Lumbar spondylosis is a type of spondylosis that occurs in the lumbar spine.
Lumbar spondylosis as a term refers to degenerative conditions affecting the discs, vertebral bodies, and/or associated joints of the lumbar spine. Spondylosis deformans and lumbar osteoarthritis are other names of lumbar spondylosis.
Lumbar spondylosis includes many associated pathologies including spinal stenosis, degenerative spondylolisthesis, osteoarthritis and also captures effects of daily use, aging, trauma on the intervertebral discs, the vertebrae, and the other spine joints.
The condition is said to be progressive and irreversible.
Likelihood of spondylosis increases with age and is considered an inevitable part of aging.
Lumbar spondylosis is the price of upright posture we have. It is quite a common occurrence because of mechanical stresses it undergoes.
Studies have reported that 85% of individuals aged 45–64 years demonstrate osteophytes within the lumbar spine. The men appear to have more significant degenerative changes than women, both with regard to the number and severity of osteophyte formation.
An MRI study in asymptomatic patients > 60 years has revealed that 80% of them have disc protrusions and 20% have spinal stenosis.
Even younger persons are found with evidence of lumbar spondylosis.
Degenerative changes have been found to be present in 3% of individuals aged 20–29 years.
Pathophysiology of Lumbar Spondylosis
When the annular ligament is put to stress body responds by forming new bone i.e. osteophytes which results in lumbar spondylosis.
The change is thought to begin with the degeneration of the intervertebral disc. Simultaneous degenerative changes in the vertebral body, and associated joints interdependent changes occurring secondary to disk space narrowing.
Intervertebral discs are believed to undergo a degenerative cascade [suggested by Kirkaldy Willis and Bernard]
The cascade is in three phases
The first phase is Dysfunction Phase and highlights the initial effects of repetitive microtrauma. This phase is marked by
- Development of circumferential painful tears of the outer annulus
- End-plate separation
- May compromise nutritional supply and waste removal
- Tears may coalesce to become radial tears
- A decrease in the capacity of the disc to maintain hydration
- Desiccation and reduced disk height.
- New vessels and nerves grow in tears
- Increase the disc’s capacity for pain signal transmission
After this begins the second phase which is also called Instability Phase. It is marked by
- Loss of mechanical integrity
- Progressive disc changes
- Resorption
- Internal disruption
- Additional annular tears
- Facet degeneration
- May induce subluxation and instability.
Phase III is the Stabilization Phase
- Continued disc space narrowing and fibrosis
- Formation of osteophytes
- Transdiscal bridging
Age, obesity, occupations that load the spine [athlete, manual labor] and hereditary factors determine the progression pace and extent.
Recent studies have suggested obesity to be a variable factor and occupation as not a factor.
Presentation of Lumbar Spondylosis
Lumbar spondylosis usually produces no symptoms. Even when there is back pain or radiculopathy, lumbar spondylosis may not be causing it and just an unrelated finding.
The symptoms occur only when it has progressed so much to cause complications like pressure effects or painful arthropathy.
The symptoms are those of pain in the back or radiculopathy.
The source of pain could be facet joints, intervertebral disks, sacroiliac joints, nerve root dura, and myofascial structures within the spine]
Similarly, the radiculopathy could be from many possible sources and the correlation to the structural change becomes important.
It could be a bulging disc, posterior osteophyte, or structural hypertrophy causing narrowing of the foramen stenosis.
Another important symptom that patient may present with is neurogenic claudication where an impairment of walking occurs due impingement of nerves due to spinal stenosis [narrowing of canal]
In mild lumbar spondylosis, the may be absolutely normal. In advanced lumbar spondylosis, some patient may have dynamic scoliosis. The lumbar lordosis may be diminished and there is a decreased range of motion of the lumbar spine.
In case some specific entity is present such as disc herniation or spinal stenosis, the findings would depend on the entity.
Lab Investigations
No laboratory studies are required for making a diagnosis. In cases where there is a confusion regarding infective etiology i.e. pyogenic infections of spine, routine blood tests may be performed.
Imaging
Mostly lumbar spondylosis is an incidental finding and radiographs, CT scans, and MRIs are used only in the event of complications.
X-rays show osteophytes, thickening of facet joints, and narrowing of the intervertebral disc spaces.
CT and MRI are able to shoe spinal canal anatomy better.
MRI is the best modality to show the details of soft tissue including discs and ligaments and nerves. It is able to reveal a nerve compression.
Treatment of Lumbar Spondylosis
It must be reiterated that lumbar spondylosis is not symptomatic and always not responsible for the symptoms.
It is always to make a diagnosis that correlates with the pain and identify pain generator for treatment.
The back pain or radicular pain needs the treatment, not the lumbar spondylosis.
And the treatment would depend on the cause of the pain.
For example treatment approach for herniated disc would be different than the spinal stenosis, though both are covered within the scope of lumbar spondylosis.
So what is being mentioned here is a treatment for back pain and radicular pain rather than lumbar spondylosis.
The treatment of back pain is discussed in detail here.
Therapy is supportive and symptomatic and involves painkillers, rest, physiotherapy and surgery [rarely] if required.
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Hi Dr,
I got the back pain, in my X ray report they have made a comment like Straightening of Lumbar Spine.. can you please explain wats the consequances and wat i need to do
@Sharath Pranesh,
Follow your doctors advice and when he permits you should start exercises for strengthening the back.
Sir namaskar! I m 21 years engg student n i m getting continuous back pain from 8 months….. I have taken some medicines n done phys treatments n exercises also…but pain is increasing day by day…..recently .i have taken x-ray n they said it is early lumbar spondylosis n oesteocytes are deposited on l1-l5….it is creating much problems n hamperoing my studies …….so what would be better for me sir?? I m waiting your reply sir……
@Pratap poudel,
Lumbar spondylosis at 21 years of age is not common. Please get investigated.
As for as your studies are concerned, please take the symptom relieving medicines and improve your posture
Thanks doctor…now i m maintaining my posture n doing exercises also….
Now pain is mainly in right hip joint….what are the exercises for this????? Or can i go to gym also for the exercises of back pain????
@Pratap poudel,
You need to discuss with your treating doctor. He would be in better position to discuss the exercise regime.
All the best.
Hello Dr.Arun,
I am Garima agarwal. I am 27,married working women.I am having back pain since 7-8 years.
