It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 01-11-2013, 12:52 PM   #1
Veteran
(female)
 
Kaji's Avatar
 
Join Date: May 2012
Location: South Florida, USA
Posts: 442
Kaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB User
Just got my MRI results. Can somebody interpret?

Saw my orthopedist today to get the results of my lumbar MRI. He didn't explain it to me except to say the report doesn't show anything serious wrong and if I'm concerned about the continuing weakness in my left leg I should see a neurologist... and he gave me a copy of the report to show to said neurologist when I see him, so at least I can share it with you.

Here's the Impression from the MRI Report.

L5-S1 - mild discogenic degenerative disease with left foraminal towards lateral disc/annular tear and extra-foraminal broad disc bulge slightly crowding the extraforaminal left L5 nerve root. In addition, there is a posterior central shallow disc protrusion impressing upon the epidural fat and slightly impinging upon the proximal S1 nerve root sleeves. Again, there is mild facet arthrosis contributing to a slight crowding of the lateral recesses and proximal descending pathways of the S1 nerve roots. There is no significant narrowing of the central L5-S1 spinal canal.

L4-5 - Posterior central disc/annular tear with posterior central shallow disc protrusion slightly impressing upon the thecal sac and along with mild facet arthrosis and facet overgrowth result in slight narrowing of the lateral recesses and proximal descending pathways of the L5 nerve roots. No central spinal canal stenosis.

L3-4 - Posterior central disc/annular tear with central shallow disc protrusion mildly impressing on the thecal sac. No nerve root impingement or canal stenosis.

Multilevel mild lumbar facet arthrosis. Again, no central lumbar spinal canal stenosis.

Question - Looks to me like the report says I have three torn discs? I know the 'no stenosis' bit is good news. Does this report explain attacks of sciatica/back pain twice a year for the last three years, with the latest one causing foot drop, a wobbly left knee, a limp and left leg weakness.

Entirely O/T for this board, I also told him that my left hip has been hurting into my groin a lot and he took another look at my x-rays (from September) and said it looks like a normal 40-yo hip and I should expect a few aches and pains. (In September he said it showed arthritis) My physical therapist was concerned at the rate my pain's been increasing so she wanted to make sure I talked to him about it, and I just got fobbed off, so I'm less than pleased with him atm!
__________________
~ asthma, allergies, anxiety, arthritis, back problems, high blood pressure, fibromyalgia

Last edited by Kaji; 01-11-2013 at 12:53 PM. Reason: typo

 
Sponsors Lightbulb
   
Old 01-11-2013, 01:11 PM   #2
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

Is this doctor an orthopedic spine surgeon or a general orthopedic doctor? If he is a spine specialist, I would recommend you make an appointment with a different doctor who has a bit more compassion. In my opinion, you don't need to see a neurologist at this point, just a good spine surgeon who is interested in resolving a problem.

Your "Hip" pain may also be coming from some of these L5-S1 and possibly L4-L5 findings.

I have to run but will be back in a couple hours and will tell you more of my reasoning then....sorry for the interruption.

Last edited by teteri66; 01-11-2013 at 01:26 PM.

 
Old 01-11-2013, 01:26 PM   #3
Veteran
(female)
 
Kaji's Avatar
 
Join Date: May 2012
Location: South Florida, USA
Posts: 442
Kaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB User
Re: Just got my MRI results. Can somebody interpret?

He's a general orthopedist. They have a spine specialist there though, so if he thought I needed it he could have passed me on. He told me to use my cane, continue my physical therapy and get into shape (ie. lose weight, as if that was easy when I can only walk at 2 miles an hour.) I didn't even bother to tell him how often my feet are going to sleep on me lately when I'm sitting or lying down. The whole thing was rather depressing - but the real question is, is the report as 'nothing' as he seemed to think?
__________________
~ asthma, allergies, anxiety, arthritis, back problems, high blood pressure, fibromyalgia

 
Old 01-11-2013, 05:14 PM   #4
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

If I were in your position, I would make an appointment with a spine specialist from another practice. Obviously we are not doctors....just fellow sufferers who share information based on personal experience...so there is always the chance I am completely wrong here, but you know what you are experiencing and this doctor is not being very helpful. Some spine surgeons aren't as helpful as they could be when it is obvious that no surgery is in the immediate plans...but most are willing to answer questions and direct you to an appropriate source for treatment.

