How to read your lumbar MRI report (in plain English)

Short answer: an MRI report is written for another doctor, not for you, so it reads like a horror story even when your spine is fairly ordinary for your age. This page translates the words you’ll see into plain English — and explains why imaging often reads worse than it actually feels. It is a glossary, not a diagnosis.

First, the most important thing

Imaging almost always reads worse than it feels. Findings like disc bulges, degeneration, and mild narrowing are extremely common in people with no pain at all, and they pile up with normal aging the way gray hair does. A scary-sounding report is not a verdict. What matters is whether a specific finding lines up with your specific symptoms.

The disc findings

• Disc desiccation. The disc has dried out and lost water content — one of the earliest, most common signs of normal aging.
• Disc bulge. The disc has spread evenly past its normal edge, like a tire under load. Common, often painless.
• Disc protrusion. A more focused push of disc material past the edge, still contained.
• Disc herniation (extrusion). Inner disc material has pushed through the outer wall. It sounds worst, but often reads worse than it is, and many settle over time.
• Annular tear/fissure. A small tear in the tough outer ring of the disc.

The narrowing findings

• Central canal stenosis. The main channel carrying the spinal cord and nerves is narrowed.
• Foraminal stenosis. The side openings where nerve roots exit are narrowed.
• Nerve root impingement/compression. A nerve root is crowded or pressed — whether it matters depends on whether it matches your symptoms.

The alignment and joint findings

• Spondylolisthesis. One vertebra has slipped relative to the one below, often graded 1-4. Sounds alarming, often carries less consequence than feared.
• Spondylosis. A general term for age-related wear changes.
• Facet arthrosis/hypertrophy. Arthritis-type changes at the small joints at the back of the spine.

Why we don’t require an MRI

Dr. Frye reads your films herself — the ones you have, MRI or X-rays — and tells you plainly what matters and what doesn’t for your case. An MRI is helpful when we have it, but a report full of frightening words is not a reason to book surgery, and the absence of one is not a reason to wait in pain.

What this means for treatment

Non-surgical spinal decompression is aimed at disc-driven pain and pressure on a nerve. Whether your findings are a good fit is a judgment call made from your symptoms and films together. What decompression does not do is regrow a disc or reverse degeneration; it works to reduce pain over a course of care.

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Frequently asked questions

My MRI report sounds terrible. Does that mean my back is badly damaged? Not necessarily. Bulges, desiccation, and mild narrowing are extremely common in people with no pain, and increase with normal aging. What matters is whether a finding matches your symptoms.

What’s the difference between a bulge, a protrusion, and a herniation? A bulge is an even spread past the edge; a protrusion is a more focused push; a herniation is when inner material pushes through the outer wall. A herniation sounds worst but often reads worse than it feels.

Do I need an MRI to be treated? No. Dr. Frye reads your films herself, an MRI is not required.

Related: Herniated discs · Degenerative disc disease · Spinal stenosis · Does spinal decompression work? · Home