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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31330
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Would decreased T2 signal and moderate decreased disc space

Customer Question

Would decreased T2 signal and moderate decreased disc space height at L2-3 and L4-5 cause pain? And diffuse disc bulges with annular fissure posterior laterally causing mild to moderate neural foraminal narrowing cause pain? Previous lamenictomy decompression at L4-l5. 2 previous radiofrequency ablations from L3-S1.
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: the pain is localized, but is starting to becoming closer and close together when I bend forward or to the sides.
JA: Anything else in your medical history you think the doctor should know?
Customer: Can I send you past two previous MRI reports
Submitted: 2 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 months ago.

I am Dr. Arun and will be helping you today.

The diffuse disc bulges with annular fissure postero-laterally causing mild to moderate neural foraminal narrowing can cause significant pain. The reason of the pain in pinched nerves which come down through the foramen (and which is narrowed). Moderate decreased disc space height at L2-3 and L4-5 also can cause pain, as this suggest degenerative changes in the vertebral joints. The initial treatment usually is (I am sure you must have tried majority of them);

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like 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 and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The 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 (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

8) If obese or over weight, reduce weight for long term benefit.

9) Epidural steroid shots

10) Surgery is usually last resort, when the above conservative measures fail.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 2 months ago.

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Expert:  Dr. Arun Phophalia replied 2 months ago.

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Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 1 month ago.

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Expert:  Dr. Arun Phophalia replied 1 month ago.

Hope you are doing very good.

Please let me know if I can help you further.