First let me explain what I see in your radiology report. Remember that the MRI is just one piece of the diagnostic puzzle...the doctor correlates what he sees with what he finds when he/she examines the patient, performs a basic neurologic exam and listens carefully to the patient's description of symptoms and how it impacts his/her life.

So a MRI is a starting point -- sometimes things sound worse than they are; other times things that look insignificant can actually be causing a great deal of pain.

First of all it is helpful to know that radiologists use specific adjectives that are used to describe specific issues that function as a type of ranking system. The system begins with minimal, mild, moderate and the worst level is severe.

You will note the most of your issues are listed as mild...which usually means that something is going on that can be handled with conservative treatments which would include things like oral medications, a course of physical therapy, perhaps massage therapy, acupuncture and a series of epidural steroid injections.

The discs both at L3-L4 and at L4-L5 are protruding, and are bulging out enough that they are pushing a tiny bit into the thecal sac...but probably not enough that it is having an impact on the nerves located within the thecal sac. These discs also have annular tears. The annulus is the tough outside radial membrane of the disc that contains the soft, gel-like inner nucleus. It depends on the type of tear, but they can be very painful as the outer periphery of the disc is filled with pain-carrying nerve fibers that are called the sinuvertebral nerves. When a tear occurs in this area, even if very small, it can cause a great deal of pain.

Also at L4-L5 the facet joints are showing degenerative changes, "arthrosis and overgrowth" which means the joints are enlarging and spreading into the adjacent foraminal opening. It is correct that you do not have stenosis in the central canal, but there is a second area that become narrowed and that is the foraminal opening (foramina/foramen). The foramen are openings that the spinal nerves travel through as they move from the spine on out to the limbs. When they become blocked or narrowed, the result is nerve irritation or compression. At this level it is causing a bit of an issue with the descending L5 nerve root.

Similar degenerative changes are occurring at the last lumbar segment, L5-S1, which is resulting again in a pinching of both the L5 and S1 spinal nerves.

These last two lumbar segments (L4-L5 and L5-S1) contain the spinal nerves that innervate the buttocks, groin, back of leg and down into the foot. When one has a sciatic-type pain, it is usually coming from one of these nerves...same with numb toes, pain in the buttocks and in the groin.

Also, I personally know several people including my mother-in-law who was being treated for hip bursitis/arthritis for several years...turned out it was a herniated disc at L4-L5. Due to the large muscles that attach into the spine and run across over to the hip, it is not uncommon for a lower lumbar problem to cause what we perceive to be "hip pain."

I'm not suggesting you do not have a hip issue...but wanted you to be aware that it could also be the back that is causing your pain in the hip area.

So basically you have 3 protruding discs, several annular tears, some effacement of the thecal sac, facet arthrosis and stenosis in the lateral recess and foraminal areas...with some compression of the L5 and S1 nerves. Sounds like a lot...but all of it is rated to be "mild" so your issues are being dismissed by this doctor. No doctor would look at this and tell you that surgery was on the immediate horizon...but that is not to say that your pain is minimal, or that you are not exhibiting signs of nerve compression, such as weakness and numbness.

Look online for a "dermatome map" if you are interested in seeing the specific areas that are innervated by each spinal nerve. I imagine you will notice that your pain follows a pattern that is fairly typical for a L5-S1 nerve compression. Remember, when a nerve is compressed, you can have pain in the back or anywhere along the pathway of the nerve....

 
Old 01-11-2013, 06:18 PM   #5
Veteran
(female)
 
Kaji's Avatar
 
Join Date: May 2012
Location: South Florida, USA
Posts: 442
Kaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB User
Re: Just got my MRI results. Can somebody interpret?

Thanks for turning it into English for me. I know everything's relatively minor compared to what it could be. I don't have major back pain except for aches very low in my back unless I've seriously overdone things, but I can't lie on anything hard, and I can't sit on anything that presses into my back (like chairs with a space between the seat and the back). And so on.
__________________
~ asthma, allergies, anxiety, arthritis, back problems, high blood pressure, fibromyalgia

 
Old 01-11-2013, 07:49 PM   #6
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

If you work to make your back and core muscles and ligaments strong and supple, you may be able to keep your issues from turning into major problems!

 
Old 01-21-2013, 10:31 AM   #7
Veteran
(female)
 
Kaji's Avatar
 
Join Date: May 2012
Location: South Florida, USA
Posts: 442
Kaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB User
Re: Just got my MRI results. Can somebody interpret?

