Question
I have a chiropractor who has been treating me for years but i had a new pain and injury that he couldnt fix so i requested an MRI. I am currently treating it with traction. I am currently 30 and into wakeboarding at a pretty high level of intensity and dont know what kind of future i have now... Please tell me what you think about the MRI readings and please explain what some of this means...  FINDINGS:Examination reveals gross preservation of vertebral body heights and signal intensity throughout the lumbar spine. there is a loss of disk signal intensity at L4/L5. Slight loss of disk space height and signal is noted at L5/S1. The conus medullaris is grossly unremarkable for alteration of signal intensity or configuration.

The L5/S1 disk reveals evidence of mild broad-based posterior disk bulge without focal protrusion. The central spinal canal is patent. Minimal IVF narrowing is noted.

The disk level of L4/L5 demonstrates mild circumferential degenerative bulging of the disk with small posterior, central peripheral high-intensity zone that is consistent with small peripheral annular fissure/tear. Mild IVF narrowing is produced from the broad-based disk bulge. Central spinal canal is grossly patent.

CONCLUSION: 1. Small posterior, peripheral, high-intensity zone, representing an annular fissure/tear at the disk level of L4/L5. There is underlying degenerative desiccation of the disk and circumferential degenerative bulging of the disk with mild IVF narrowing.
2. Mild broad-based posterior disk bulge at L5/S1.

That was work for work the MRI report. I only catch some of it. I know i have DDD, but from what i can gather, alot of poeple do...  I want to know how this can directly effect what i live for and love, Wakeboarding... And most importantly, how i can get over it fast! I bought an inversion table this weekend and even though it hurts while i use it the next day i feel like a million! So, how bad is it, because i cant make sence of it?

Answer
Dear Casey,

Sorry about the lateness of this response but my office has been a madhouse with the holidays and patients all trying to schedule in before I close my clinic for Christmas.

Your MRI results have fairly common findings, but they are significant enough to generate low back pain as well as radiating pain into the buttock and possibly down the leg.  The disc dessication is common and basically means that the disk is starting to thin out due to decreased water content.  This is not a huge deal except that you have tearing of the outside of the disk layers with bulging as well.  The outer potion of the disc does contain pain fibers, and so do the nerve roots that exit the spine...so irritation easy results in pain.

The IVF is an abbreviation of intervertebral foramen (the hole where the nerve roots exit the vertebral column)so when this is narrowed it can cause direct inflammation of those nerve roots due to chemical irritation or compression.

I would suggest that you look into a posture pump for home based care...a pneumatic decompression device you can utilize for your low back that specifically targets the disks of the spine with intermittent and then static traction.  It will help to keep the disks hydrated and help with the healing by scar formation stressed along the proper motion.  You can buy this online, retail cost about $199.99, but can often find them cheaper on Ebay etc...they are easy to use and safe.  Also check on line for multiple sources of how to perform a bird dog exercise.  This targets the low back specifically the multifidus muscle which is key for spinal stability because it attaches to the posterior fibers of the disk and supports the facet joints of the spine.  You do not want this muscle to atrophy as research directly correlates it to increased back pain and degenerative conditions

The inversion table you purchased is okay, but they tend to increase the pressure inside the blood vessels of the head and pressure inside the brain.  Especially if you are hanging at an increased vertical angle (more than 30 degrees).  If you have any history of high blood pressure, vascular compromise, or stroke in your family this may not be a wise choice for you.

Considering the wake boarding, this does increase pressure on the disk, however, at least you are on the water which will mitigate some of the force.  I would be really careful with this until you have had a chance to heal more...Also no repetitive bending or twisting for the next 4-6 weeks as this will continue to injure the disk.  If you take it easy and do the rehab, you should be able to wake board next spring/summer.

Also talk to your chiropractor about a referral to another chiropractor that utilizes cox flexion, or spinal decompression in the office.  This can help speed your recovery.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net