Brief Answer:
Back pain may be due to bulging lumbar disk

Detailed Answer:
Good afternoon and thank you for your query regarding your condition. I'm very sorry that you are having difficulties. Please understand that you've not provided any clinical information regarding your condition and therefore, the only information comes from your attached tests.

I did review all of your lab work, your electrical studies of the upper extremities, and the MRI of your spine.

The only results of relevance to your stated condition would be that of your MRI study, however, be aware that no matter what an MRI SHOWS, there is a low level of sensitivity with respect to its ability to GUARANTEE that what one is seeing on the scan is actually what is responsible for a patient's symptoms. I know that sounds difficult but let me give you this example. 40% of patients who have NO OVERALL symptoms of back trouble at all will have abnormal findings on MRI scans of their backs including bulging disks (your case), herniated disks, pinched nerves, and EVEN in extreme cases, compressive tumors/infections. As incredible as that may sound, it is true. Therefore, what an MRI shows is not at all what may turn out to be the case. Information from such studies must be taken in concert with neurological history, examination. and other ancillary or supportive tests such as EM/NCV, labs, etc.

Having said that, your MRI studies do suggest the presence of a MINIMAL bulging disk in the cervical spine (the neck) as well as a slightly more important bulging disk in the lumbar spine. Let's take a look at each of those a bit more carefully.

In the neck you have MINIMAL disk bulging that only slightly seems to be narrowing the space in the spinal canal at multiple levels (C4/5, C5/6, and C6/7). However, this mild narrowing of the diameter of the spinal canal in no way compromises the nerves or the cord passing through this space. These changes are most likely due to arthritic disease which for a 51 year old man is considered normal aging outcomes. Actually, your neck looks PRETTY GOOD in my opinion in terms of the MRI scan. Therefore, that radiographic finding is of little to no relevance to your back pain problem.

In the lumbar spine you also have rather mild changes at one of the most commonly seen levels where arthritis tends to affect people and that is L4/5 and L5/S1. And in fact, the changes that are seen are not even in the way of degenerative changes ascribable to bony defects as might be expected. There is DISK BULGING which is occurring POSTERIORLY (toward the back end of the spinal column) which tends not to interrupt or interfere with the trajectory of any nerves and definitely would not touch or irritate the spinal cord. Nonetheless, a bulging disk could in theory at that level of the spinal column....barely touch very thin filaments of nerves that could be passing close by to the bulge which is NOT DETECTABLE by the MRI since they are so very small and dispersed. The other possibility is that the mere BULGING of the disk itself could be causing pain receptors that are believed to be present in the disk and therefore, the pain would be referred to as MECHANICAL BACK PAIN. This often happens due to a person being overweight, obese, engaged in repetitive lifting or pushing types of activities such as heavy manual labor, moving furniture, etc.

So, again, without knowing anything of your background or history as to how this problem evolved I cannot tell you the most likely scenario to explain what's happeneing.

I can tell you that the electrical studies and lab tests that you obtained do not show anything that would be of importance or relevance to BACK PAIN that you describe and I assume they were ordered for unrelated reasons unless the doctor thought that the cervical degenerative changes were of enough significance to warrant a study of the arms. Perhaps, an electrical study of the legs would be helpful as well since the abnormal changes in the disk would if anything, have the most chance of causing back pain symptoms.

Also, none of the labs obtained seem to have anything of relevance to assist in the diagnosis of BACK PAIN.

CHEERS!

If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get you back on the path of feeling well soon.

This query required 60 minutes of professional time to research, assimilate, and respond in complete form.

---