Small right paramedian L4-5 disc protrusion encroaching on right L5 nerve root

(Baltimore, MD)

Hello Dr. Lewis,

Your site is a life saver. I recently had an MRI confirming the above slipped disc and I have severe pain in my left upper leg (burning, needles, stabbing, itching etc). I have an appointment to see a specialist (in a month!!) who I just found out will probably only give me drugs. I need to find a good chiro in my area ( I have commenced with your 3 exercises gently at home).

I have purchased a ab/arm "tower" that has padded arms that I can "hang" my arms over and take the weight off my body as I can barely sit or stand or lay down, so it's a 4th position. My question is, is it safe to "hang" my arms over this to relieve my back i.e getting the weight off my spine -- I suppose it may stretch out or decompress my spine a bit -- is this Ok with my condition? The piece of equipment has not arrived yet.

Heretofore, I have been an active karate student/instructor for 17 years, gardener, do too much lifting at work person. I am 55 years old/female and very active, but now I can barely walk since last week.

My back was originally diagnosed as SI joint issue 4 years ago, but with no MRI, I think it's been the slipped disc all along with possible SI here and there. Bones are good and no stenosis noted on MRI. Mild arthritis of lumbar spine at L1-2, 4-5 and L5-S1.

I do not wish to take drugs, and I need to be active again for work and karate. I very much appreciate if you can answer the above question re the tower/hanging idea.

Also, assuming the disc can go back in it's place, is it possible to go back to all my activities like kicking/running/bending etc if I am well warmed up and careful? I know this is going to take several months to get better....Also, I have no intention of ever have back surgery due to the risks and side effects.

I look forward to your reply to my two questions. Thank you SO much!!!!


Hello Lili,
There is unfortunately not too much stretch as your legs just aren't heavy enough. But try it, I can't see it doing any harm

Better, is an inversion traction device, but they have to be used under supervision, and I'm very careful using it with the acute back. But many people have found great relief from inversion traction.

The sacroiliac joint often is blamed for problems of a more serious nature. The reasons are many: many of the lumbar joints actually refer down to the buttock and SI area (sup cluneal nerves for example). The SI often locks up with L5 conditions particularly, but is not the primary, and unless the lumbar joint is treated, the SI pain and fixation just returns.

You have a long history of being very active. Now slow down and be careful, sit much less, don't bend, do the exercises faithfully, go for short walks, for at least six weeks.

Small bulges oddly often cause more pain and trouble than a great big bulge which is more easily reabsorbed.

Good luck, thanks for the compliments.

Dr B

Comments for Small right paramedian L4-5 disc protrusion encroaching on right L5 nerve root

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Sep 24, 2014
Severe lower leg pain
by: Anonymous

I am a 65 year old in very severe pain in my right leg below the knee. According the report I have
multilevel disc degenerative changes with type 2 endplate changes at L3/L4. and adequate CSF seen around the cord; suggested to do an operation.

You'll need to give me a lot more information. From your computer, not the phone please.

1. Where on the lower leg does it hurt?

2. Do you have back pain?

3. If you bend forwards, backwards, to the side, does it provoke the pain in the leg?

4. When did it start?

5. What other treatment have you had?

6. What provoked the pain.

Let me know.

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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