Back and Neck Injury/Back Pain

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Question
QUESTION: Dear Sir,   
My wife at 68 & of 36kg,is suffering of back pain due to bulging at L4/L5 & protusion at L5/S1.Her such issue is repetitive-2003.2008.2011 & July 2014.
After viewing MRI Neurologist prescribed-Shelcal-M twice/day & Cholecalciferol once/week.he also prescribed Calcitonin Nasal spray in alternate nostril.
She is also advised rest & some excercise.(So far, orthopedic surgeon gave pain killer & asked for rest & excercise.)
She does have Varicose,on Left Leg,since last 30 years & Vascular surgeon,opined to consult Neurosurgoen,this time,as her pain is predominantly on Left side only.
Whether this treatment for three months will resolve the issue?
.Are you anticipating surgery?Do you feel some degeneration of bones in Spine?I submit the comments of Radiologist on MRI.
You may kindly review & opine about treatment plan & also advise to take preventive steps to combat against recurrence.

MRI Scan of Lumbar Spine. Rekha Desai-68.
MRI was performed using T1/T2Wsequences in multiple planes.
Mild scoliosis of dorso-lumbar spine is seen towards left side.Mild exaggerated lumbar lordosis is noted.Mild degenerative lumbar spondylotic changes are seeen in the form of marginal osteophytes & multilevel disc dessication.Patchy hyperintensity of spine is seen on T1W/T2W images.
Correlation with BMD is sggested to rule out Ostenpenia V/S osteoporosis.(Since 2003,she is taking Rocaltrol-0.25mg once/day)
Mild posterior disc bulge with small left foraminal disc protrusion is seen at L3-L4 level,partially effacting anterior subarachnoid space & indenting existing L3nerve root.Mild left neural foraminal narrowing is noted at L3-L4level.
Small postero-central disc protrusion is seen at L5-S1 level,effacting anterior epidural fat,indenting both traversing S1nerve roots.Bilateral mild neural foraminal narrowing & mild central spine canal narrowing(11.1mm)is noted at L5-S1 level.
Diffuse posterior annular disc bulge is seen at L4-L5 level.
Minimal posterior disc bulge is seen at L2-L3 level.
Mild facetal arthropathy is seen from L3-L4 to L5-S1levels.
Mild ligamentum flavum thickening is noted at L4-L5 & L5-S1 levels.
Thin fatty filum terminale is noted at L2-L3 level.
No central spinal canal stenosis is seen in this study.
Distal cord & conus appear normal.Both SI joints are normal.
No pre/paravertebral,epidural soft tissue or haematoma is seen.
Bilateral psoas & posterior paraspinous muscles are normal.

14.7.2014.

Dr.Kindly appreciate our anxiety level & respond.
GOD bless you.
With warm regards,
anil.

ANSWER: Dear Anil Desai,

Disc bulges and functional scoliosis come from muscular contractions of the spinal musculature.

The proper approach to resolve them is to recover control of those muscles and movements, as detailed in the provided article:  http://somatics.com/back_pain.htm

More on disc bulges and scoliosis | http://somatics.com/back_pain_terms.htm to reassure you.

---------- FOLLOW-UP ----------

QUESTION: Dear Sir,

I am glad that you provided adequate information of Disc bulge.

May I request you,once again for your comment on Drugs recommended & also your findings on MRI.

It will add-up to her confidence as it has become Chronic & the treatment plan suggested by Neurosurgeon is to continue drugs for 3months & some excercise-till she has recovered.

Kindly extend your help,as it will not be taken as second opinion on Issue to discuss with treating doctor.
Thanking you for your prompt reply.
GOD bless you.
Warm regards,
anil

Answer
Dear Anil,

To add to my comments, spondylitic changes come from long-term pulls of spinal muscles upon their attachments.

Facet joint arthropathy means that the joint surfaces where neighboring vertebrae meet have been rubbing due to too-close proximity -- again, due to muscular pulls.

Drugs are of no use in correcting the problem, but only mask symptoms, while tissue damage continues.

With somatic education exercises, changes come rapidly, feelable after one or two practice sessions, so drugs become irrelevant quickly.

A more extensive article exists here: http://somatics.com/wordpress/chronic-back-pain

Back and Neck Injury

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Lawrence Gold

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