Question
QUESTION: I'm having great pain in my lower back and it radiates down through my left buttock and down my left leg. at times its both legs but mostly my left and its a constant pain that never lets up it just gets worse at times. i cant wear a belt. cant sit very long. stand very long, and when i try to go grocery shopping I'm limping with the help of the buggy at the end. i seem to notice the pain the most at night, in bed because i toss and turn because of the pain. theres no position that eases my pain. this is something thats been going on for about nine years. ive been in several car wrecks. two of which were head on collisions. a dirt bike wreck. when i really noticed the pain was after i tried to help someone get their truck unstuck by lifting the front of their truck up. I'm six foot seven three hundred pounds.          My mri results are as follows L3-4 level loss of disc hydration. broad based disc bulge flattens anterior thecal sac. neural foramina are narrowed on the right and patent on the left.L4-5 level:loss of disc height and hydration with right parasagittal disc herniation indenting right anterior thecal sac producing right lateral recess stenosis. right posterolateral disc herniation narrows right neural foramen. left posterolateral disc bulge in combination with facet arthropathy produces left neural foramen stenosis .posttraumatic etiology cannot be excluded.L5-s1 level:loss of disc height and hydration with broad based disc bulge incompletely effacing ventral epidural fat. posterolateral disc bulge in combination with facet arthropathy narrows left neural foamen.right neural foramen is patent. left posterolateral disc bulge produces left neural foramen stenosis with compression of exiting left L5 nerve root. right posterolateral disc herniation narrows the right neural foramen. posttraumatic etiology cannot be excluded.  can you please explain this to me in plain English and is it bad. thank you for your time and consideration

ANSWER: Dear Quentin,

You have several findings on your MRI.  The report indicates that you have significant disc degeneration, meaning that the pads of cartilage between the joints are worn out. They have lost much of their integrity, resulting in dessication, loss of hydration, bulging, etc.  The problem is that when they are bulging, they are pushing up against the tissues that cover the nerves and the spinal cord.

Here are some basic definitions:

Thecal Sac:   The tissue that surrounds the spinal cord
Neural Foramen:  The tunnel through which a nerve passes
Disc Herniation:  Part of the disc is pushing out
Lateral Recess Stenosis: Narrowing of the cannal through which nerves exit the spine
Fact Arthropathy:  Arthritic degeneration of a joint in the spine
Ventral Epidural Fat:  Fatty pad that protects the cord
L3-4, L4-5, L5-S1:  These describe levels of the discs.

You have significant spinal degenerative problems, with nerves being irritated and pinched. This can be a very debilitating condition.

I hope that this helps you to understand.

Keith Biggs, DC
http://www.eastmesachiropractor.com

---------- FOLLOW-UP ----------

QUESTION: can the problems found in the mri of my back be fixed and if so how. also if untreated will it continue to get worse. sorry i didn't ask the first time. thank you for your quick and accurate response time. my apology again for not asking the first time

Answer
Dear Quentin,

Degenerative changes of the spine cannot be reversed. In other words, there is nothing that you can do that will make you grow new discs and make your body remove the spuring.  You have to change your mind set away from "what can I do to fix this" to "what can I do to help manage and control the condition."

Management and control, in an ideal situation, would include:

1) Spinal manipulation/chiroopractic care and physiotherapy
2) Stretching exercises
3) Strengthening exercises
4) Proprioceptive training/exercise
5) Decompression spinal traction therapy
6) Epidural injections, if warranted, followed by continuation of 1-5 above
7) Possible facet joint injections, as a test to see how much of the pain is caused by facet joint arthrosis
8) if 7 is beneficial in easing the pain, than radiofrequency neuroablation might be indicated
9) Testing for use of an implanted nuerostimulator is an option
10) Spinal surgery is a LAST resort... only after everything else has failed.

Again, it is important to remember that if 1-9 are beneficial, even only temporarily, they should be continued.  There is nothing that will make the condition go away, even surgery. Surgery often fails in easing the symptoms, and always results in scar tissue and potentially other very serious consequences.

I hope that this gives you some ideas of things that you can do.  The 1-10 list is how we approach this type of condition in my office with Arrowhead Health Centers in the greater Phoenix area.

Here is a link that might help you to understand some of the anatomy of the spine.  There is a lot of information on my website that talks about spinal degenerative changes and potential treatments.  http://eastmesachiropractor.com/index.php?p=97737#a2

Good Luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com
http://www.arrowheadhealth.com