It got worse and the pain started radiating in legs and arms too. On 5th dec.2010,it got more worse and
i couldn't sleep for whole night. I consulted an orthopaedition and he prescribed me bed rest for
7 days. and i got an x-ray done, that shows the straightning of the spine.
Please suggest me ,whether i should start with the exercises now because orthopaedition has asked
me to avoid the exercises for 2-3 weeks more.
and can it be related to Pott's disease as dr.also asked me about fever and appetite
waiting for your reply
Regards,
Garima
@garima agarwal,
Back pain has got various causes and also includes those you mentioned.
When you visit a doctor, he would ask questions that would suggest or rule out a particular set of possibilities.
Examination and investigations further guide the physician to reach at a diagnosis.
Straightening of spine is an effect of the disease. It is not the cause in true sense.
Backpain radiates to the limbs when there is a compression or involvement of neural structures which supply our limbs.
Follow your doctor's advice. He is the best person at the moment to guide you about your problem.
I can offer more knowledge on the subject if you would like to ask me but a physician who is taking care of you is the best informed to answer your specific questions.
How are you BTW?
i am currently dealing with a client who has symptoms of spondylosis and her x-rays prove my diagnosis. She is a very stressed individual with a very bad lifestyle structure with regards to eatng and overall wellness. i have recommended a few processes which may alleviate some of the pain which she is experiencing currently and would like a medical opinion on these processes. . .i have recommended daily hyperextention stretching as well as piriformus stretching and compression exercises to assist in release of the hamstrings to alleviate lower lumbar and lower appendage pain. when testing flexibility my cliets ROM is impaired and this is predominantly due to hamstring shortening. when diagnosing for spondylosis please consider the stretching and improving of ROM in the Hamstrings as a possible way to alleviate some of the pain. i know this is not a cure but at least it might help.
@K Smith,
Thanks for input.
Hamstring stretch is frequently prescribed for backpains.
Lumber Spondilitis or spondylitis is a condition where there is an inflammation of lumber (lower vertebral) spine, popularly called as Back ache. These changes may be mild, moderate or severe leading to a range of severity of symptoms. There is not only inflammation of the vertebra but also some amount of fusing, which gives painful stiffness.Homeopathy treatment is targeted at relieving the inflammation and stiffness, making the life comfortable. Also, the underlying process leading to such chronic inflammation and the complications can be prevented as well.
Greetings, this is really a truly absorbing web blog and I've cherished learning quite a few from the content and posts contained on the web internet site, keep up the excellent do the job and desire to examine a good deal a lot more stimulating articles within the long term.
hi!
this priya Jain.
i am having severe back pain which makes me handicap for various things.now a days i feel very weak and find myself unable to do daily work.pain shoots up when i knead dough,roll rotis,stand or sit for long,climbing down stairs,….
my family thinks that i have no pain and its all a drama as i don't want to work..
i don't know what i am suffering from as some doctors say i have nothing, some say i have ankylosing spondilitis arthritis, some others name it as disc prob,some others say its due to degenerative vertebrae,some others say its a mental case……………….i am in a fix……can someone please help
these are some of my details:-
sacralisation of l5,
anterior marginal osteophytes noted from l1 to l5,
blood sugar fasting – 75 to 445,
hydroxy vitamin d3 – 3.1,
bp 90/60 to 120 /90
tell me if any other detail/investigation report is required.
pls help
@PRIYA,
Only a doctor you can meet in person would be able to make a diagnosis.
The xray report does show spondylotic changes also called degenerative changes.
Disc cannot be visualized in xray.
dear dr. My name is Biju. I am having severe back pain last couples of week. So I have taken x ray it says that "straightening of lumbar spine, likely due to muscle spasm. Narrowing of LS-S1 disc space" can you just tell is it serious or it is commonly showing..why it is coming….can just clear it for me please…help
I've back pain. It seems to me as kidney problem. Urine is gone out 10 minutes later on, if water is taken over 2 liter, after 2 hours. Already X-ray Report taken.
They say-
a. Nature of Exam:- X-Ray Lumbo-sacral spine B/V
1. Straightening of lumbar spine is seen.
2. No bony lesion is seen.
3. Disc spaces are maintained.
4. Interpedicular distances are normal.
5. Both SI joints appear normal.
…………………………………………….
Impression: Straightening of lumbar spine (may due to muscle spasm).
b. Nature of Exam:- Plain KUB region.
No radio opaque calculus or abnormal calcification is seen in KUB region.
…………………………………………….
Impression: Normal findings
@Biju,
Most of degenerative changes occur following over use /misuse/ abuse of the spine.
drugs and physiotherapy should restore you to normalcy.
@Ratan Das,
You have beginning of lumbar spondylosis. Ho are you now?
hi doctor!!
i 've consulted many doctors , 1 described as SSA
another 3 said its ASA
another 2 said its RA Factor
another 2 says its mild pain
another 2 said its combination of ASA and RA Factor
another says its just vit. D defficiency !!!
????
i am confused a lot………….pls advice what to do now
bcoz some prescribes to include certain things while others restrict that………
pls help
@priya jain,
Please let me know what problems do you have? Let me know the investigations done so far in detail too.
Hello doctor.
I live in Sant Nagar and would like an appointment with you. Could you let me know where your clinic is and when it would be convenient? Please let me know at my email ID. I have been suffering from lower-back pain these past three years and X-rays show I suffer from a straightening of the lumbar spine. I would therefore like to consult with you.
Best Regards,
A
hi doctor!!
as you said that "The xray report does show spondylotic changes also called degenerative changes. Disc cannot be visualized in xray." you may be right but this is it………….
my X-RAY LS SPINE AP/ LAT VIEWS as on 17/08/2009 says that:
Sacralisation of L5 vertebral body noted.
Anterior marginal osteophytes noted from L1 – L5 vertebral bodies.
Disc spaces are normal.
Pedicles, laminae and spinous processes are normal
Bone densty is normal.
Soft tissues are normal.
HLA B27 NEGETIVE
RHEMETOID FACTOR NEGETIVE
MRI OF DORSAL SPINE as on 27/05 06Shows
The dorsal vertebral bodies and inter vertebral discs reveal normal signal intensity. Thee facet joints and the visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminate at L1 level.
Screening of lumbar spine shows STRAIGHTENING of lumbar spine, no other significant abnormality noted.
