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Spine and Back Health

Bulging of L4-L5 w/ Annular Tear of L4-L5



I had fallen on my back side 2 weeks ago and the MRI results revealed bulging 0f L4-L5 and annular tear of L4-L4. My physician told me to stay bed bound and not to put any stress on my back. I would like to know what would be the best treatment and what could be the long term effects of this injury. If I don`t seek proper care can paralysis one of the side effects of this injury? Should I see a back specialist? What does this injury mean and how will it affect me long term if proper care isn’t provided?


Hello, thank you for your question. First of all, bed rest for any period longer than 24-48 hours is harmful, and you shouldn't do that. Second, with proper treatment you should have a very good chance of returning to basically normal function. You cannot be paralyzed from the type of problem you've described, though the pain certainly can be tremendous at times. These types of injuries are usually treated with combinations of physical therapy, anti-inflammatory medications, and activity modification. If those things don't work, you might eventually need to see a specialist. These types of back problems are highly variable, and often resolve on their own. Other people become quite impaired by them, and some end up needing surgery, though this should always be a last resort. I would say that if you aren't getting any relief after a couple of weeks, you should ask your doctor to refer you to a specialist. Good luck.

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University