L3 L4 Herniated Disc Evaluation

Here I show you a patient who has signs and symptoms of an L3-L4 herniated disc. I do a brief evaluation and talk about how I like to mange these. Enjoy! Thanks to the patient for allowing me to show his situation to help teach.
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#lowbackpain #herniateddisc #lumbarpain #radiculopathy #medical #health #orthopedics #Physicaltherapy #OccupationalTherapy #orthopedicevaluation

[@t.des4580]

Great content! Thank you

[@HungGarEarthBender]

Thanks, this was very informative

[@user-vv3ow5hh2o]

Very good explanation

[@Ca_1021]

Great video!

[@samconway5288]

Now that was a good video. Thank you.

[@thisisbob1001]

Good vid.

[@msheebasrivtex6020]

Good and efficient C

[@Mjzzz11]

Thanks for all of these !

[@OrthoEvalPal]

Glad you like them!

[@system3335]

thanks I have the same problem. i also have snapping hip syndrome which made it difficult for the physios to identify where the root pain was coming from

[@alandavey3010]

thanks from aussie

[@pavanba9712]

Same situation is mine

[@oOIyOuMeOo]

Perfectly described - Thanks for this! Little idea: it would be very helpful if you could write down the name of the exam while you are doing it (for example the lasegue or bragard sign). This would help even more in following the exam :)

[@OrthoEvalPal]

That is a great idea. Only problem is that I'm pretty technically Challenged!

[@ashleypatrick2111]

What’s the name of the test when patient is laying prone and bringing the foot/ankle towards the glutes?

[@UrviShah-hp7hq]

@@ashleypatrick2111 reverse straight leg test.

[@adrianadelafuente9856]

great video! I was wondering, how do you differentiate between a tight quad and disc bulge with the reverse straight leg? Seems like this patient's pain was localized to the anterior thigh during the RSL and not the back

[@ethanbates3484]

You can differentiate by having the pt extend their head to slacken the nervous system. If the symptoms diminish, it's coming from the back.

[@UrviShah-hp7hq]

Hello sir, the mckenzie extension exercises is advisable only in prone or standing also?

[@mayangpongen901]

Sir My dad is 61 year old and he is having back pain which is spine L3 L4 need some demo how to cure

[@tonysorice5142]

doc i have herniated disc.bluge disk L4 L5 S1 last MRI said leaving left root and said slightly worst last study doctor gave me a flex on my kness my kness didnt move or jerk ,,doc what do you think ,can you help me out ,,i been watching ur video i happen to like them,

[@RICREYNOLDSMUSIC]

I have been dealing with all Lumbar locations and can barely walk with constant pain.

[@ArizonaMMJ]

Where is the vid on how to heal a bulged disc and stenosis?

[@gfscfinance8866]

Paul, where are you based at. I would like to visit you to get a consult

[@brohd9597]

Urgent! Dear Dr Paul, In 2018, my mother, 63 years old now, had a bulging disc surgery for lumbar disk replacement: "The operation was performed in April,2018. L3-L4 and L4-L5 recalibration, completed by stabilization of L3-L4 spondylolisthesis (interbody arthrodesis with posterior osteosynthesis)." according to the surgeon doctor. Yesterday, she performed a CT scan and here is what it says: Results : • Significant bone demineralization. • Plate screwed in place. • Significant L3/L4 disc narrowing. • Body and posterior zygapophyseal osteoarthritis. • Global degenerative disc protrusion L3/L4 and L4/L5. Conclusion : • CT aspect in favor: Degenerative bodily and posterior zygapophyseal changes on an osteoporotic background. A global L3/L4 and L4/L5 disc protrusion, with plates screwed in place. What do you think, Dr Paul? What is the best exercise for her? other tips would be appreciated! Note that my mother is having a hard time these days especially pain sometimes acute pain in lower back down her right leg because she is going through withdrawal symptoms of stopping tramadol for two weeks now. I bought her some supplements like vitamin D3 and C, Omega 3, B complex, Magnesium glycinate, Selenium, Propolis and Royal Jelly. Many thanks, Dr Paul! Subscribed!