MRI OF LUMBO-SACRAL SPINE as on 13/11/2007 FINDINGS
The adjoining endplates at L5-S1level shows grade-II degenerative changes . similar altered signalintensity is also noted along the anterior aspects of the upper endplate of L1 and L2 vertebrae.remaining lumbar vertebral bodies appear normal in height,alignment and marrow signal intensity.
At L4-L5 level an insignificant posterior bulge of the disc is seen, however the central spinal canal and neural canals appear spacious.
Facet joints show degenerative changes bilaterally at all the levels.
No abnormal pre or paraspinal soft tisuue signal intensity is seen.
Conus and cauda equina roots display normal MR signal.
MR myelography reveals spacious central canal.
IMPRESSION:-
MR FINDINGS REVEAL DEGENERATIVE ENDPLATE CHANGES AT MULTIPLE LEVELS IN THE LUMBAR SPINE ALONG WITH THE FACET JOINT ARTHROPOLOGY. POSSIBILITY OF UNDERLYING SPONDYLOARTHROPATHY SHOULD BE RULED OUT.
BONE DENSITY as on 17/08/2006 FINDINGS
PERFUSION AND BLOOD POOL imaging shows unremarkable perfusion and blood pool activity in the Lumbo Sacral region.
CORTICAL PHASE: Overall skeletal uptake of tracer is good with nominal soft tissue uptake.
Focally increased tracer uptake seen in posterior calcaneum of both feet(? Achilis tendonitis)
Tracer distribution i n the rest of the skeleton is within normal physiological limits.
Both kidneys are well visualized.
IMPRESSION
LESION MENTIONED ABOVE APPEARS TO BE INFLAMMATORY IN ORIGIN.NO OTHER SKELETAL LESION SEEN.PLEASE CORRELATE CLINICALLY.
CURRENT TESTINGS:-
WBC HIGH
NORMOCYTIC AND MICROCYTIC HYPOCHROMIC ANEMIA WITH MILD ANISOCYTOSIS
RUBELLA IgG DOUBTFUL
RUBELLA IgM EQUIVOCAL
THALESSAEMIA MINOR
ANA NEGATIVE
APTT NORMAL
SGPT NORMAL
CRP POSITIVE
VIT D DEFFICIENCY
ESR 32 – 60
@A L,
I a sorry for the delay in reply. Where is Sant Nagar? I am currently practicing in Punjab.
Hello Doctor,
Thank you for your response. Sant Nagar in Delhi. I did not realise you were practising in Punjab. I have been having lower back pain for the last four years or so. Initially it would be in the mornings. After a hot water bath it would recede only to come back next morning. Now it's kind of chronic pain. When I finally got an x-ray done, it revealed straightening of the lumbar spine. I met an orthopaedist and he gave me a set of exercises to follow. I do them occasionally but don't have discipline.
That's the background. My queries are as follows:
Will I have to live with this pain all my life?
Will it get worse?
Is there any chance that it can be permanently cured without a surgical procedure? What can I do?
Is playing badminton a bad idea? What about jogging and basketball?
Rgds,
A L
Hello Doc,
I am 20 years old, X-Ray revealed that I have straightened lumbar spine…hmmm!! I'm worried so much with this result…I'm a nurse…does prolonged standing and sitting can contribute to this condition?
Thank You so much!
27 year old female auto accident victim with loss of normal lordotic curvature from L-1 to L-5, mild kyphosis in upper lumber spine. also central posterior herniation at L-5-S-1 which is also identified as a focal convexity in the posterior aspect of the disc. MRI 's also showed disc bulging at L2-3, L3-4, L4-5 and T7-T8. Have received all types of physical therapy and trigger point injections over past 4 years with no relief. Is any part of this not considered soft tissue injuy? Chief complaint is lower back pain. However no significant leg pain. Are there any types of surgury that would benefit
@priya jain,
OK. What do you wish to know?
sir,
i am showing my MRI OF DORSOLUMBER SPINE report which i got yesterdey,plz tell me .Is there any problem.
1)Straightening of spine seen.
2) no singnificant infective and neoplastic seen.
3) Minimal posterior bulge of L4-5 And L5-s1 Disc seen. no significant nerve root and cord signal intensity.
4) Maintained vertebra alignment seen.VERTEBVRAL BODIES ARE NORMAL IN HEIGHT AND MARROW SIGNAL INTENSITY.
5)CANAL DIMENSION IS NORMAL.
6)
CONOUS ENDS AT L1 LEVEL SHOWS NO CONOUS ABNORMALITY.
7)ROOTS OF CAUDA EQUINA ARE SEEN WELL DISPERSED WITHIN THE THECAL SAC.
8) NO ABNORMAL PRE AND PARA VERTEVBRAL SOFT TISSUE SINGAL INTENSITY.
9)REST OF THE DISC ARE NORMAL IN HEIGHT & MARROW SIGNAL INTENSITY.
Sir plz tell me what is the means of all these points…..i m having prob in my back from last 2 month…
@John,
Yes! Prolonged sitting could be a factor.
@A L,
Please follow your doctor's advice. Exercises are mainstay of treatment in chronic backpain. It usually resolves to conservative measures and surrgery is generally not needed.
@CB,
Yes! there are surgeries available but what would be required in your case would be dtermined by a doctor who sees you.
@Deepak Raghav,
Your MRI report is almost normal except for straightening of spine which may be the earliest spondylotic change in your body.
Hello Dr!
I am 24 yrs old(female, unmarried). X-Ray shows ''straightening of lumbar spine suggestive of muscle spasm". what is this? n what should I do?
@SEHRISH,
Please see a doctor who would prescribe the treatment and suggest exercises.
dear doc.,
i want to know the correct diagnosis of disease, the treatment ,dos and don'ts……….!!
hope this time i don't have to wait for long….!!
As per our policy we do not offer diagnosis and treatment. You would have to consult a physician in person.
I apologize for the previous delays but sometimes they are inevitable.
Dear Doctor,
Good Afternoon!
I am 30 yrs old.
I have got a back pain a year back wen i was driving a bike, i consulted a Ortho-Consultant he suggested me to take rest and suggested me to take NSAIDS.
Then i got cured and i used to get pain often and on apply simple pain killer gels it will disappears.
But a month back i got pain in my back, i have consulted a Ortho specialist after an X-ray he told me that there is Lumbar Lordsis. He prescribed me NSAIDS and simple excercise and walking.
But still the pain has not gone , i cannot concentrate on my work. Some of my friend suggested me to take an MRI.
