MRI says Posterocentral protrusion of L4-5 disc is abutting the L5 nerve root bilaterally What does this mean?

Question

Hi,

I am a 32 year old male. My MRI report says: Posterocentral protrusion of L4-5 disc is abutting the L5 nerve root bilaterally. (In MRI it is black between L4-5 and kind of poking the nerve). My back pains occasionally and I think it is the nerve which is hurting, because the pain is like a sting. Currently I am taking rest and doctor said that he will check if physiotherapy can be started after a couple of weeks. I am afraid of the pain especially when it is near the neck or shoulders. I am able to walk and work. I am being treated by a spine specialist. Please let me know if I have to go to another doctor like a neurosurgeon and can I lead a normal life in future.

Answer 1

Hi,

Welcome to icliniq.com.

I am not sure of your neck symptoms as the neck has nothing to do with your lower back and from your description it is not clear if you have any leg symptoms or bladder symptoms. However I need to see your MRI scan to be able to make a judgment on the further management.

The reason is, if the disc is large and compressing the nerve roots significantly then surgery would be the choice especially if you are being bothered by pain and numbness in your legs along with back spasm affecting your life.

Back pain is really not a disc issue, it is the result of pressure on the the anterior longitudinal ligaments which gets stretched and nerves are irritated. Later facet changes occur and back pain becomes prominent especially after long periods of sitting. Disc pressing on nerve roots will cause shooting electric current like pain going down below the knees and straining while coughing will aggravate the symptoms.

Treatment of a disc prolapse is to remain active within limits of pain rather than bed rest.

Pain settles down in 90% people just by the above method along with analgesics and some physiotherapy in about 6 weeks to 3 months time and they will lead a normal enough life.

Revert back with the reports to a spine health specialist online for further follow up.