylosis and bilateral facet arthrosis. Marked central canal
stenosis with thecal sac compression with visualized midline
residual AP thecal sac diameter of approx. 3 mm. Marked left
greater than right lateral recess stenosis. Patent right neural
foramen with proximal left foraminal narrowing with distal neural
foramen remaining patent.
*L5-S1:Reduced disk hydration with adequately maintained disk
height. Minor annular bulge with no substantial endplate
spondylosis. Mild bilateral facet arthrosis. Normal central canal
and lateral recesses with normal bilateral neural foramina.

*IMPRESSION-Large, cephaled migrating disk extrusion at L4-5 with
minor annular bulge, endplate spondlyosis and mild bilateral
facet arthrosis, with resultant severe central canal and left
greater than right lateral recess stenosis with accompanying
neural impingement.

I was doing great, going in for adjustments once a month or every other month depending on how I felt. Somehow I hurt my back again this week. So I have a few questions: Since chiropractic care worked so well the last time what are the chances it will again? I realize because of the injury it causes swelling, does that make it easier to bruise? I've never thought my injuries were that bad, am I making too light of them?


Dear Pam,

Yes, you are making too light of your injuries and lower back troubles.  Don't worry, everyone does.

Your chiropractor has helped you to keep the symptoms at a minimum over the past several months, but the chiropractor is unable to make you grow new discs in your lower back.  Once they begin to degenerate and tear and bulge, they are never the same.

Chiropractic/physical therapy is STILL YOUR BEST OPTION.  You need, however, to change your mind set.  The doctors will not make this condition go away. They will simply help you to manage it.  It is kind of like heart disease or diabetes.  People who have these types of conditions never fully recover. They learn to manage the condition through diet, exercise, drugs, etc.

Even if you opt for spinal surgery, YOU WILL NEVER GROW A NEW DISC. Surgery, again, is simply a technique in which they cut away damaged tissue... leaving scar tissue in its place.  Long term studies show that those that have spinal surgery VS those that do not have similar outcomes 10 years later.   The good news is that the chiropractic/physical therapy pathway leads to fewer complications and risks.

Bruising is the breaking of blood vessels with bleeding in the tissues.  Your spinal injury might not have you more prone to bruising, but you could have bruising secondary to a back injury.

I hope that this helps you.

Keith Biggs, DC

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