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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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History Of Back Injury. MRI Shows Lumbar Disc Disease With Disc Bulge. Have Constant Pain. Want Second Opinion

Hi, I injured my back at work last September. have had constant pain since, had a x-ray which showed l1-l2 wedged vertebrae and mild schemans disease, had \ ct scan which show L4 L5 slight bulge, just had a MRI which says
General Findings, The alignment appears normal down to the lumbosacral junction with a minor degree of disc height reduction of L5-S1 with preserved hydration. There is also a minor degree of loss of disc height at lever L1-L2. Disc hydration preserved.

The remainder of the lumbar discs appear satisfactory. The vertebral bodies show normal signal. The conus medullaris appears normal.

At the level of L5-S1, minor central disc bulge is show. It does not appear to indent or displace the S1 nerve roots. Exiting L5 roots normal. Minimal facet joint disease.

At the level of L4-L5, minor facet joint disease. The disc contour appears satisfactory. Central canal and foraminal arrears satisfactory.
At the level L3-L4, L2-L3, normal disc contour.

At the level of L1-L2, minor degree of left paracentral disc bulge. It does not appear to contribute to central calal stenosis or foraminal stenosis.

Cauda equine appears normal.

Conclusion.

Mild degree of lumbar disc disease L1-L2 and L5-S1 with minor disc bulges. no significant calal stenosis or disc protrusion is seen.
Minor degree of lower lumbar facet joint disease. No pars defect.

My question is that my Doctor has the reports and said I can go back to work with full dutys after seeing the MRI results, I have constant pain which spikes during the day, My job is a tyrefitter which is a heavy work load on the back, I don't know what to do so should I get a second opinion or suck it up and go to work, The doctor said I have to learn to live with the pain.
Sat, 3 Aug 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

All the MRI findings in the description suggests that you have LUMBAR DISC DISEASE with DEGENERATIVE CHANGES.

The management of the condition is as follows -

* avoid lifting heavy weights as it imparts more strain on your back
* avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.

Hope this information is helpful .Good day
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History Of Back Injury. MRI Shows Lumbar Disc Disease With Disc Bulge. Have Constant Pain. Want Second Opinion

Hi, thanks for writing to HCM. All the MRI findings in the description suggests that you have LUMBAR DISC DISEASE with DEGENERATIVE CHANGES. The management of the condition is as follows - * avoid lifting heavy weights as it imparts more strain on your back * avoid forward bending activities as it will worsen the disc protrusion * Use a lumbosacral back support to augment your spinal muscles * Intermittent pelvic traction to cause a regression of disc * Maintain optimum body weight,if you are obese * Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided. * Judicious use of analgesics and muscle relaxants. Hope this information is helpful .Good day