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A health problem as serious needs to be taken care of by a competent health professional. Such a condition when poorly managed can have a disastrous effect on your health for the rest of your day.

The facts:

If I were to gather a group of middle age folks (45 average age) who have NEVER had back pain before and shoot MRIs on them all, here's what we would find:

• 38% would have disc bulges,


• 37% disc protrusions (aka: contained herniations),


• 11% disc extrusions (aka: non-contained herniations),


• 0% disc sequestrations (aka: free fragments) and


• 4% nerve root compression by the disc herniation.

A more shocking statistic is that 60% of asymptomatic middle aged people would have findings of disc bulge or worse (protrusion, extrusion) on MRI!

Discal hernia, the leading cause of lombosciatica, is a result of a long and silent degenerative disc which will decompensate more or less abruptly on the occasion of an effort, sometimes minimal.

The lombosciatica almost never an "accident" occurring on a perfectly healthy spine.

References:



1) Jensen MC, et al. “MRI imaging of the lumbar spine in people without back
pain.” N Engl J Med – 1994; 331:369-373



2) Boden SD et al. “Abnormal magnetic resonance scans of the lumbar spine in
asymptomatic subjects: A prospective investigation.” J Bone Joint Surg Am 1990;
72A:403-408



3) Weishaupt D et al. “MRI of the lumbar spine: Prevalence of intervertebral
disc extrusion and sequestration, nerve root compression and plate abnormalities,
and osteoarthritis of the fact joints in Asymptomatic Volunteers.” Radiology –
1998; 209:661-666



4) Boos N, et al. “1995 Volvo Award in clinical science: The diagnostic accuracy
of MRI, work perception, and psychosocial factors in identifying symptomatic
disc herniations.” Spine – 1995; 20:2613-2625



5) Powell MC, et al. “Prevalence of lumbar disc degeneration observed by
magnetic resonance in symptomless women.” Lancer – 1986; 2:1366-7



6) Boos N, et al. “Natural history of individuals with asymptomatic disc
abnormalities in MRI: Predictors of low back pain-related medical consultation
and work incapacity.” Spine 2000; 25:1484



7) Borenstein G, Boden SD, Wiesel SW, et al. “The value of magnetic resonance
imaging of the lumbar spine to predict low-back pain in asymptomatic individuals:
A 7-year follow-up study. J Bone Joint [am] 2001; 83:320-34



8) Wiesel SW, et al. “A study of computer-associated tomography: I. The
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11) Wood KB, et al. 'Magnetic resonance imaging of the thoracic spine.
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20) Jarvik JJ, et al. "The longitudinal assessment of imaging and disability of
the back (LAIDBack) Study." Spine 2001;26: 1158-66.



25) Boden SD, et al. "Abnormal Magnetic-Resonance Scans of the Lumbar Spine in
Asymptomatci Subjects." J Bone Joint Surg [AM] 1990; 72:403-408



26) Fraser RD, Sandhu A, Gogan WJ. 'Magnetic resonance imaging findings 10 years
after treatment for lumbar disc herniation.' Spine 1995 Mar 15;20(6):710-4. "The
findings of this study indicate that long-term improvement of a patient's
symptoms after treatment of disc herniation may occur with or without resolution
of the hernia. This and the similar morphologic findings in the different groups
is consistent with the 10-year clinical results after the treatment of disc
herniation reported by Weber."



27) Masui T, et al. 'Natural History of Patients with Lumbar Disc Herniation
Observed by Magnetic Resonance Imaging for Minimum 7 Years.' J Spinal Disord
Tech. 2005 Apr;18(2):121-126. "Clinical outcome did not depend on the size of
herniation or the grade of degeneration of the intervertebral disc in the
minimum 7-year follow-up."



517) Giuliano V, et al. 'The use of flexion and extension MR in the evaluation
of cervical spine trauma: initial experience in 100 trauma patients compared
with 100 normal subjects.' Emerg Radiol. 2002 Nov;9(5):249-53.