Thursday, April 21, 2011

L5 S1 Paracentral Disc Herniation and Foraminal Stenosis

Here is a sample diagnosis of someone suffering from back pain.
"L5 S1, small para-central disc herniation, superimposed on an annular bulge, bilateral foraminal stenosis present, and degenerative hypertrophy of the facet joints."

Well that's a lot to think about and that's just an abbreviated sample report. An entire diagnostic report can be a few pages long, along with a doctor's notes, and possibly even more on top of that from previous treatments, not to mention the possibility of failed treatments or surgeries in the past.

Its understandable that patients can become confused, depressed, and don't really know where to turn and may feel like they are losing an uphill battle. No one would argue that the medical care system is fairly daunting, and not really set up to provide readily available answers. However you have to understand that the medical language is set up to be easily, uniformly, read and digested by medical professionals. So naturally theres a feeling that the patient is given a report in difficult to understand language and then set off to find a specialist. Terms and conditions are based in facts and studies. Diagnosis are backed by medical findings, not guessing, so essentially a fact based language that doesn't infer, to avoid potential problems, is best suited to provide for our safety.

With that out of the way, lets dissect the report above and try to offer a better understanding of whats going on and the available treatment options.

L5/ S1
This is usually how a diagnostic report starts out, by listing the physical location of the problem. L5 is the 5th Lumbar vertebrae, its located in the lower back, and S1 refers to the first sacral (sacrum) vertebrae. Its not unusual to have multiple bulging or herniated discs, along with other spine problems like a lordosis (exaggerated curvature.

Para-central Disc herniation
This is a way of noting the location of the disc herniation, since the discs are round and can herniate from a few different locations. A para-central herniation is located next to the center of the disc. Lateral would mean side, posterior meaning back, etc.

Annular Bulge
The "annulus" is located on the outside of the spinal disc, and wraps around it - kind of like the word annular means once a year, meaning something is cyclical.

Foraminal Stenosis
Stenosis means that something is narrowing or narrow. The foramin is an opening in between the vertebrae that allows the nerve roots to pass through to the spine, and over time, due either to spinal stenosis or other factors, like debris, these openings can become narrow and interfere with the nervous system.

Facet Joint Degeneration
The facet is the connective/ support structure that lies between each vertebrae, and this support and connective structure can wear down over time and cause problems with the spinal structure.

So this is basically a multifaceted problem, that requires an approach that's not all that unusual or difficult. Living Well Medical has been leading the way in treating pain with a multidisciplinary approach. Using Physical therapy to address structural weaknesses, and chiropractic, and decompression to de-stress and de-load the spine, a combination of therapies has been the most efficient way to treat painful conditions. those conditions often being complicated ones.

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