Many times a patient will come to my office with a diagnosis of Lumbar Disc disease. Commonly, they have been told they had a herniated disc. The patient is convinced this is the cause of their pain because they had an MRI sometime in the past which showed it. Pain management approaches, including epidural steroid injections, have often failed to provide any significant or lasting relief. The patient may then be referred for surgical evaluation, and come to me hoping I can offer something less invasive.
In such cases I will review the MRI myself. Often a disc bulge is present, but not pressing on anything. This is a very common finding in the healthy, pain free population. Yet, for those medical professionals with a superficial understanding of back pain, any finding on an MRI becomes the diagnosis, and treatment is prescribed accordingly.
Further, many disc bulges will heal on their own over time, and may not be evident on a subsequent MRI. This is to say that if you were diagnosed with a bulging or herniated disc even a year ago, much less several years ago, it may have self-healed.
The Mayo Clinic published an article entitled: Comparative Role of Disc Degeneration and Ligament Failure on Functional Mechanics of the Lumbar Spine. In this paper the Mayo Clinic researchers wanted to make a clear distinction between back pain from disc disease and back pain which resulted from spinal ligament damage.
Their bottom line: A competent, thorough, physical examination of the patient is essential to making a correct diagnosis of the actual source of the patient’s pain. Relying on the MRI alone often leads to a wrong diagnosis, sometimes followed by unnecessary and unsuccessful surgery.
This only confirmed what I have come to realize in my years of practice: low back pain should be diagnosed on an educated and detailed physical examination, then confirmed with an MRI if indicated.
If the low back pain comes from ligaments, then treatment with Prolotherapy is a very successful approach.
If the low back pain truly comes from a herniated disc, then treatment with Spinal Decompression complemented with Acupuncture is very successful.
If you have been told you have a bulging disc, please see us before undergoing surgery- the disc may not be the true source of your pain!