What are the implications of having a diffuse disc bulge at the lumbar spine (L4-L5)?

Doctor's Answers 1

Photo of Dr Shee Yan Fong
Dr Shee Yan Fong

Orthopaedic Surgeon

A diffuse disc bulge in your MRI, assuming your MRI radiologist meant a small disc protrusion in his report, represents an aging disc that has naturally lost his water content and its cushion and height with time, resulting in a bulge, like a bulging "worn out" car tyre. Because this is a natural aging process it cannot be reversed or “cured” and disc bulges can also be seen in MRI even if you have no back pain as you age.

But in the presence of back pain from disc bulge, treatment must be started to “depressurise” the disc (usually with lumbar traction) and strengthen your spinal core muscles (usually with physiotherapy) in order to reduce risk of worsening to a larger “slipped” disc in the future, like a “burst” car tyre, requiring surgery to treat in the end. Prevention is always better than the cure.

Similar Questions

Is it safe to continue doing sports with a mild disc bulge?

Thanks for your question. This is indeed problem that many of us will face as we get older and certainly even in young patients this may occur. My only question to you is why you underwent the MRI? Was it for back pain or nerve symptoms in your limbs? As a Sports/MSK physician, I believe that exercise is a essential. This will help keep the weight off, maintain your strength and hopefully limit the progression of your wear and tear (degenerative) changes in your back.

Photo of Dr Dinesh Sirisena

Answered By

Dr Dinesh Sirisena

Sport Medicine

How can I get rid of persistent back pain that is not responding to physiotherapy?

Thank you for your email and I am sorry to hear about your ongoing pain symptoms. This can be an issue after surgery even if it does resolve the disc issue/symptoms that you were experiencing. The only way to resolve pain is to assess you and consider the pain generators in the back - unfortunately there can be many. It could be residual pain from degenerative discs, facet joints, nerve irritation, muscular tightness, scar tissue formation and so on.

Photo of Dr Dinesh Sirisena

Answered By

Dr Dinesh Sirisena

Sport Medicine

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