[@jd21349]

Any reason you didn't do a quick DTR on patellar reflex to check for radiculopathy? Awesome video by the way!

[@OrthoEvalPal]

Hi Jay, I did. Both L4 and S1 were absent therefore not good info. He was an L3 nerve root compression so the DTR's were not helpful.

[@karenparks6087]

I have same issues 😕 but with severe pain. 😪

[@kim88211]

I’m having the same have you gotten any better?

[@jpeezy1976]

This is precisely my issue. Unfortunately it seems to be acting up more & more. Ugh

[@shiviahuja9840]

Howwvare u nowww please update i am facing the same

[@wntr415]

@@shiviahuja9840 how you doing now?

[@wntr415]

@@shiviahuja9840 how you doing now?

[@robynschmitt5446]

​@@shiviahuja9840 ex

[@thehumanmechanic1174]

What Clinical relevance or inference you draw by asking your patients regarding ' any pain during coughing, sneezing, or laughing ' ? plz help

[@lmTheFlea]

That’s what I am wondering. I have pain when coughing or sneezing.

[@sahilrana1792]

L5 anterolisthesis over S! secondary to isthmic lysis of lytic 1,5-spondylolisthesis. Degenerative disc changes coexist with posteromedian and left posterolateral disc herniation, shaping the anterior thecal slope with space conflict with the S1 root emergences, namely left S1 and also space conflict with the intracellular content. spinal. The aforementioned alterations determine elongation of the central spinal canal with deformation of the conjugation canals, also assuming foraminal root conflict - In the remaining intersomatic levels studied there are no aspects of significant compression L5 roots. extrinsic nature of the intraspinal content. Other permeable conjugation channels. Absence of significant morphostructural anomalies of the skeletal parts visualized with regular alignment of the study position, particularly in the sacrococcygeal region. Regular caliber of the sacred channel, with regular densitometry of the intra-sacred content. Regular caliber and permeability of sacred foramina. - [ ] Hello this is my MRI report .Please recommend some exercise . - [ ] Thank you🙏

[@OrthoEvalPal]

I would definitely seek out a neurosurgeon first to confirm that exercise would be ok to do. then meeting with a physical therapist could help guide you best. It would not be good of me to prescribe exercises for this injury without seeing you

[@codymiller510]

"immediately undertake decompression therapy with an inversion table!!"

[@BlueSky-sz9pz]

can u plz tell me why all thoes test when mri scan clearly show damage to disk or nerves?

[@OrthoEvalPal]

You could have a bad looking MRI and no weakness. Just because the MRI says there is a problem doesn't mean they need surgery.

[@mixytampa812]

@@OrthoEvalPal that’s what I wanted to hear surgery is so risky so I’m looking for more ways to deal with this I have L 3 4 and 5 canal franaminal narrowing My accident happened in 2004 did one year of therepy and traction had covid 2 moves ago and now I have severe inflammation.

[@anupriya4645]

I am having disc bulge at L4-L5 and L5-S1 nd due to this, pain in my thighs and buttocks. I am a student so I have to sit bt sitting makes my pain worse, I am using lumbar support also. I had taken physiotherapy, chriopracteric treatment and also taken snrb injection bt my pain still there.. Sir, can u suggest me something for the same

[@himadrinathnayak8235]

Osteopath treatment at Jodhpur. Parasar healing center..

[@mauromartinez3091]

What can be done of you have a 'Incendental Labrum 'Tear's on both Hip's....61 year old male Weight 162 5 ' 10 Ht...and also a have L--4 l - - 5 S1 Bulging Disc.....Also Excercise should be Avoided..💢💢💢💢💢💢

[@OrthoEvalPal]

Meet with a hip surgeon