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Stephen asked...

No cartilage between my lower discs

Hello, following an MRI scan, I have been advised that I have no cartilage between my lower discs. Although I have back pain, I am still active, walking, swimming, cycling and racket sports. I am wondering 1. Can scan results be wrong, or misinterpreted? 2) What can I do to alleviate the pain, which is always present? Thank you

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The answer

Back pain unfortunately is one of the most common ailments which people experience and accounts for a high percentage of sick time off work.

You say the MRI findings show an absence of cartilage between the discs- this is where the cushions between the spinal bones in your lumbar region have reduced in size and also the gel aspect of that cushion has been lost. (The discs between the spinal bones consist of cartilage and gel).

This often occurs as part of the ageing process but, can also occur as a result of injury by means of incorrect posture, lifting and movements as well as physical injury say through sports.

An MRI scan is an accurate way of assessing the health of the spine as it can show where the discs between the spine have degenerated as well as showing if nerves are impinged or whether there are any bony deformities present.

It is very unlikely that the results of your MRI have been misinterpreted as findings are reported by a trained radiologist and would then be reported onto doctors who would in turn explain the findings to you.

The back pain you are experiencing may well be due to the fact that in your lower spine you now have bone rubbing against bone and also perhaps there is inflammation present that can affect your nerves in the lower spine- particularly the sciatic nerve.

The ways of managing the condition are generally through exercise, maintenance of a healthy weight, strengthening of the core body muscles, analgesia and if necessary surgery.

Exercise is a good thing as this can strengthen your core body muscles and maintain your weight.

By strengthening your muscles you are helping yourself by maintaining a good posture and increasing the support around your spine. Specific low impact sports such as swimming, yoga and pilates are particularly helpful.

Physiotherapy can help as this can educate you in back care and specific exercises to maintain back health as well as providing you with some treatment for the back pain.

Seeing an osteopath or chiropractor may also be of some assistance.

Massage can also help as this can ease tension where muscles have overcompensated for the injury to your back.

Pain relief can help particularly those of an anti-inflammatory nature.

Your GP will no doubt be able to advise and prescribe you pain relief that is suitable for you.

Some people may also be prescribed medications which work on the nerve receptors in the body in order to ease discomfort felt.

A non- pharmaceutical form of pain relief is a TENS machine which blocks the nerve pathway to the brain therefore reducing the perception of pain- these can be obtained through pharmacies.

Other treatments available may include epidural like injections- usually steroid and anaesthetic based, into the space between the bones which reduce inflammation and provide analgesia to the affected area.

If pain is extreme and the spine is unstable surgery may be considered which would mean fusing the bones together therefore preventing bone rubbing on bone when moving.

We would suggest discussing the results of the MRI with your GP as then a plan can be made as to what analgesia and treatments would be beneficial to you at this time.

Answered by the Health at Hand nurses  

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