Question
Hi. I fell at work and recent CT findings showed a unilateral inferior facet fracture and a following MRI showed a "small central and left paracentral disc extrusion." The MRI report also states that "this configuration suggests that the annulus is not intact." What does that mean? My lower back has hurt since I had my son 3 years ago, and I am not sure what is causing what. However, since I fell, I have had numbness in both legs on and off with losing control of my bladder once (which I have not done for about 25 years). I was extremely embarassed, even told my chiro, and he is not doing anything at this point. What is the typical treatment for this type of injury?

Answer
Hello, Misty.

Disc extrusion usually indicates disc rupture; disc protrusion indicates disc bulge.  "Annulus" refers to the outer layer of the disc, which is ring-like.

Leg numbness and loss of bladder control usually indicate nerve impingement.

The back pain since you gave birth indicates back muscles in contraction, and sore.

Your chiropractor can't help.  You may need disc surgery, followed by muscular rehab.  Get a referral from your doctor.

Once the surgical repair has been done (if deemed necessary), your best approach to muscular rehab is clinical somatic education.  You will probably be given a referral for physical therapy.  Clinical somatic education substantially accelerates improvements obtained through physical therapy and can make the difference between a long period of therapy and incomplete recovery and rapid and complete recovery.

Please read the articles on back pain at somatics.com/page4b.htm for more details.

good wishes,
Lawrence Gold