On self interest i have taken an MRI of Lumbascaral Spine and i didnt consult any doctor after my MRI.
The radiologist impression as follows….
* Early Lumbar Spondylosis with the loss of Lordsis and minimal scolisis with convexity to the left side.
* Minimal Posterior Bulge of L4-L5 Disc.
* No Lytic/Destructive Lesion or Infective/ NEoplastic Process.
*Normal Lumbar Spinal Canal.
* Normal Lower End of the Cord.
Doctors please advise me wat to do, the pain is still off and onn.
Wat type of excercise i have to follow. Is there is any serious problem that i have to consult a dcotor immediately.
Waiting for your advise to have a painless days.
Thanks
Senthil
r/sir i have been told told by my physcian that my lumbar curvature is straightened much worried tell me what should i do now
@Senthil,
I with my advice could remove the pains. But the proper and actual path goes to a specialist. You are having degenerative changes in your back and nedd to put on exercises and medication.
And you need to see an orthopedic doctor for that.
All the best.
Dear Dr.
I am a 36 year old female who has had back and neck pain since i was 18 years old i had a new MRI done but dont quite understand the results i was wondering if you could explain them to me better than the printout.
IMPRESSIONS:
1.Straightening of the normal lubar curvature indicates paraspinal muscle spasms.
2. Early degenerativechange in the lumber spine in the form of ligamentum flavum and facet hypertrophu at the L4-L5 and L5-S1 Levels.
3. No focal disc pathology, central canal or neural foraminal stenosis.
Please help me understand what all this means. I was told at 18 that my back would always get worse and it has all they are doing is treating me with pain medications and trying physical therapy AGAIN. Im in a tremendous amount of pain daily and its now interfering with 80 percent of my day.
Is surgery my only option? will i have to be on pain meds the rest of my life like the doctors say or is there something else that i can do?
Thank you for your time
Frustrated mother of 3 and wife.
@Colette,
In nutshell you have a back which is showing degenerative changes. It includes formation of bone spurs called osteophytes, alteration in curvature of the spine like mentioned at no1.
Good thing is that none of these changes is affecting your neural structures.
Now coming to your back pain.
First thing that you should do is use your back carefully. It means minimum bending and no weight lifting.
Avoid continuous sitting at a stretch for more tha half hour. If you are in a profession that demands constant sitting, take frequent breaks.
Keep your sitting posture straight. Do not slouch.
Start strengthening your back. First under supervision and then yourself. Do your back exercises daily.
Take medication as prescribed. As you strengthen your back, the pains would reduce and so would need for medicine.
I am sure you do not need surgery. At least that is what I can deduce from available info.
Take care.
Sir,
The result of my lumbosacral x-ray shows that:
The lumbar lordosis is still preserved.
There are marginal osteophytic lippings on L3 and L4 vertebrae.
The bone density, alignment and disc spaces are intact.
Conclusion: early lumbar spondylosis.
I want to know the meaning and causes of marginal osteophytic lippings. Also, I hope that I don't have any straightened lumbar spine. My back pain started all of a sudden and I find it difficult to trace the cause because I have never hit my back on hard surface and I never had any problem with it.
good after noon sir. my age is 21 years. i getting back pain since 1 year. in x ray report "no problem", in MRI report "strightening of lambar spine". using L S belt &doing exercise but no releaf. please give me treatment sir.
@rambabu,
You would have to visit a doctor in person. As noted in our policy we do not provide the treatment, only knowledge about the condition.
I hope that helps.
hello dr.
I am 38yrs. old female suffering from severe pain in both knees and right hip. It started some 8 yrs. ago with pain in my right knee and pain in right hip developed side by side. doctors took condiserable time to diagnose problem, some said meniscus tear, some called chondromalacia patella others even rule out it. X-rays and MRIs show no visible gap or deformity. The problem wd my right hip has also worsened over the years, now, I have problem wd my lower back also. lower back x-ray showed L5s1 spondylosis but orhtopeadician ruled out the same. I am nearly crippled due to intensity of problems, can't squat, can't climb stairs properly, can't bend with m y back and doctors say nothing serious., I've constanct 24/7 pain. I live in mohali, can you suggest me a doctor who can seriously listen to me and examine my problem. I would really be grateful to you. Please help me out
@Esther,
It is not necessary that an injury should occur to cause the back pain. Our daily routines and back strains over the time can cause this cumulative effect.
You have lumbar spondylosis and that is causing the pain. Lipping is part of this whole process.
One gets better with rest, medication and physiotherapy.
@hema sharma,
It is difficult to diagnose a problem from a distance. See a specialist doctor. You might want to try PGI or GMC if you can't understand whom to consult.
I am 39 yrs old and in August 2010 I began having pains in my lower back. I visited my GP who treated me for a kidney infection but after 10 days the pain became worse and I was finding it difficult to sit and get back up again. I went back to my GP who told me it was my Coccyx (even tho I had no accidents or injuries) and he referred me to a Physiotherapist for 11 wks of what I can only describe as sheer hell. Eventually I was referred to hospital for cortisone injections, which I had two of over a period of 6 months, last injection Sept 11. It seemed to have settled down until I had an accident a work and jerked my arm and shoulder since this my back pain has flared up again and I am in complete agony to the extent I visited A&E in my local hospital. After having an Xray the doctor told me that I have spinal straightening because my back is in spasms, this now is effecting my whole body. I have been given Diazepam to help relax the muscles and I seem to be living on pain killers but still cannot cope. What would be the best cause of action for me please as I can no longer tolerate this pain and dont know where to turn.
thanks
Dear Sir,
Greetings !!!!
I am 26 years old student and from 1 year i am suffering from back pain and X-ray report says no problem and mri report is L.S spine i treated very qulify dr. but there is no relief in my position i also do daily walking now i'm very disturb from it pls give me and that how to remove my pain i'm waiting to your answer….Pls reply me as soon as posibe
i m 22 yrs old n have l4 l5 disc protrusion along with mild disc protrusion at l5 s1. while doing any activity pain incresases and also there is convexity to the left side. Is this scoliosis????????? and how can it be cured??????????? is surgery the only treatment???????
@Linda Fulton,
I do not think that delayed answer is going to benefit you.
How are you now?
I have been diagnosed with seronegative rheumatoid arthritis. In viewing my x-rays the rheumatologist mentioned that had some straightening of the spine. These are lumbar x-rays. What does that mean?
