Dr Shee Yan Fong

Degenerative spine disease includes both degenerated disc (known as "slipped" disc by lay person) and facet joint arthritis. It is actually not a "disease" (unlike cancer or diabetes) but a natural aging process of our spine as we age, similar to wear and tear in our joints and dementia. As such degenerated spine including "slipped" disc is not a disease that can be "treated". Rather, "treatment" for patients actually means management (or "reduction") of his neck/back pain and subsequent disability.

The term degeneration in medicine means deterioration or decline of function of a cell, tissue or an organ with time, usually as a person ages. Osteoarthritis, osteoporosis, atherosclerosis and Alzheimer disease are well known examples. Degenerative conditions occur in everyone as everybody will age without fail (i. e. "natural" degeneration) often after age of 40-50 but some degenerative conditions can occur at younger age (i. e. "acquired") after an injury (accident or overuse), an infection, or after inheriting a hereditary disease (e. g. ankylosing spondylitis of the spine).

An L4-5 disc bulge in your MRI, assuming your MRI radiologist meant a small disc protrusion in his report, represents an ageing disc that has naturally lost its water content and its cushion and height with time, resulting in a bulge, like a bulging "worn out" car tyre. Because this is a natural ageing process, it cannot be reversed or “cured” and disc bulges can also be seen in MRI even if you have no back pain as you age.

There are 3 main reasons why there is no improvement after physiotherapy treatment for back pain : incorrect or undiagnosed pathology, e. g. the treatment may concentrate on degenerative discogenic pain but unknown to both the therapist and patient; the pain may be caused by something else like a fracture, infection, cancer in the back or from somewhere else like kidney stones, uterine/ovarian disease (further investigation by your doctor is required). inadequate treatment, e. g.

Please bring this to the attention of your chiropractor as soon as possible. He/she will most likely ask you to stop all chiropractic, gym and/or sports sessions and rest your back for about a week. Despite this, if there is no improvement, please seek early medical attention by visiting your doctor/specialist, not a chiropractor.

"Stenosis" is the medical term for "narrowing". Spinal stenosis means the narrowing of the channel in the spine (spinal canal) containing the spinal cord and nerves as they travel to your arms and legs from the brain. This spinal canal is a completely enclosed passageway surrounded by bones and joints of the spine (like a "train tunnel") protecting the spinal cord and nerves within from harm (similar to your skull protecting the brain within). Unfortunately, narrowing of this spinal canal will compress the spinal cord and nerves within it too.

Spinal osteoarthritis means the normal degeneration of our discs and joints in the spine as we age naturally, just like osteoarthritis in our knees and hips. Similar to our knee and hip joints, this natural gradual degeneration can be hastened by abnormal and/or repeated stresses on our spine, both at work and at play.

By the time we are 40 years old or above, all of us will see our disc or discs degenerated if we all undergo an MRI scan of our spine experimentally. This is because degenerative disc "disease" is actually not a "disease" but a natural ageing process that happens to all of us as our spine bears our load and weight day-in and day-out, both at work and at play. In fact, only four-legged animals and astronauts living for a long time in a space station will never see degenerative discs in their spine!

Sorry to hear about your injury. Your tailbone is most likely to be painful when pressed on, when sitting and leaning back and when sitting to get out of bed every morning. Hopefully no issues when you are passing urine or motion; if not, please seek urgent consultation for an MRI scan. Two things may have occurred during the fall: A buttock/tailbone contusion in which the pain usually lasts for about a month before it gradually and naturally settles down on its own without any treatment apart from reducing, cushioning or changing sitting postures.

What is sciatica? Any type of pain and/or neurological symptom that originates from the sciatic nerve is referred to as sciatica. The sciatic nerve is the largest nerve in the human body. It is formed by the union of 5 nerve roots from the lower spine. It passes deep in the buttock and down the back of the thigh all the way to the heel and sole of the foot. The sciatic nerve serves a vital role in connecting the spinal cord with the skin and muscles of the thigh, leg, and foot. Symptoms of sciatica The symptoms of sciatica are typically felt along the path of the nerve (i. e.

Physical therapy (including physiotherapy) comprises up to 90% of treatment for pain from degenerative disc conditions (most commonly called "slipped disc" in layman's term). Degenerative discs result from natural ageing "wear and tear" of the disc materials in between our spinal bones (vertebral bodies) as we load our spine with physical activities and/or prolonged postures day after day.

A diffuse disc bulge in your MRI, assuming your MRI radiologist meant a small disc protrusion in his report, represents an aging disc that has naturally lost his water content and its cushion and height with time, resulting in a bulge, like a bulging "worn out" car tyre. Because this is a natural aging process it cannot be reversed or “cured” and disc bulges can also be seen in MRI even if you have no back pain as you age.

Diffuse disc bulges (with or without nerve impingement) in MRI is a natural process as we age and can be found in your MRI even if you have no back pain or nerve pain. Nothing needs to be done and nothing can be done to reverse this natural aging. But if there is back or nerve pain, you will need a spine specialist to examine the MRI images in detail to assess the severity of nerve impingement. You cannot just base on what the report says. If not serious, most will need physical therapy to treat the pain and strengthen the back just like any aging joints in your body.

Laminoplasty is a specific surgical procedure performed on the back of the neck to "open up" the spinal channel which contains the spinal cord on its way down to the rest of the body from the brain. It is performed on patients whose spinal cord in the neck are being compressed (known as cervical myelopathy) for various reasons either acutely or over many years.

Usually, "disc bulge" in a radiologist's report describes disc herniation. It is a small disc protrusion due to the natural ageing process. More serious/larger disc protrusion or extruded disc are called "slipped disc" which will require surgery as treatment. "Disc bulge" is used due to a lack of universal standard term to describe this condition.