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Ask A. Schuyler, NP Your Own Question
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 16211
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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Hi, I have a moderate circumferential disc buldging at L4-5

Customer Question

Hi, I have a moderate circumferential disc buldging at L4-5 worse than L5 S1 level without any involvement of both neural foramina.degenerative changes at the facet joints noted and mild thickening of the ligamentum flavum at the lower lumbar.

I asked this question previously but it has not helped so now can you tell me if my disc is anterior pushing towards the stomach or posterior sticking out the back or sideways to left or right.

Also if you can explain what does degenerative changes at facet joins mean and it this permanent change can this be cured?
I have pain in my back and in my heels and right leg and stiffness in right knee.My heels are sour like i have been hit and they hurt if you touch and feel cold all the time.

I have started to do hyper extension exercises but recently i took someone's advice they told me not to do this as this will push the disc even more towards the stomach and I should do exercises like crunches and lifting legs in the air towards the stomach.

So can you please advice which exercises i should do and if this is an serious and will this get worst with time and what i can do to improve please give ma detailed explanation.

Regards.
Submitted: 3 years ago.
Category: Health
Expert:  Dr. Chip replied 3 years ago.
Hi. First off, cirumferential bulging means that the disk is bulging out all around--in a complete circle so it's bulging forward and backward and to both sides. Degenerative facet joint changes indicates arthritis with extra bone growth where the vertebrae interlock with each other in the rear and that can't be improved and is permanent. As for safe exercises for you, you shouldn't try any on your own until evaluated and advised by a trained physical therapist since the wrong ones could do more harm than good
Customer: replied 3 years ago.
Relist: Incomplete answer.
Hi, I have a moderate circumferential disc buldging at L4-5 worse than L5 S1 level without any involvement of both neural foramina.degenerative changes at the facet joints noted and mild thickening of the ligamentum flavum at the lower lumbar.

I asked this question previously but it has not helped so now can you tell me if my disc is anterior pushing towards the stomach or posterior sticking out the back or sideways to left or right.

Also if you can explain what does degenerative changes at facet joins mean and it this permanent change can this be cured?
I have pain in my back and in my heels and right leg and stiffness in right knee.My heels are sour like i have been hit and they hurt if you touch and feel cold all the time.

I have started to do hyper extension exercises but recently i took someone's advice they told me not to do this as this will push the disc even more towards the stomach and I should do exercises like crunches and lifting legs in the air towards the stomach.

So can you please advice which exercises i should do and if this is an serious and will this get worst with time and what i can do to improve please give ma detailed explanation.

the answer i receive previously was not satisfactions if the bone is growing at facet joint would this be painful later in life? or what can i do to improve my health or the bone?

also if the disc is bulging all side then how can it be fixed as i believed the disc is anterior bulging therefore i should do curl exercises and exercises which make abdominal stronger?

why are my heel sore both of them and how can i get rid of pain in my leg?

Regards.
Expert:  A. Schuyler, NP replied 3 years ago.
Hello,

Answers provided are for informational use only and don't confer patient-provider relationship. My name is NP Schuyler and I will do help you.

Let's try this one question at a time:


1. I have a moderate circumferential disc bulging at L4-5 worse than L5 S1 level without any involvement of both neural foramina.degenerative changes at the facet joints noted and mild thickening of the ligamentum flavum at the lower lumbar.
I asked this question previously but it has not helped so now can you tell me if my disc is anterior pushing towards the stomach or posterior sticking out the back or sideways to left or right.

"Circumferential" means that the disk is bulging all the way around, front, back, and to both sides. It isn't an "either/or" situation, but all the way around the spine. It isn't anterior or posterior but both as well as both sides - north, south, east, west, and all points in between.

Degenerative changes generally occur with age. The definition is gradual decline of cells and tissues that leads to decline in function.

2. Also if you can explain what does degenerative changes at facet joins mean and it this permanent change can this be cured?

Degenerative changes mean that there has been deterioration of the facet joints. Once something has degenerated it cannot be "cured" but is permanent.

3. I have pain in my back.

This may be from the degenerative changes in the facet joints. However, only your physician can make that diagnosis.

4. and [pain]in my heels....why are my heel sore both of them.

What diagnostic tests have been run to determine why you have pain in your heels? This can be from injury, heel spurs, plantar fasciitis, etc. Without an examination, there is no way to tell what is causing the pain. Without a cause, there is no way to fix it.


5. and how can i get rid of pain in my leg and right leg and stiffness in right knee.

What is the diagnosis for the pain and stiffness in your leg and knee? Getting rid of the problem would depend on what is causing it. It can be from improperly done exercise, or from problems in the muscles or in the knee joint itself. Xrays would be required to determine what is going on.

6. I have started to do hyper extension exercises but recently i took someone's advice they told me not to do this as this will push the disc even more towards the stomach and I should do exercises like crunches and lifting legs in the air towards the stomach.
So can you please advice which exercises i should do...

You shouldn't do exercise until you meet with the physical therapist or physical medicine and rehabilitation physician. Exercise can actually make the problem worse.


7. ... and if this is an serious and will this get worst with time and what i can do to improve please give ma detailed explanation.

Degenerative changes do not get better with time. If the bulging disk is causing the back pain, physical therapy may help some to increase the muscle strength. However, if that doesn't help, then surgery to stabilize the spine would be required. At the same surgery they could clean up any calcium deposits on the facet joints.

8. the answer i receive previously was not satisfactions if the bone is growing at facet joint would this be painful later in life? or what can i do to improve my health or the bone?

Any degeneration in the spinal anatomy can cause more serious problems over time as the problem gets worse. There isn't anything you can do to improve this at home until you know for a fact what is causing all your problems and meet with a physical therapist for the proper exercise regime. Once you know from him or her what exercises you should do, you can practice those exercises at home.

9. also if the disc is bulging all side then how can it be fixed as i believed the disc is anterior bulging therefore i should do curl exercises and exercises which make abdominal stronger?

Surgery may be required to "fix" the vertebrae so that bulging is no longer a problem. There are several approaches to doing this, so only a surgeon can decide what is best in any given case. You should not do exercises of any type that involve the back until you meet the physiotherapist.

Best regards,

Schuyler
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