relief of pain?

[rozina]

i have a pain in lower back & left leg since 3 months.i went to neurologist he advised for mri which shows central diffuse disc at level of l5-s1 causing slight anterior thecal indentation with mild encroachment of the neural foramina bilaterally.at l2-l3 level there is a left far lateral disc protrusion causing left lateral recess stenosis of a mild to moderate nature with a left foraminal narrowing.loss of normal lumber lordosis.                                                      my age is 28 years.i m married.i have 2 childrens.please tell me about the diagnosis and treatment other than surgery according to this mri report?thanks.

[Jaybay]

Surgery is not automatically necessary for these kinds of spinal changes.  Of course, if your doctor recommends it, you need to sit up and listen to his reasoning.  Most doctors will want you to try physical therapy before resorting to the knife.  By strengthening your core body muscles, you remove much of the strain on your spinal joints and thus less the pain response.  

Epidural steroid injections may be of great benefit to you as well.  The damaged area of the spine is bathed with a corticosteroid solution that reduces inflammation and pain.  Many patients remain pain free for weeks or months giving them time to do the physical therapy work.  A pain management physician administers these injections in an operating room under twilight anesthesia.  The injection itself doesn't take much time at all.  If you don't already see a pain doc, ask for a referral and discuss injections as an option to treat your pain.  Good luck!

[Tuckamore]

Hello Rozina,

Welcome to the Pain Mangement Forum. I am glad that you found us and took the time to post. But I ma very sorry to hear about the concerning results of your MRI, especially at such a young age.

As Runningmom said there are no physicians on this forum. Most of us have personal experience in chronic pain, some of us have a medical background but none of us are experts.

Unfortunately radiologists or physicians don't always use the same terminology when describing the findings in an MRI or other diagnostic testing. This often causes confusion not only to clinicians but to lay persons.

Diffuse disc means that it has increased in size, or spread out, central is self explanatory. Usually there are other words that go along with the description of a diffused disc.

The words encroachment and stenosis are significant. Stenosis is a narrowing of the space and encroachment is a similar term meaning coming close to or pressing upon. Whenever there is a narrow this can cause encroachment upon the nerves. This usually means pain, radicular pain.

Loss of normal lumber lordosis refers to the natural curvature of your spine....meaning you have lost the natural curvature.

Maybe more important than the specific terms is that the over all report says pain producing spinal structure changes.

I am sorry that I cannot tell you what may be your best plan of treatment. I would guess that a good physical therapy program, steroid injections and pain management would be the first approach to your structural issues. Physicians usually try to calm things down first. They may take a wait and see attitude and try to determine how fast or IF your condition will progress or deteriorate.

How severe is your pain? Surprisingly some of the worst MRI reports find patients with little pain, just as sometimes little disease or structural changes can produce higher than expected pain levels.

Your surgeon or specialist will decide on the best course of action and develop a plan of care (POC) for you. In my opinion surgery should be your last resort and most good surgeons will say the same. However if they beleive that there is an urgent change that will not respond to conservative therapy, surgery may be your only option.  Only a skilled professional can make those determinations.

I encourage you to do just what you appear to be doing, educate yourself. Learn exactly what each term means and the treatments available. Once you have done this sit down with your medical provider and take an active roll in deciding your best POC.

I also suggest second opinions. Make sure the provider you select is skilled and very experienced, not matter what may be your treatment plan.

Please keep in touch and let us know how you are doing. Feel free to ask additional questions. I hope you will become active in our community. And of course I wish you the very best. I'll look forward to hearing from you again soon.

Take Care,
~Tuck

[RunningMom]

Hello and welcome to the pain management forum.  There are no doctors here on this forum.  We are a community who support each other on our journey of chronic pain.  

I can not tell you anything about your diagnosis.  You will have to talk to your doctor who is experienced in reading your findings.  The treatmenet is up to you and your doctor.  I find it best in getting more then one opinion from the surgeon.  You will most likely benifit from a pain management clinic.  They will help you in lessening the pain through medication, Injections, PT, biofeedback, acupuncture, tens unit, ect..

I'm sorry I'm not more help.  I personally have had a spinal fusion just over a year ago and all the procedures and nothing helps the pain.  There are no two injuries that are the same and everybody bodies handle the treatments differently as well.