A 24-year-old female asked:
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my mri states that i have 2 bulging disc at l3-4 and l5-s1 and moderate spinal stenosis at l4-5 narrowing the thecal sac to 8.7 mm. what does it mean?

1 doctor answer
Dr. Laurence Badgley
52 years experience General Practice
Non-specific: 24y female has reported unilateral sciatica 4 weeks post-delivery & MRI shows "spinal canal stenosis" L-4/5 & "disc bulges" lumbar regions. MRI report does not explain symptoms; disc bulges oft seen in asymptomatic people. More likely birthing injured pelvic sacroiliac joint, now hyper mobile & impinging presacral plexus. Was excessive trendelenberg posture forced while had epidural anesthesia?
Answered on Sep 15, 2015
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Dr. Laurence Badgley
52 years experience General Practice
Provided original answer
Any young female with sciatica needs to be evaluated for Hypermobility Syndrome, which can potentiate sacroiliac joint subluxation, which is a common cause of sciatica. There are several other causes of sciatica, and an Osteopath can help to diagnose.
Sep 15, 2015
Dr. Laurence Badgley
52 years experience General Practice
Provided original answer
Pain of sciatica can be worse "resting than walking" because ground forces of chair seats and mattresses torque the pelvic girdle bony ring, impinging neural plexi contiguous to major pelvis joints, the sacroiliac joints. In women with benign Hypermobility Syndrome, SIJ subluxation becomes a consideration.
Sep 15, 2015
Dr. Laurence Badgley
52 years experience General Practice
Provided original answer
Largest joints in axial spine are sacroiliac joints, SIJ, & can be loosened by childbirth & injury. Lumbar nerves that conjoin as sciatic nerve lie on ventral sulcus of SIJ; pre-sacral plexus parasympathetics also. SIJ hypermobility can tug/stimulate these nerves, arousing back/pelvis pain, sciatica, IBS & Interstitial Cystitis.
Sep 15, 2015

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