There are those who have sudden major compression due to an acute incident, the pain of which is on a magnitude several times over others who have a more progressive nature of structural deterioration over the course of time. It is my belief that the latter experience significant stiffness and lack of ROM, but in terms of radicular pain it is much more limited due to the cord still being able to navigate the structures.
You can have two backs(or necks) with almost identical MRIs, but because one protrusion is 1.5mm to the left of another's, his pain is intolerable while the other's is barely noticeable. The protrusion size is the same. You can even have a protrusion that is massive but the nerve root around it doesn't feel it because the nerve is not entrapped due to the fact that it is encased within adipose tissue(fat) which allows it to glide with ease, like foam packing peanuts protecting shipping contents.
Each case is unique which is why VAS scoring, which are subjective, are used to determine course of action versus images alone.
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Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea.
Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try.
MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge.
L5/S1 taking on new shape, chronic sciatica, etc.
DEXA bone scan performed 5/7/14 showing mild osteopenia.
Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar.
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