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Old 05-02-2008, 05:16 PM   #1
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nomoredenial HB User
Unhappy they say nothings wrong but mri says... which is it

hello everyone I ve been to this board off and on. mostly off because sitting still is very problematic. I have to change positions/activity very often. I get real stiff in L5 and cant straighten up after sitting. sometimes there is a sharp pain there suddenly when I am moving about. but not so much anymore its improved.
so heres my delima IME says nothing is wrong with me. I wont go into the lame review of his but it did not address the situation ongoing. I now have to go back to work but cant do what I did before which repeated lifting. I feel ok when moderately moving about until I fatigue out. but I cant remain still so I force myself to do stuff to keep from locking up at the cost of some pain. I can work I will likely do something part time, but I am walking away from a lucrative career. only because an IME review in the healing process is sending me back before I know how much I am going to heal.
what I will post is the mri report if anyone recognizes any of this tell me because I have looked up the stuff and I see justification for the constant 3-4 pain level it gets worse but mostly is here. what I feel is a connection between degenerative disk, facet arthrosis, annular tear, and L5 issues listed. also not listed is a transitional vertebrae L5. And either I have a high tollerance or I am a wimp about a little pain. but I do feel this. and it is different than previous Sacral illiac pain that I used to have years ago. this came suddenly and has been slow to recover. I will lose my job tuesday if I dont return but I cant see how to do so.

Mri lumbar spine
sagital midline images demonstrates the presence of shmorl's nodes involving endplates at the L1-L2. there is mild edema involving endplates L1 and L2. this is adjacent to scmorl's nodes described. there is no frank compression fracture or other trabecular injury.

L1-L2 disc level: there is normal posterior disc contour with no central canal or neural foraminal narrowing.

L2-L3 disc level: normal disc height and signal intensity there is normal posterior disc contour with no central canal or neural foraminal narrowing. there is mild flaval hypertrophy.

L3-L4 disc level: there is normal disc height and signal intensity normal posterior disc contour with no central canal or neural foraminal narrowing. There is bilateral flaval hypertophy and facet arthrosis that contributes to a mild trefoil configuration of the central canal without frank narrowing. the neural foramina are minimally narrowed inferiorly.

L4-L5 disk level: There is desiccative change. There is a left foraminal annular tear. there is a very small superimposed left foraminal protrusion that contributes to the mild narrowing of the entry zone of the neural foramen inferiorly without frank compression of the exiting nerve root. the central canal is not narrowed . there is mild flaval hypertrophy and facet arthrosis. the right foramen is widely patent.

hmm it seems that the IME did not return page 2 when they copied records. I dont know if anything more is on page 2 of the report. but I know he said theres nothing wrong and I can return no restrictions but certain movements like daily care is uncomfortable too say the least but I am doing better than when I last post as now mild movement activity helps versus here: <http://www.healthboards.com/boards/showthread.php?p=3445119#post3445119>
but worse than way worse than here last year at this time and the previous several years when I was starting to think I had conquered my back demons and my inner demons that resulted from dealing with healing over time.

Last edited by nomoredenial; 05-02-2008 at 10:09 PM. Reason: missing pg two

 
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Old 05-03-2008, 01:13 AM   #2
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Re: they say nothings wrong but mri says... which is it

You need to get page 2 of your report. It seems that the "impression or findings" of the MRI is missing. That normally follows after what you posted.

Actually your MRI looks pretty good on the whole. Your discs are in good shape, for the exception of L4/L5 is starting to age and dry out. Your main issues from that is facet arthritis basically in most of your lumbar spine and the foraminal tear and whatever protusion you have there.

I don't know if a tear in the foramina can heal on it's own or not. And if it were me, I would want to know what that "protrusion" there is. I would assume that the body can heal that, but if not, I would think that would require a surgical correction. Having that tear there, leaves the nerves there very irritated and more vulnerable there. I think this needs to be more thoroughly discussed with a spine surgeon on if this can heal on it's own and what options may be available to you to repair it.

Have you ever had any injections done at and around your facets to see if they bring you relief?

What medications are you currrently on?

Regarding the L4/L5 disc. This disc takes more impact and movement than any other disc in the lumbar spine. When a disc is termed as "dessication", as it dries out and hardens over time, it can often emit a chemical which can often irritate the nerve root it is closest to. The fact you have the foraminal tear at this level is more likely exaggerating this two-fold.

Pain is relative to the person experiencing it. What hurts one, may not hurt another at all. This does not make you a wimp, but someone that simply hurts. You do have cause for your pain. A disc that is aging can be very painful for some people. This can also be called discogenic pain, which means pain is eminating from within the disc itself. A disc does not have to be herniated or bulging for this to occur either. The facet arthrosis can be very painful. The tear you have..this is at the core of where you nerves are.

Hope some of this helps. I would do what you must in regard to work, but I would get another opinion from a spine surgeon.
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"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 05-03-2008, 02:10 AM   #3
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nomoredenial HB User
Re: they say nothings wrong but mri says... which is it

thanks for the reply I had to edit upon realizing I was looking at pg 1 of 2
my initial pains and inability to do corrective stretching "modified yoga" led me to find a good surgeon he just doesnt elaborate on much. now IME has closed that route. I need to get his report too. but overall lifting 40000 - 50000 lbs in a day is not going to be a good idea anymore as I already had a SI injury in 99 and recovered but the upkeep for that recovery was yoga and it took care of it all even random soreness from overexertion. I have been through all a good share off physical stress on the body. It is time to look out for my health.

I am very sensitive to what I think are side effects of a med, or tollerant of it main componant, so to have it work it has to be a very high dose but if it causes somulence even a little Im out for a long time. and most of the meds dont touch this. I was doing 2400mg Ibuprofen but that was ineffective and the opiate based stuff id sleep for days because etodulac did not work either have done vicadin soma zanaflex some others to all with undesireable side effects and no effect on the pain it was taken for. I am taking naproxen and nap seems to stave off the stiffness. so Ill take that its at least touching some of it.

I am just wound up tight about leaving this job I really liked it no stress. and fun. but hard on the body so even though I want to get better to the point of going back I realize I should find some thing for middle aged men instead of a young mans job.

I dont get sciatica or leg pain just localized @ L5 area. So I count my blessings because this does not feel like nerve pain in spite of occasional foot numbness it feels like instable and folds back like the facet spines bump along with a severe sharp ache/stab.

I also think that appealing industrial commision will be useless because I am incrementally improving and by time I get a hearing I likely will not need PT anymore. So I will just take some more time to heal then find a part time job and see what I can tolerate then go full time when I figure my new limits

 
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