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Any L1-L2 studies showing conservative treatment not effective for L1-L2 tear?

Hi folks,

Thanks for the opportunity to join the board.

Not asking for medical advice.

I have a broad-based disc bulge with an annular tear (is this the same as a herniated disc?) at L1-L2 per MRI report (sudden blast of pain due to injury and haven't felt the same since).

From what I see online it's a rare lumbar disc to injure.

An old poster said there was a study showing L1-L2 disc problems don't respond nearly as well to conservative treatments as the much more commonly herniated L4-L5 and L5-S1.

The poster also said that a certain surgeon's last 500 surgeries consisted of only one patient who needed surgery at the L1-L2 level.

Does anyone have any links to L1-L2 studies, in particular? I'm trying to do some research for my condition.

I have 24/7 pain (pain in right side of lower back, but pain often extends up to shoulder blade, pain in right flank, pain in right hip, pain in right groin, pain in right scrotum, pain in right buttocks and pain in the right front side of leg, above the knee).

I see pain management but no medication has helped thus far.

A chiropractor advised no exercise period, and no stretching period. Based upon my pain level 24/7 I would never even attempt to exercise.

I tried PT on my back (generalized) and also pelvic floor therapy, but no injections and no targeted PT on just the L1-L2 disc.

I'm at a standstill for over a year.

Any links to studies on L1-L2 studies would be most appreciated.




  • wajihwwajih torontoPosts: 48
    Hi L4_L5
    Yes in generic terms it is herniation but when the disc ruptures and release its contents it is called extrusion. If the disc is intact and bulging that would be protrusion. In your case its extrusion. Regardless of both conditions the bottom line remain that how much nerve compression is there or how far the disc has gone to spinal canal. I agree L1 is a rare site for herniation but the debate is useless since you have it now. I have gone through extensive research and more or less same rules apply to any lumbar disc extrusion with the exception of symptoms as different levels of spinal nerve  such as L2 L3 L4 L5 S1 taker care of different areas and somewhat different . functions. As you move up the spine from S1 upward the degree of movement increases for example at S1 there is least movement but very high weight transfer. You should try to avoid Chiros and Physios if by any means they are aggravating your pain. Do only what your body allows you to do. Your immediate destionation should be a Neuro or Orthopedic surgeon who would guide through the options you have. Chirogeek is a good website with lot of "referenced" research papers and overall information.
    Prayers and Good Luck. I hope it helped
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