Why would radiologist and orthopedic surgeon diagnose findings of MRI differently?

Hello,
I have had problem with right degeneration of lower lumbar discs too. It has been a long recovery. My empathy to you all who suffer the same problem. I am recovering and would like to share my story, in hope to encourage everyone who is suffering with the same. Here is the sequence of what I have done to discover the exact nature of my pain and recovery (90%) so far.
1. Started with lost of daily mobility capability. Could not stand, sit, or walk for more than 5 minutes. Pain radiated from R. calf to buttock.
2. Physical therapy from July 2012 - December 2012 - very slow progress - muscles were getting stronger but still having lots of pain, especially the hamstring. Only flexing movements release the pain and also traction on lower back. Physical therapy twice a week.
3. Started to walk the stairs to rebuilt body strength and loose weight in January. Had an MRI that showed L3/L4 and L4/L5 were bulding. BUT major source of pain was/is due to Facet Joint Arthropathy on L5/S1.
4. Once figured out the source of pain causation, physical therapy were designed to accommodate the arthritis on L5/S1.
5. Cut out sugar and eat healthy. Must loose the excess lbs to make room and ease the pressure on the lower lumbars. Sugar is the major causes of inflammation; I was in so much pain daily that motivated me to stay off sugar.

As of today, I have lost 10 lbs - this is a must to ease the pressure on the joints; daily PT exercises to keep core muscles strengthen, daily stair climbing (77 steps up/down). A few days without the exercise would restart the pain.
Now, I am getting much stronger, can walk, stand for more than 10 minutes.

Thanks
JP.

Rosa and Anon-
Thank you both for you comments. Rosa- I, too, am a nurse. This injury happened at work and after more than five months of conservative treatment I am unfortunately not much better. I still have the radiculopaty and back pain. I lean more toward the radiological dx especially as time and therapy have made no difference. It is really discouraging to still have pain and to be unable to work due to lifting restrictions. I am not a fan of back surgeries either but I would like to seek a form of treatment that might offer recovery rather than management with opiates or drugs heavy on side effects and sedation. D.,RN

Hi Anon,

When a disc is herniated, then it means that it has been bulged, torn, or broken-- this can cause pain, numbness, and weakness in that location. If the disc never broke and was bulging back in November but pressing on your root, then this is likely why the radiologist said it was a herniated disc. The good thing about a bulging disc is that with therapy or with time, it can actually come back into place or at least to the point where it is no longer pressing on a root. This may be why your orthopedic surgeon sees it as a bulging disc (which requires no surgical intervention) and not a herniated disc.

Personally, I'm not a fan of unnecessary spinal surgeries due to their risks-- but if you feel as though you need a second opinion, please do so. You can also ask for massage therapy as a form of treatment even if it is a bulging disc. 

Best Wishes,

Rosa