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Forum Name: Spinal problems and back pain

Question: Herniated disk or srained lumbar?


 maca123 - Thu May 14, 2009 7:20 pm

Here are two MRI's that they marked ( http://i77.photobucket.com/albums/j62/d ... mri1-1.jpg ) - ( http://i77.photobucket.com/albums/j62/d ... 3/mri2.jpg ) The diagnostic center says "small central dish herniation at L5/S1". The doctor says "strained lumbar". so which is it if you are able to tell?
 Tom Plamondon PA-C - Fri Jun 12, 2009 12:03 pm

User avatar Hello,
From the lateral view all the disc levels appear the same. I do not appreciate a bulge from the lateral view comparatively. From the sagital view, there is a mild disc bulge but should also be compared to the other levels and correlated with clinical symptoms.

If there are no neurological symptoms, then conservative treatment is indicated (hot/cold modalities, activity as tolerated, physical therapy, NSAIDs) otherwise consult with the neurosurgeon.

This is likely a lumbar strain versus a herniated disc causing the low back pain.

Take care.
 maca123 - Sun Jun 14, 2009 7:54 pm

Would a lumbar strain cause a semi sharp pain to go down my right leg to my knee? i had physical therapy 3 times a week for 3 weeks my back pain comes and goes as the pain in my leg does. Shouldn't the disc be part of the diagnosis? Is there a next step my doc. will do since i still get pain?
 Tom Plamondon PA-C - Sun Jul 12, 2009 8:43 pm

User avatar A lumbar strain can cause radiating leg pain if there is acute inflammation in the facet joints (small intervertebral joints).

Yes, disc protrusion can cause radiating pain if is touching a nerve. This should be reported by the radiologist upon MRI review.

If the leg pain continues or worsens despite physical therapy, pain management may be the next step. They can do spinal injections to alleviate pain and inflammation. If you back and leg show severe physical deterioration then a trip to the neurosurgeon would be next.

Take care.

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