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Annular tear, lower back pain, where to from here

davefddavef Posts: 1
edited 03/24/2015 - 2:17 AM in Lower Back Pain
I have a couple of protruding discs in my neck which have been causing me pain in my shoulders, neck & wrists for 8-9 years. I'm used to the pain, most days it's 3-4, I regularly go through flare ups which sends the pain to a constant 5-7 and occasionally 8-9. As I say I'm used to it, I've learned to push the pain to the back of my mind. I don't take any pain killers as they don't work.

About 1-2 years ago I got pain in my lower back, which is normally about 2-3, worse in the morning and at night and especially bad if I sleep longer than normal. The pain has been radiating down my legs and sometimes to the top of my feet. I was working on the assumption that it was another case of protruding discs but in my lower back. Anyhow just over a month ago I rolled my ankle and after week or two I was convinced to go get it checked. Turned out I had torn a ligament. While with my GP I mentioned the lower back, leg and footpain. As I also have Type 2 diabetes, my GP was worried it might be neuropathy and checked me out. He felt I had poor reflex reactions in my ankles. As I had no signs of neuropathy he referred me for an MRI to check for disc protrusions or arthritis. My GP called me afterwards and said the MRI didn't show and protrusions or arthritis. He suggestion for treatment was to get some back exercises from the web and do them.

Then out of the blue he called me on Saturday, I missed his call and he left a message to say again there wasn't anything really significant but that he'd send me a copy of the report to show "my" physiotherapist (why he thinks I have a PT is beyond me).

I got a copy of the report which is:

Technique: Non contrast multi-planar T1 and T2 weighted MRI Scanning of the lumbar spine was performed.

Normal vertebral alignment.
Desiccated disc and minimal central disc bulge and annular tear present at the L5-1 level and there is some minimal
facet joint hypertrophy at the L4-5 level but no appreciable canal or exit foraminal narrowing at either level.
No degenerative disc protrusions and widely patent neural foramena at remaining upper lumbar levels.
Normal signal throughout the visualised lower cords and conus.
No other abnormality seen.

I'm confused as GP first said there wasn't anything on the MRI, but there's reference to an annular tear and minimal disc bulge, minimal facet joint hypertrophy. From what I can find online, the facet joint hypertrophy could be cause if the sciatic pain I get in my legs, I'm still reading up on the annular tear.

I'm not sure where to do from here, I'm not sure if physiotherapy could/would help or if I should be looking at/for an epidural to relieve the pain.

Any suggestions or insights would be greatly appreciated.

Welcome to Spine-Health

It would be very helpful if you could provide us with more details. So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong,

Here are some questions that you should answer:

  • - When did this first start?
    - Was it the result of an accident or trauma?
    - What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)
    - What Conservative treatments have you had? Which ones?
    - What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)
    - What medications are you currently using? (details, dosage, frequency, etc)
    - Has surgery been discussed as an option? (If so, what kind)
    - Is there any nerve pain/damage associated?
    - What is your doctor’s action plan for treating you?

Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

Please take a look at our forum rules: Forum Rules

Please remember that no one at Spine-Health is a formally trained medical professional.
Everything that is posted here is based on personal experiences and perhaps additional research.
As such, no member is permitted to provide

  • - Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
    - Medical advice of any kind
    - Recommendations in terms of Medications, Treatments, Exercises, etc

What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.

It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are
I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

Diagnosing spinal problems can be very difficult. In many ways its like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then its up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

Specific comments :
There is no one on these forums that is trained to provide you with medical advice. However, just reading some of what you wrote about the MRI, it sounds ok. You always want to look for three key words in any diagnostic report. MILD, MODERATE and SEVERE. Those words alone identify the situation

Personal Opinion, not medical advice :
Any time pain levels start to reach 8, you need to think about going to the ER. At that pain level, you really can not take care of yourself.

--- Ron DiLauro, Spine-Health System Moderator : 03/23/15 08:14 est


  • Lots of uses of the word minimal are encouraging.

    If you want to understand the report, you would be best booking an appointment with your GP and ask them to explain it all to you, face to face.

    Nobody here is qualified to do that.

    L5-S1 herniation. Both knee meniscus tear. L4-5 herniation - 2 x nerve block injections. L4-5 discectomy. L1-2 nerve block injection. L4-5 reherniation - TLIF fusion. 2016: L1-2 and L5-S1 retrolistheses and multiple facet joint degeneration.
  • To Dave F and others with annular tear, I agree with the forum moderator. Re: going into the office, and getting the results face to face. Also, I've found it very helpful to have read the research, and developed a set of questions. Finally, with such back problems ( I have three annular tears, one severe lL 4-5), I have found it helpful to get several expert medical opinions, ie specialists in the area. Finally, the third specialist recommended against back surgery, which matched the literature in my case. So, I learned PT, and also medications, some supplements. I'm very glad as the pain has become manageable, and I recently my rheutologist discovered ( DNA tests, and others, ) that I have a genetic disease EDSIII. If I had had the recommended back surgery, the. results of such with my disease are abysmal. Also, with this I had injuries and intense pain,
    yet by consulting a Pain Management physician ( Anesthesiologist ) I found medication that is satisfactory.
    Also PT can work, but it will be a combination approach that usually gets best results. By the way, please don't walk around in level eight and above pain, not getting help. Why? I used to do that, sometimes working a full day or longer in very strong pain. Finally, the evaluating neurosurgeon hospitalized me to run some tests. While I was in, he showed me that my blood pressure ( usually low normal ) was almost two hundred over one sixty, AND climbing. He said you are going to have a stroke without pain control. I let him give me a pain shot, and thirt minutes later it was normal. So, I started combination treatment after that ( added medication to the PT, and supplements. ) My blood pressure is now low normal, which is normal for EDSIII. Please remember that there is hope, it just takes becoming more educated about your condition; seeing the right physicians, PTs,etc., and becoming your own advocate.
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