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Posted on 04-19-2012

"Large Midline Inferiorly Extruded Disc Herniation Detected"
What Does an MRI Report Really Mean?

As we've mentioned in a previous article, reports obtained from diagnostic screening such as an MRI can be pretty tough to understand. These reports are written for doctors in very exact language so there isn't much guesswork or room for interpretation involved. Usually, unless something is missed or if a finding is unclear, something either is or isn't wrong. That isn't to say that if something doesn't show up on your MRI, you aren't really hurting, or that its all in your head. There are muscles, bones, tendons and ligaments in your body, even if not located directly in/ around the spine, that can cause back pain. So something lower down in the kinetic chain can be causing the pain, or in the case of sciatica, the cause of the leg pain is higher up, in the lower back.

Remember that this isn't any sort of definitive guide to understanding, even worse self analyzing, an MRI report. That must be done by your doctor, or chiropractor, or another medical professional that is qualified to treat your condition.  We are simply here to help you, and to help you understand pain, its causes, methods of treatment, prevention, and help you learn about what may be causing harm to your body.

We see a lot of patients suffering from painful conditions, often chronic conditions that they may have been unable to find relief form in the past. Where other treatment centers or plans my have failed, we pull from a vast reserve of methods, and combinations of methods to find solutions, and get people back to living, and yes, enjoying, their lives once again.

A few weeks ago we had a patient email us and asking for information and help for pain that they described as being a "10" or unbearable, and only finding relief from if when lying down.
The pain was located in the lower back and shot down through the back of the leg, all the way down to the lower leg. This is what is commonly referred to as sciatica, lower back pain shooting down the leg, and often causing mobility problems along with sometimes excruciating pain.

The patient described an increase in pain when standing and walking. We also noted that they were a diabetic and had high blood pressure, which usually also means that there is a lack of exercise and physical activity that might have contributed in the long term, to the degradation of an intervertebral disc, and caused the condition which resulted in sciatic nerve pain.

Exercise is a very important factor in remaining injury free, and we also have a physical therapist available that works with our patients once they have recovered enough to be able to perform rehabilitative, and strengthening exercises.

Findings:
Straightening of the Lumbar lordosis compatible with muscle spasm:
Lordosis of the spine is a word that used to describe the curve that exists in the lower back, it looks like a slight S shape when viewed from the side. Lordosis of the lumbar spine can be exaggerated in some people, causing the pelvis to over rotate towards the front of the body, which is also called an anterior pelvic tilt. These tilts can be cause by loose or tight muscles due to sitting, bad posture, or even bad exercise technique, or overtraining one muscle group and ignoring another. In this particular patient, the muscle spasms were getting so bad that they were causing the spine to deviate form its natural curvature.

L5-S1: Large midline inferiorly extruded disc herniation detected. The findings result in severe spinal stenosis and bilateral recess and neural foraminal narrowing.
Most people are walking around with one or more bulging discs, and they may or may not experience pain from them. Sometimes people might experience pain from bulging discs, and then recover from simply resting or changing one bad habit. Others may not have it so easy, and the pain associated with a bulging or herniated disc can become excruciating.
This patient has disc material that is extruding towards the bottom of the disc, and the opening in and between the vertebraes are becoming very narrow.

This particular patient had wanted to undergo spinal decompression, and did not want to have surgery or rely on long term drug treatment, which wouldn't treat the cause of the pain anyway, and just mask symptoms.
Pain is the last symptom of an injury, and taking prescription drugs with tons of negative side effects to relieve the pain is not what needs to be done, instead of masking the symptom we treat what is causing it, in this case an extruded disc, and that results in long term pain relief from the body's healing/ repair process and not drugs.

The patient responded very well to spinal decompression, and reported a very noticeable reduction in pain after just two visits. As the treatment continues there will be a consistent review of the treatment, and additional treatment protocols like cold laser, STIM, Physical Therapy, may be prescribed to help ensure long term relief.

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