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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does My MRI Scan Report Indicate?

I had an MRI today. I saw the findings are: L4-L5: Broad-based disk osteophyte bulge, mild central canal stenosis. Bilateral facet effusions/facet synovitis. How bad is this? There are times I can barely walk because of pain and then other times it s not so bad.
Fri, 9 Dec 2016
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General & Family Physician 's  Response
As per your history is concerned you have degenerative disk disease so first start conservative methods like this-
!)a physiotherapist will teach you the basic body mechanics, such as the correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into a car, and sitting in a car. Back school also teaches patients the proper and improper approaches for sitting, bending forward, lying down, coughing, or sneezing when their back is painful.
2)Exercise
Different types of exercises are prescribed, depending on each patient's diagnosis. Floor exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises are some of the best activities for back pain. Aerobic exercises improve endurance if performed regularly (ie, ≥ 3 times/wk). Relaxation exercises are good for relieving muscular tension that may aggravate back pain.
3)Medications
These include muscle relaxants, nonsteroidal anti-inflammatory drugs, and analgesics.
4)Physical modalities-
These include the use of ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation.
5)Injections-
Epidural steroid injections are most commonly used for therapeutic purposes. The type and dosage of steroid varies widely. Methylprednisolone (80-120 mg) mixed with normal saline to achieve a volume of 8-10 mL is an effective and safe dosage and volume.lidocaine or bupivacaine can be used in combination with the steroid to achieve immediate pain control.4 injections should be given annually.
if above conservative approach fails or no respond at all or if any compression of nerve occurs then surgical treatment is the last options.
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What Does My MRI Scan Report Indicate?

As per your history is concerned you have degenerative disk disease so first start conservative methods like this- !)a physiotherapist will teach you the basic body mechanics, such as the correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into a car, and sitting in a car. Back school also teaches patients the proper and improper approaches for sitting, bending forward, lying down, coughing, or sneezing when their back is painful. 2)Exercise Different types of exercises are prescribed, depending on each patient s diagnosis. Floor exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises are some of the best activities for back pain. Aerobic exercises improve endurance if performed regularly (ie, ≥ 3 times/wk). Relaxation exercises are good for relieving muscular tension that may aggravate back pain. 3)Medications These include muscle relaxants, nonsteroidal anti-inflammatory drugs, and analgesics. 4)Physical modalities- These include the use of ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation. 5)Injections- Epidural steroid injections are most commonly used for therapeutic purposes. The type and dosage of steroid varies widely. Methylprednisolone (80-120 mg) mixed with normal saline to achieve a volume of 8-10 mL is an effective and safe dosage and volume.lidocaine or bupivacaine can be used in combination with the steroid to achieve immediate pain control.4 injections should be given annually. if above conservative approach fails or no respond at all or if any compression of nerve occurs then surgical treatment is the last options.