Question
hello doctor.... i am 21 years old. i have been experiencing a low back pain and sciatic nerve pain from last 3 weeks. i think this is because of my bad posture at my job and also while sleeping. doctor advised me to perform mri scan.. so the mri test reveals there is a mild posterior bulging of l1-2 disc. and hyperintense signals are seen at left sacro iliac joints. i just want to know in detail about my condition based oon the report. is it very serious ? what should i do now ? how much time it will take to cure fully? can i able play sports as earlier ? help me doc....

Answer
Hi Prasad,

It depends on what the problem is.

The bulging at L1/2 is mild and does not indicate if it is to one side more than the other, but pain from this disc is possible to cause lower back pain and sciatica like pain.

The hyperintense signals in the left sacroiliac joint is concerning. A sacroiliac joint problem can cause similar symptoms. It could be sacroiliitis or an early indication of  ankylosing spondylitis. So, further diagnostic work needs to be done on that. Blood testing can give an indication regarding the sacroiliac joint along with any similar problems in your family history.

So, it has to be determined what exactly is causing the pain. With the lumbar disc being mild and not being indicated to one side, just straight back, I would focus on the sacroiliac joint, if your pain is on the left side. Try to get together with your doctor to discuss this.

With sacroiliitis and ankylosing spondylitis being ruled out, there is always rehab, postural modification, manipulation and determination if there is a short hemipelvis or leg. If you sit with a wallet in your back pocket, switch to the front pocket. Try to take frequent breaks to stretch or move around some, changing your posture. Make sure your have a firm mattress, you can see if it helps to sleep on the floor for a night or put a half inch plywood board under your mattress. Also, try to get an extra pillow to put under your knees when sleeping on your back and between your knees when sleeping on your side.

Therefore, you must find out the problem before discussing treatment parameters. As far as sports, let your body be your guide and pace yourself for now or follow your doctors instructions.

Kind regards,

Dr. Steve