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    Old 02-19-2014, 07:48 PM   #1
    Rachael1972's Avatar
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    MRI lumbar spin

    Hi, I injured my back while I was lifting and walking heavy products.
    My MRI says
    L1-2 1-2 mm posterior disc bulge without impingement ( I no what this means)
    L3-4 2.2 left lateral disc bulge, without impingement
    L4-5 4 mm left lateral disc protrusion, with annular tearing extending over 9 mm, with mild bilateral facet arthropathy, causing minimal narrowing of the left neural foramen, without significant central canal or right neural foranimal stenosis.
    L5-s1 preserved disc height and normal posterior contour, with mild bilateral facet arthropathy and ligamentum flavum hypertrophy, without impingement.

    My question is would this be causing pain in the legs from standing to long. I have pain in my back all day due to aching. But I am having pain in my legs when I am at work after I have stood to long.

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    Old 02-19-2014, 10:01 PM   #2
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    Re: MRI lumbar spin

    To answer your question: definitely!

    The spinal nerves run out from the central canal to innervate various parts of the body. They run in specific patterns that are called dermatomes. You can look up a "dermatome map" online to see which spinal nerve innervates which particular part of the body. For example, if you tell a doctor your big toe is numb, the doctor will know to check out the L4 nerve in the spine.

    At L1-L2 and L3-L4, there are small disc bulges that are not pushing into a spinal nerve.

    The bulging disc at L4-L5 is the one that is probably causing your leg pain. It is larger and there is also a 9mm annular tear on this disc. An annular tear or sometimes called a fissure, is a rip in the outer layer of the disc. It can be painful as there are nerve endings in this outer layer. In addition, this bulge/tear is pushing out of the disc space and is taking up space in the foramina of the left side. This causes the foramina to narrow which can cause pain as the spinal nerve travels through the foramina as it exits the spine out to the body. Depending on the amount of narrowing, the spinal nerve will be either irritated or compressed. It is not causing a problem with the foramina on the right side or in the central canal. These conditions tend to cause arthritis in the facet joint at the level of the this case, L4-L5.

    At L5-S1, the disc appears to be OK, the disc has not flattened, but there is mild arthritis on both sides of the facet joints, and the thick ligament that runs along the back of the spine and serves to link things together is showing signs of drying out and losing its elasticity...but the spinal nerves at this level are not compressed. These are small signs of the beginning of disc degeneration, something almost all of us get eventually from every day living.

    The L4 to some extent, and the L5 spinal nerves when irritated or compressed can cause sciatic type pain, pain that runs down the back of the leg, can cause numbness in the feet and toes, etc. Take a look at that dermatome map to see what they innervate. Although the nerve is compressed in the spine, the pain radiates along the path and you can have pain all along the path or just one part of it.

    Hope this gives you some idea of what is going on.

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    bulging disc, pain in back

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