@Sharad Kumar Vishwakrma,
I am sorry. I cannot suggest you diagnosis or treatment.
For that you need to see a doctor in person.
Please tell me what this means? I had an MRI and I stsy in pain with what feels like my hip but here are the findings/conclusion?
1. There is straightening of the lumbar spinein the lateral view. A mild thoracolumbar scoliosis is noted.
2. At L5-S1 bilateral facet arthropathy and mild disc bulge result in mild bilateral nearal foriminal narrowing without central spinal stenosis.
3. Above L5-S1 Leval the Lumbar spine is negative.
@sunny gupta,
What does your doctor say?
@Pam Drake,
Normally the spine in lumbar area is curved with concavity at posterior side. Loss of this concavity occurs in lumbar afflictions due to spasm and this is seen as straightening of spine.
Dear Dr Arun Pal Singh,
I greatly enjoy and appreciate your efforts to give everyone a clearer view of this condition.
I am a 26 year old female nurse. For more than 5 years, I have been experiencing daily chronic back aches which I usually attribute to my posture and menstrual period . Recently, the backaches has been quite intolerable which led me to seek medical help. I got an xray done of my lumbar area which showed mild degenerative lumbar spondylosis and attempted sacralization of L5-S1.
I am just wondering what does the word "attempted" means when there is fusing of my L5-S1? Also is my current findings a sign of an impending serious condition? I understand that pain management and series of rehab might help but my follow up will still be in a week's time and these results are already worrying me.
Hope you can shed some light regarding my queries.
Respectfuly,
Christa
@Christa Sian,
Attempted may be used to imply incomplete. Lumbar spondylosis is a discomforting condition and by no means serious.
I'm a 28 year old woman with chronic lower back pain. I had an MRI 9 years ago which revealed L5-S1 spondylosis, grade 1 spondylolisthesis, right side bulging disc and straightening of lumbar curvature. I used to be very athletic but now find I have to minimize my activities. Although I currently have no apparent neurological impingements I'm worried about progression. I'm considering having children in the near future and wonder how pregnancy and birth with affect this condition/how the condition will affect pregnancy and birth.
Thanks for your help and advice!
Am Abbey, 25yrs old. I've been experiencing back ache for more than a year now. I was told to go for an X-ray and the result showed straightening of the lumber spine due to muscular spasm. Am worried wat can be done to cure this ache. Tanx
Hello.
I have had knee pain since i was 14. At first i thought it was from track in high school but i am 25 now and not only have they gotten worse but i have sever b ack pains. My legs go out from under me almost daily, i can’t pick up my son without fear of dropping him. I can hardly move when my back pain flares up. When i wake up in the mornings my back is knotted and it spasms. I have to use a heating pad before i can move too much. I get painful sensitivity on both thighs. Then travels down my legs to the bottoms of my feet. Doctors say there was nothing wrong til a few weeks ago when i made sure to get an xray. They still wont tell me anything but my xrays are almost the same as the picture here on the site. The only thing i was told was not to carry more than 15lbs and to limit movement. I read all your responses and you say excersice is best but i just dont know what to do since doctors here wont help me. Any ideas??
Hi Dr.Arun,
Can you please refere a good Doctor in PUNE & Mumbai for My mother & me also.
She has Osteoporosis & now she is suffering from dorsolumbar spondylosis.
Her treatment is going on in Fortis hospital, mulund,mumbai but still I want to have second opiniun for her.
I will be thank fule if you suggest.
Regards,
Arvind.
I am sorry but I do not have an idea. You need to rely on your local input. All the best.
Hi Doc
i have pain in pelvis foe last 5 months , my MRi reorts have these findings
1.. Right posterolateral broad based disc protusion at LS junction intervertebral disc level causing effacement of epidural fat and indentation of thecal sac with compression of lateral recesses and nerve root on right side
please tell me if its worring , will my pain go away , and what should i do to stop this pain
Have you taken an opinion from an orthopedic surgeon
Hello doctor,
I am 32 yr old male. Last six months
I am having pain in lowe back and right leg. Unable to bend back,Body bending forward. X rays report says oss of iordotic curvature in LS, LUMBAR VERTEBRAE AND THEIR APPENDAGES APPEAR NORMAL, intervertibreral spaces are maintained, no obvous bony patholigy in sacro iliac articulation. Orthopedician has suggested for pelvic traction, muscle relaxatant, pain killer, calcium tablets. Will you kindly advise me the dos and donts in this situation?. And how to now that it is improving during this tx?
Thanks a lotfor your time and reply in advance.
Sir i also want to know pelvic belt wearing position details, other facts if any .
Dibyendu,
You should take precautions not to stress your spine. I think following article is just right for you
Tips for Good Posture to Avoid Back Pain
Hi doctor,
i m suffering from lower back pain. In x-ray, lumber spondolysis is diagonozed. Pain is like any if i m moving even a bit to other position. Pain is going to front abdomen n hips With some currnt needle pain. Plz advise. I ve not yet cosulted with any doctor. Thnx
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Hi doctor,
i m suffering from lower back pain. In x-ray, lumber spondolysis is diagonozed. Pain is like any if i m moving even a bit to other position. Pain is going to front abdomen n hips With some currnt needle pain. Plz advise. I ve not yet cosulted with any doctor. Thnx
It seems like you need to consult a doctor because you are in need for prescription.
Pls what us d meaning of loss of lumber lordosis? And what type of exercise is good to correct this as I have nerve pain on my right leg due to muscle spasm..thanks
Lumbar spine appears arched with convexity in front in normal xrays.It iscalled lordosis. However in lumbar afflictions, the spine loses the arched appearance and it becomes straighter. So their is loss of lordosis.
Hi doc my name is Aurelia I resently fell of my chair at work when the chair rolled back and flipped foward pushing me of and free falling on the tile hitting my lower back and tail bone hard it went numb and over some days it’s gone worse I had an xray done which shows no fractures but they state further investigation be done and it states narrowing of L5 and S1 I am having so much pain and was given celebrex and tramadol for pain is there any advice for me.i can’t sit for long or stand for long my lower back is sore and it burns with pain from my buttocks right down my legs making it hard for me to do my daily work.
Kind regards
Auri
Hi Auri,
Most of the pains in the back respond well to rest and medication. Rest is very essential. It is boring, impractical but their is no alternative to rest. Give your pain few weeks. If it does not improve, you may be investigated further.
