Anular tear L4-5

In this video Dr. Castanet will show you what is an anular tear, what it looks like on a lumbar MRI scan, the symptoms this patient had, and how they may differ in different patients.

In this particular patient, he had a lumbar MRI scan done 2 years previously, and had treatment, but continued to have low grade pain of his lateral left thigh, i.e. the side of the left thigh. Aside from the anular tear, his MRI looks pretty good. This is a circumstance where the cause of the pain cannot be known with certainty, but an anular tear may be the cause. In any case, what matters is finding getting him relief of his pain, and proceeding with a trial of any conservative treatment is appropriate. If, in fact, the anular tear accounts for his pain, then spinal decompression should prove effective in relieving it, as it helps almost all spinal disc lesions.

I’ve made this point before, but in about 10-15% of patients who present to a spine specialist, we are not reasonably certain what is the cause of their pain. This patient is such a case. I will treat him under the assumption his pain is coming from this anular tear and hope for the best. If I can’t help him, I will offer him a referral to pain management to try an injection. I think, however, as is often the case, that he may decline any injections and prefer to try something else or to live with his pain.

My job as a healthcare provider is to explain what I know about his problem, what I do not know about it, tell him how long it will take me to help him, or determine I cannot, and what other options he may have for effective treatment, and who I can refer him to if I cannot help him.

If i can help you with your back, buttock, or leg problem and pain, call me at 404-558-4015.