Question
hi, am 32 yrs old , have a lower back problem for close to 18months. i recently had an MRI scan   and the findings were as follows

There is a focal bulge at L4/5 with a background broad disc bulge which is in close contact with L4 and L5 nerve roots in the paracentral region and lateral recesses.There is also compromise of the exiting L4 nerve roots in the exit foramina. At  L5/S1 level, there ia a mild broad disc bulge which is compromising more of the exiting L5 nerve roots with minimal effects in the central canal. At all other levels ,there is reasonable appeareances of  the central canal and exit foramina. The cord terminates at the right level.Minimal desiccation of the L4/5 and L5/S1 discs. Mild facet degenerative changes bilaterally.
conclusion
There is an L4/5 focal disc bulge on a background of a broad disc bulge which is compromising the central canal and exit foramina particularly on the left side.
Less effects on a mild to moderate broad disc bulge at L5/s1..


My doctor recommended me to see a physiologist.
What type of exercise should i do?..and what should i not do...? Will this need a surgery...?

Answer
I believe that your doctor is correct. A physiologist would work with you to try and improve function and stability in your lumbar spine. You have significant disc injury in the spine, but often these conditions can be managed with conservative care, and will not need surgery. If conservative care fails to provide you with adequate relief, then surgery might be considered as a last resort.

Studies show that the long term outcome of those that have spinal surgery over those that treat their conditions with manipulation, acupuncture, exercise, therapy, etc, are more or less the same. In other words, surgery has no better long term benefit over the less invasive treatment methods. If you can find relief with the physiologist, or other non-surgical methods, you are better off.

Take your time. Recognize that there is nothing that is ever going to make you grow a new disc in your lower back. Change your mind set and goals more in alignment with the reality that you must now take actions to decrease the risk of further injury, improve function, improve core stability, improve core and leg muscle flexibility, and learn to manage the affects of pain.  If you can do this, the long term outlook is positive.  

I personally would have to be in horrific pain with absolutely no hope before I would subject myself to spinal surgery.  Time is on your side, so do not be impatient.

I hope that this helps you to make good decisions for your recovery. Good luck always,

Keith Biggs, DC
http://www.eastmesachiropractor.com