Take care.
Hi doc
Thank you for your reply.I had an MRI done and shows disk protrusion on L4 an L5 with an annular tear and dessication how bad is it because the doctors here in South Africa don’t always tell the truth I’m finding it hard to drive my car at present and the pain is unbearable what would be the best option since it is IOD and I am currently of work but cash is low so I am gone depressed I have a 5year old to rake care of.
My xray. Says there is straightening of the lumbar lordosis with lumbosacral facet arthropathy. What does this mean?
This means that you have arthritis of facet joint and normal lordosis of the lumbar spine is lost. It is not as bad as it sounds in words. Happens to most of population in due course of life. Loss of lordosis occurs due to spasm and in the beginning is reversible by exercises and improvement in posture.
Take care
Auri,
Disc dessication means that it is not hydrated any more and annular tear means a tear in the ring that surrounds the disc. As such it is not a problem. The problem arises when disc compresses the nerves in vicinity. I had suggested general measures in my previous answer. But for specific tratment, you would need to meet a doctor in person and get a prescription.
You are welcome to resolve any doubt or query.
Take care.
I had x-rays taken after several yrs of extreme hip and leg pain and difficulty standing, walking and laying down. x-rays are showing mild narrowing of L4/L5 space and complete loss of interspace at L5- S1. Also straightening of the lumbar spine. Vertebre are all lined up ok. I have no difficulty bending forward to the floor but can not bend backwards. I am more than a month away from a MRI to get a better look. I have psoriatic and rheumatoid arthritis but it is well controlled by Enbrel. There is Bilateral sacroiliitis noted more prominent on the right side. No evidence of fusion or erosions noted. (this has been there 20yrs and has not gotten worse.) While I am waiting for the MRI, is there a type of exercise that can help my mobility? Chiropractic adjustments were helping but insurance has run out on that for the rest of this year. Any recommendations would be great. Thanks
Hi Dr.Singh,
You are providing great services on this forum. I appreciate your concerns.
Sir, my husband is suffering from lower back pain. It started 7 years back but occurs all of a sudden and rarely.
The MRI report conclude “Disc dessicatory change with lumbar spondylosis more marked at L4-5 & L5-S1 vertebral levels”
At L3-4 level, there is broad based central and paracentral disc buldge with grade I impression Upon the anterior sac and mild narrowing of both exiting nerve root foramina.
Sir, Please help me understand this and guide me further.
Regards
Joan,
I could not make recommendations on this platform. You can simply conduct a search for spine exercises and chose extension exercises and see if they suit you.
Take care.
Your husband has lumbar spondylosis and dis degeneration. One of the disc has narrowed the space where nerve exits from vertebral column. He needs lifestyle changes, analgesics when needed and exercises. Have you shown him to a specialist?
Hi
Am 35 years old I.have been diagnosed of lower spine space reduction
Facing severe pain.and inflammation in the lower back
Have been suggested to take.rest and.physiotherapy
Am obese
Now am feeling very down will this problem get cured or.will it.continue.for.lifetime
I have two young children.
First of all, Thank you for your kind reply.
Sir, we consult a Neuro Surgeon and he gave some medicines and tube for pain relief but did not recommend any exercise or change in body posture. I am worried because my husband’s nature of job demands sitting for almost 10 hours consecutively. Should i consult any Orthopedic?
Hello Dr. Singh,
I have been reading through your forum .. and like the way you have been responding, very well indeed good sir.
I ask you if you can “explain” an x ray report,
“a reduction in the lordotic curvature all vertebrae appear intact and well aligned. an equivocal mild narrowing in dics space L5 -S1 is present. other disc spaces well preserved. Sacroiliac joints are suboptimally visualized but no abnormalities are identified. ”
The pain stays now for 3 months ..therapy meds .. nothing has worked.
Thank you,
Luke
You can do that or you could read about postures and precautions. You can start her
https://boneandspine.com/tips-for-good-posture-to-avoid-back-pain/.
You need to take active participation to get better. First plan and get rid of extra weight and you would feel much better as it would take extra load off the spine. Seek help if you are not able to do it yourself.
Follow your doctor’s advice. With precautions and healthy habits, you could be absolutely normal.
Normally the lumbar part of the spine is convex in front, called lordotic curvature. Your spine is less lordotic than normal. That indicates some kind of spasm in the muscles.
Rest of features are normal.
Difficulty, severe pain in walking, bending, legs up lifting. Doing office job, continuously sitting for 9 hrs since last 30 years. Now i am 50 years. My weight is 82 kg, height is 5 feet.My X-ray report is as under:
Straightening of spine noted.
disc spaces appear normal.
Marginal osteophytes around vertebras.
Slight anterior shift of LV4 over LV5.
Radio opaque shadow medial to right iliac spine and anterior to disc plate between LV-LV5.
Soft tissue shadows appear normal.
Bone density appears normal.
CONCLUSION:
lumber spondylosis with spondylolisthesis.
Stone in pelvis and anterior to spine.
I am too much worried and sick
What I has to do. I am simply taking pain killers. I will retire from services after about 10-13 years. My husband is already retired due to heart problems and prostate cancer. kindly guide me , help me.
Sofia,
Did you consult a doctor. Drugs and physical therapy are mainstay of the treatment along with some lifestyle changes. you should meet a doctor and if you have a specific query, please let me know.
To Sophia: Try not to get too worried. You need a MRI to know what it all means but if your disc spaces are good, that is huge in the good department. The small shift could be causing your pain if it is pushing on the nerve. A chiropractor might be able to help with that. I wouldn’t waste money on their therapies. Just the adjustments. If it can’t go back in place, I’m hearing great things about laser surgery for that kind of thing. Mine turned out worse than I thought after the MRI but it explained everything. My bottom disk is gone and the 2 above it are herniated. It must run in the family, I have always been very careful picking things up and I didn’t take a hard fall or anything like that. He’s calling it severe spinal stenosis so He is going to try a steroid shot in the area and go from there. He said if that didn’t help, I would have to have surgery. I know it can’t happen in the coming year, I have too many commitments. The Chiropractor helped my comfort and mobility a lot but I ran out of what medicare would pay for and my Orthopedic specialist doesn’t believe they help so he won’t give me a referral so I can get more. I wish they could work together on this stuff. I think if I had gone to a chiropractor 5yrs ago when it started, I might not be in this position now. I will see if medicare will cover some more adjustments after the new year. I’ve heard it was 30 without a referral so I could space them out when I would need it most. Good luck with yours. :)
Hello Sir,
I want know whether my condition is improved or not.
