Anonymous wrote:I've had degenerative changes come up on a back MRI before too but otherwise normal and no one addressed the degenerative part. what does that actually mean and do I need to do something to mitigate further degeneration or is it a normal part of aging for 40+?

Keep at a healthy weight and strengthen your core. Use proper techniques like squatting instead of bending at the waist to pick something up off the floor, etc.

I was a marathon runner and soccer player. Jacked my back up all those years of running.

You may end up with a lami/fusion at some point but see a neurosurgeon about it. Don't mess with an ortho, or if you do, get at least 2 other opinions.

It depends on if you have degenerative joint disease or degenerative disc disease.
Both Mark changes in the spine. Degenerative joint disease is usually a breakdown of the surfaces of the bones of a joints. This causes more friction and more inflammation in the joint. Think of any mammals surface versus sandpaper.
Degenerative disease usually marks a decrease in the fluid of your disc. This decreases the distance between the vertebrae and can cause pressure on the bones and more often the nerves of the spine.

This is due mostly to aging, but also can be due to injuries and increased wear and tear. Preventative health would include maintaining a healthy weight, postural exercises, maintaining flexibility, and no smoking.

Anonymous wrote:I've had degenerative changes come up on a back MRI before too but otherwise normal and no one addressed the degenerative part. what does that actually mean and do I need to do something to mitigate further degeneration or is it a normal part of aging for 40+?

I'm 51 and had an episode of acute back pain and then sciatica for months earlier this year due to a degenerating/herniated disc. I think it was aggravated because I started a full time WFH desk job, sitting in a crappy chair, and at the same time I really reduced my exercise (before the job I'd been going to orange theory 4-5 times a week)and my core strength went to crap. Lesson learned.

Steroids, PT and time helped. Towards the end of my PT I went to Pilates and that was beneficial too and my PT approved. I had to do 6 weeks of PT before my insurance would cover the MRI. My physical therapist said something like that if you looked at the spines of 100 adults about a third would have spinal issues but then only a third of those have symptoms.

I've had degenerative changes come up on a back MRI before too but otherwise normal and no one addressed the degenerative part. what does that actually mean and do I need to do something to mitigate further degeneration or is it a normal part of aging for 40+?

It depends. How old are you? Degenerative changes start early. If you are over 35 this will be on your MRI.
Regarding the herniated disc, it also depends. People have some degree of discrimination. The physicians should ensure your pain and sxs Map to the dermatome where the herniation was found. If your pain and other symptoms are not in the dermatome where the disc herniation exist, it is irrelevant.

Not that you asked, but I would try conservative treatment first. In fact, I would exhaust conservative treatment before even considering surgery.

Disc pressing on nerve.
Josh Wind at Sibley.

Herniated disc.

We have had good experiences with orthovirginia. Not downtown but McLean and Alexandria and Arlington locations

Maybe the hospital was looking for less benign changes. Or it’s possible that everyone has some disc changes past a certain age, and they considered them unremarkable.

op here, thx all.
Any recommendations for a back dr in downtown DC that might be able to help me with this? seems it keeps happening every few months and gets worse every time

Sounds just like a herniated disc and degeneration. Discectomy might help?

No, obviously not normal, OP. You will be offered PT, most likely, as well as pain meds, possibly steroid injections. Surgery is a delicate procedure and only done once you've exhausted the other options.

Run it through ChatGPT

Degenerative changes and lumbar spine L4-L5 where there is a left foraminal disc protrusion and annular fissure along with facet hypertrophy resulting in mild to moderate spinal canal stenosis, as well as contact and deviation of the exiting left L4 nerve by disc material.

Is this normal? I have been in terrible back pain for last week but at hospital a week ago they said all was fine but now I am reviewing the mri report as still in pain and not sure this sounds fine?