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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should Back Pain Based On This MRI Result Be Treated?

My MRI shows a posterior osteophyte disk complex with bilateral foraminal extension. In conjunction with mild bilateral facet hypertrophy, and are severe foraminal stenoses bilaterally. There is some contact with the exiting left L5 nerve root. Also a lesion within the L4 vertebral body believed to be a hemangioma.Don t know where I should go from here. I have had back pain most of my adult life which has gotten much worse the past year.
Tue, 13 Jan 2015
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Radiologist,  's  Response
Hi,
Thanks for writing in.

The lesion within the L 4 vertebral body is a hemangioma which is a completely benign finding. It is not a concern if there is no weakening of the vertebra and probably due to formations of blood channels within.

The disc osteophyte complex might be the reason for your back pain. The nerve roots at L 5 level on the left side is getting pinched and therefore the pain. Initially physiotherapy, avoiding excessive physical activities and taking over the counter pain killers help.

If you do not get sufficient pain relief then taking neurogenic pain relievers and oipoid medications might be required and these are prescription medications.

If pain persists with more than a year even with adequate medications then the pinched nerve must be released with small surgical procedures. Laser assisted techniques are also available in some hospitals and clinics.
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How Should Back Pain Based On This MRI Result Be Treated?

Hi, Thanks for writing in. The lesion within the L 4 vertebral body is a hemangioma which is a completely benign finding. It is not a concern if there is no weakening of the vertebra and probably due to formations of blood channels within. The disc osteophyte complex might be the reason for your back pain. The nerve roots at L 5 level on the left side is getting pinched and therefore the pain. Initially physiotherapy, avoiding excessive physical activities and taking over the counter pain killers help. If you do not get sufficient pain relief then taking neurogenic pain relievers and oipoid medications might be required and these are prescription medications. If pain persists with more than a year even with adequate medications then the pinched nerve must be released with small surgical procedures. Laser assisted techniques are also available in some hospitals and clinics.