I am having backpain from last 10 years, Last february my LS MRI report states the following finding:
Date : Feb 2015
———————
1. Straightening of lumbar spine is seen.
2. Partial disc dessicative changes seen at L5/S1 level.
3. Mild posterior disc bulge is seen at L4/5 and L5/S1 levels causing thecal sac indentation without causing compression on exiting nerve roots.
4. there is a evidence of altered signal intensities in the form of T2/STIR hyperintensity and linear irregular T1W hypointensity involving the bosy of S2,S3 and S4 without any displacement and communition – likely fracture.
MRI Report on 3rd Jan 2016
————————————
1.There is straightening of lumbar spine with normal vertebral alignment.
2. L5-S1 intervertebral disc reveals disc dessication with mild posterior diffuse disc bulge and small posterocentral disc herniation causing effacement of anterior epidural fat, however no significant thecal sac / nerve root compression seen.
From 11 months i am taking allopathic treatment with painkillers and muscel relaxant.
Am i going in right direction?
Should i change my doctor ?
How much more time before i get totally healthy?
Thanks, waiting for your response.
ved verma
Ved,
There is no need to undergo MRI repeatedly to look for any sign. You would not be made healthy by medicines. You need to understand first what you have and how you could approach that.
Moreover, healing is not determined by the images. It is you who would determine if you are improving or not. Then base your further course on those decisions.
Here is an article you could go through
Lumbar Degenerative Disc Disease
Let me know if there is any query.
hello doctor,
I am 22 years old student. I have a lordosis where my pelvic tilted quite bad recently, and my doctor said there is a problem in L1 and L2 spine bone. So does adjusting the L1 and L2 bone will correct my pelvic posture back to normal? Thanks
I want know whether my condition , the report conditions are
Bone density is decreased
Mild degenerative changes are present
Disc spaces are intact
Normal Paravertebral soft tissue densities
Normal sacroiliac joints
conclusion: Mild Spondylosis Present
Kindly guide and helped ma about this condition.
I am not sure what you are suggesting about. Are you talking about surgical correction. because otherwise they cannot be adjusted. Moreover, pelvic tilt if fixed would not come back even after correction of the original problem.
Shumaila,
This indicates mild degeneration of spine which is normal part of aging. Happens to everybody. Treatment is needed if symptomatic. Please see a physician.
Hi sir!
Im 23 yrs old and working as a public health nurse.
I have been experiencing chronic back pain specifically at the thoracic and lumbar spine for almost 3 years. Pain is tolerable but it’s getting worse. My pulmonologist recommended a thoracolumbar xray and it showed that I have ” Straightened lumbar lordotic curve due to muscle spasm”.
By the way, I had PTB history last 2012 but already treated for 6 mos. Now, my latest chest xray showed that there is no significant changes compared to my previous chest xray.
Is my chronic back pain related to my PTB before? I am suspecting of having a Pott’s disease. What can you say Doc? Hoping for ur reply.
In your age, most of the back pains are due to postural issues rather than degenerative changes. Tuberculosis is one of the causes of back pain but it is unlikely that you have TB for three years and no structural changes in the spine. It should be a concern if you work in an endemic area.
Still you can discuss this with your physician and he could examine you to address your concern and if needed investigate you.
If everything else is alright should take care of your postures or work related stress on the spine.
Take care.
hello sir, from last 6 months i am getting si joints pain, doctor suggested for MRI LS Spine, in that report everything is normal but loss of posterior concavity of the discs noted at L4-L5 and L5-Si levels,
I am worried about that , will you please explain what is the exact problem and what kind of treatment i have to take.
Hai sir my name is dharmaraju I’m 23 years old 9 months back electrical shock to me my mri report result is NO SIGNIFICANT ABNORMALITY IN THE DORSAL SPINE AND LUMBAR SPINE
MILD NON SIGNIFICANT LEFT PARACENTRAL DISK PROTRUSION AT C3-4 LEVEL
Sravanthi,
That is not significant change and you should not worry much about it. Seems like more of postural pain which may be related to your work demands and postural habits. Early spondylosis is another likelihood. Medications, exercises and lifestyle changes is the treatment.
Take care.
Dharmaraju,
That as per MRI is not significant. What are the symptoms that you have?
Hello doc.
I am a volleyball player on our school for about 3 years. 19 years old. I am playing outside and when I jumped and spiked the ball i heared a sound on my back like its disordered. I fell down and cant walk easily for 2 mons. .this happened last july 2015. I decided to undergo to an x-ray last august 2015 and the result was straigthened lumbar lordosis probably secondary to spasm. Im still suffering from pain everytime i am playing and tired. Less than 2 mons then it would be 1 year from this injury and yet im still suffering from pain. but the pain not like before that it makes me cry . Doc my question is do my lumbar spine will come back to its normal shape? When will the time that i will be free from lower back pain? Lastly can i play volleyball ?
Hey doc , My mother was having problem in her back for 16 years , the pain stops for few months and starts again , but now days it has got sevier problem for her. we consulted wit the doctor he asked her to have an x ray. and the report says that / radio opaque shadows seen overlying body of L3 ? nature. so please help f
She needs to be investigated further Siddharth. There is a lesion which demands further probing.
Consult a specialist and get the relevant investigations like MRI done.
Ivan,
Eventually it does get well but to rejoin your sprts you would need supervised training and develop habits that would prevent strain on the back. If you are a professional player, you should reenter the sports once your trainer/physician fells you can go ahead.
Best of luck.
Hi..im Hamid 26yr old..i have back pain for a couple of weeks.. xray report shows that i have straightening of lumbar lordotic curve due musculr spasm…so what should i do? Is it serious or nt??? Any medication or physiothrpy..???
Hamid,
You need medicine for pain and exercises for back for this spasm in your back. Please consult a docotor.
Sir I am Geeta Sharma suffering from severe back pain during sleeping in supine position.Dr diagnose me bilateral sacroilitis by digital x ray.He advise me Defcort 5mg for 7 days then again 7 days in alternate day.Is it necessary to take this? MyHLA B27 ASSAY is negative as well as ASO titer also negative but C reactive protein is high.
