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Emmanuel asked...

The difference between a bulging and slipped disc?

Tags: backache , bones

I am wondering what is the difference between bulging disc, slipped disc and herniated disc. If the MRI report says that I have a Partial sacralisation of L5 vertebra is seen. Dessication of the L4/L5 disc is seen with an asymmetric left disc bulge. Suggestion of a left posterolateral broad based protrusion with indentation of the left L5 root nerve is also made. Severe left lateral recess and moderate left exit foraminal stenosis is noted. What does it mean and can I be cured of this condition totally? Already now I don't feel any more pain and I have stopped taking painkillers. It has been one month since I sustained this injury. I can run and bend forward and exercise. I dare not lift heavy things and do sit ups though. My physiotherapist said I can recover fully and return to my normal self like as if I don't have slipped disc anymore after a few more sessions. But by specialist was unsure of whether I could recover.

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The answer

Back scan terminology can sound complicated - a variety of simpler common terms are also used to describe a damaged spinal disc (herniated, bulging, slipped). These are descriptions of the loss of the normal structure and shape of the disc which can cause nerve root pressure resulting in back and leg pain. The spinal discs cushion the load on the back and when they come damaged they can press on the nerve roots (indentation of the nerve roots) which causes pain. Sacralisation of the bony spinal vertebrae means that two of the vertebrae are joined together rather than being cushioned by the usual shock absorbing disc - this does not usually cause any major problems other than loss of some spinal flexibility.

It is well known that scan findings do not always correlate with the symptoms that a patient may have - for example there may be minor bulges of several discs seen on a scan but these do not cause any symptoms. Attention to the patients symptoms is of most importance in making a diagnosis. The fact that your symptoms have resolved suggests that the pressure on the nerve root has settled.

It is important to now maintain good back strength, correct posture and lifting technique to prevent the symptoms recurring which is always a possibility if you have a damaged disc.

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