If there is a sacroilitis, it suggests that it is likely to be inflammatory back pain. It could be otherwise but must be ruled out. How are you now?
hi dr. i am having severe pain in lower backbone. dr told it is marginal osteophyte format noted at lv3 . and advised me mecobal tablets! they are not working. what to do sir ? thanks
Hi Doctor ,
I have back pain and I cannot wake up from the bed in the morning it’s difficult me to sit also. I consult a doctor and I did some blood test and my Uric acid level is high.and I did xtray and it says straightening of lumber spine is seen which may be due to muscle spasm.is it severe disease or what?? I have no idea about that??? Can you please guide me what I need to do (example:excersices or resting With medication )
And they given No ur icon 300 mg, Etoria 120 mg ,Rarezol 20 mg. is this pain killers or what???
Hopefully waiting for your response as soon as possible
Thank you sir
Please speak to your doctor again and tell him that you have not improved. Follow his suggestions and prescription.
Take care.
Saliha,
Most likely you have lumbar spondylosis which needs analgesics, rest followed by exercises and life style changes for correct posture. For treatment, you must consult with your doctor if the treatment has not shown any results.
Take care.
hi doctor!
I am 33 year old female with 5 feet height and 75 kg in weight. I have fallen down while stepping down the stairs fifteen days back and could’nt sit straight then onwards due to severe pain. I have consulted the doctor and an X-ray was taken for Sacro-Coccyx .
the report says
*the vertebrae are normal in density, structure and alignment
* Marginal osteophytes is noted at L5 and S1 levels
* intervertebral disc spaces are normal
*no soft tissue abnormality is seen
the overall impression is LUMBAR SPONDYLOSIS
I am already suffering from low back pain from the past 6 years. now the condition has become more worse. I am using pain killers and calcium and vitamin D tablets from 15 days but I didn’t get relief from the pain.
doctor advised me not to use two wheeler for 3 months, not to sit straight, not to bend or lean back more for 3 months.
please tell me whether i could ride two wheeler after 3 months or not. could i lead my normal life style again without pain?
thank you doctor. hopefully expecting a reply from you as soon as possible.
Josyula Usha,
Lumbar spondylosis per se does not hamper with life styles. With few precautions, you should get back to normal life style.
Most likely the restrictions have been made due to injury to your back so that it is not loaded unnecessarily and abnormally.
Take care.
I am not a doctor but have some pretty severe disk issues. In your condition, I might try swimming and other exercises to strengthen your back muscles with a lot of stretching and if riding the 4 wheeler, I would let your legs do the work by leaning forward and barely sitting- almost a crouch when you are going over bumps so you don’t take any impact on your spine. Let your legs work like shock absorbers. You will get the best shaped butt ever and a flat stomach- all good
Sir,
I got lower back pain before 1.5 months my doctor advised me for 1 week rest and 15 days physiotherapy. And some exercise. But I couldn’t done exercise in routine. As of now my MRI report is ” multilevel small marginal oestotypes are seen L3 to L5 levels disc height are reduced. Partial degenrated L-4 5 and L 5 S1 disc are showing posterocentral disc protusion causing thecal sac indentation.”
Now same treatment repeated 15 days physiotherapy and 1 week rest. Kindly advice with precautions.
Gaurav,
You seem to be treated well. Please continue the treatment and follow your doctor’s advice.
Take care.
Hello Dr, myself Nikki, my mom has twice underwent microdisectomy and fenestration surgery for l4 and l5 and in the first for l5 and s1, nowerdays again she started feeling pain in the back and right leg and underwent x-ray and we have got a report with impression lumbar spondylosis with PIVD, again is she need to undergo surgery or other alternatives can keep her healthy?
Nishita,
Surgery in disc surgery is not always indicated. Non-operative treatments are effective but take longer time and require higher degree of patient participation. A detailed discussion with her treating doctor can help both doctor and patient decide on the treatment.
GoodMorning Dr Arun. I had a Ct scan done on 12/10/2015
and just want to know how does this look and what does this say?
Thank you so very much. Aundrea
ct report evidence of surgery PLIF at L4-5 without canal stenosis with foraminal narrowing identified bilaterally as described above. l3-4 bulge with moderate canal stenosis with recess narrowing and foraminal narrowing bilaterally. there is calcification along the posterior margin of the disc. l2-3 disc bulge with mild canal stenosis. there is mild scoliotic curvature
Good Morning Dr Arun. Here is the X-ray report done on the same say. as my Ct scan 12/10/2015
Impression:
Evidence of Surgery with Fusion at L4-5. Spondylitic Changes at L2-3. Facet
Disease Identified. There is slight curvature of the lumbar spine. No fracture is present.
Also Findings: There is evidence of surgery at L4-5 with endplate sclerosis and fusion present. This is noted on the Ct examination of the same day as well. There is no fracture identified. There is no expansile lesion identified. There is hypertrophy identified.
Aundrea,
It is a CT after the surgery where fusion has been done at L4-L5 levels. There is a disc bulge at L3-L4 levels which has resulted in narrowing of formaina [space from where nerves come out of spine]. There is a disc bulge at L2-l3 too.
There is mild scoliosis also.
Dear sir
I m from Dhanbad ,Jharkhand
My mri report is…
1. Grade -l retrolisthesis of L5 over s1.
2. Central and right paracentral disk herniation of L4-L5 disk causing stenosis of spinal canal , right lateral recess and neural foramen ; comprising right exiting and traversing nerve roots.
3. Annular disc bulge of L3-L4 causing thecal sac indentation only.
Sir I have feeling problem to standing ,sitting toilet and walking..
Pls tell me what can I do
My current doctor is on leave for ten days..I have no medicine now. pain is increasing..Sir pls reply fast
RK Mehta,
I am sorry. It is not a platform for advise. You are requested to consult a physician in person.
Sir i am 22 yr old i am suffering from back pain .dr.diagnoised me that ssa anamia. I have suffering since 3yrs .n using medicine for abt 3yrs is there is any chance for curable
Vani 5,
You need to elaborate to enable me to answer. Take care.
Hello Doctor,
I have little pain in my back since last 3 weeks, so finllay i decided to do X-Ray and Below are the Points from X-Ray report.
Please let me know is this serious and what kind of treatment will help more?
Spondolisys of L5 Vertebral body with mild anterior offset of L5 over S1 seen.
Above is only point that X-Rays shown abnormal.
rest all things are normal. please advise
thanks in advance.
Sameer,
I would advise you to see a doctor in person. Thank you for your query.