After being more or less dismissed by the orthopedist, I tried to go off my anti-inflammatory meds last week to see if I really needed them any more, because they can raise your blood-pressure and mine is problematic. The first day I just hurt but I could move normally. The second day I could hardly walk. I didn't realise how bad my walking was until I went to physical therapy and shuffled my way into treatment, to the horror of my therapist who thought I must be in agony. I wasn't, just pain, but I couldn't lift my feet off the floor. My cane wasn't really any help to me because it wasn't just my 'bad' leg dragging, BOTH legs were being non-cooperative - if I was going to stay like that I'd have to use a walker! And what's more, my blood pressure was high enough to alarm my therapist, presumably because I was in pain. I went back on my meds that night and was 50% better in the morning. I guess that goes along with the fact that the only time I've been entirely symptom-free since August was when I was on prednisone for two weeks for asthma.
__________________
~ asthma, allergies, anxiety, arthritis, back problems, high blood pressure, fibromyalgia

 
Old 01-21-2013, 12:47 PM   #8
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

Prednisone can be a miracle worker. Too bad we can't stay on it long term.

Did you see a spine specialist or was this the other orthopedic doctor?

 
Old 01-21-2013, 12:58 PM   #9
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

I had to go back to reread your MRI. You do have issues with facet joints at several levels. This is probably where the anti-inflammatory makes you feel better. Facet joints are synovial joints just like the hip, knee, ankle, etc which means they contain fluid which aids in movement. As a result, they are prone to arthritis, which often causes joints to enlarge...which means less space for the nerves, and also the growth of bone spurs....

Then there are the annular tears which can also cause pain that is not necessarily seen on MRI because there is no nerve compression. But the outer part of the disc contains nerve fibers and when there is a tear, there can be a chemical reaction that the nerve fibers are very sensitive to...thus, the pain.

I still would recommend that you go to a fellowship trained orthopedic spine surgeon or a neurosurgeon. Take the MRI along with you, so the doctor has it available to review while you are there. The other option would be to get an appointment with a physiatrist. This specialty is also known as a "doctor of physical medicine and rehabilitation." They are often very good at diagnosis and figuring out a treatment that will reduce your pain and return you to more normal function. This specialty often works with stroke patients, but are also useful for patients with many other ailments that affect their daily function.

 
Old 01-21-2013, 03:09 PM   #10
Veteran
(female)
 
Kaji's Avatar
 
Join Date: May 2012
Location: South Florida, USA
Posts: 442
Kaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB UserKaji HB User
Re: Just got my MRI results. Can somebody interpret?

I've got a neurologist's appointment this week, but I expect my next stop to be a spine specialist. My doctors were concerned I might have MS instead of/as well as fibromyalgia, but I very much doubt it. I'm pretty sure now that my back is the big culprit, because if it was neurological the anti-inflammatories wouldn't have such a dramatic effect. At least I don't THINK they would... the pain isn't a huge deal, and it barely hits a 5/10, but the walking thing is alarming. Some days I'm fine, others I can hardly walk 50 feet without shuffling. On the good side, my leg and hip have been hurting much less lately, so the sciatica has pretty much resolved itself for now.
__________________
~ asthma, allergies, anxiety, arthritis, back problems, high blood pressure, fibromyalgia

 
Old 01-21-2013, 04:31 PM   #11
Senior Veteran
(female)
 
Join Date: Nov 2010
Location: USA
Posts: 6,742
teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
Re: Just got my MRI results. Can somebody interpret?

Remember it is the spinal nerves, in your case lumbar nerves, affected in your spine that can cause the loss of sensation and/or muscle strength in the legs and feet. One doesn't need to have any back pain whatsoever to have a compressed lumbar nerve that is causing numbness in the toe or loss of muscle strength in a leg that causes one to suddenly stumble or even fall.

 
Old 01-21-2013, 10:19 PM   #12
Newbie
(female)
 
Join Date: Jan 2013
Location: Selmer, Tn USA
Posts: 1
Joyinpain HB User
Wink Re: Just got my MRI results. Can somebody interpret?

[B][/B]Hi, I am experiencing almost the exact same symptoms as you, my discs are bulging in L3&4 & L5. I have sciatica as well and as long as the discs continue to bulge and if I continue to "over do it" as you said, my sciatica will continue, my discs will herniate and my pain will continue and/or increase. It gets worse not better, I am loath to report! I have been dealing with this for 5 years now and I have had steroid injections, physical therapy, pain medications and countless MRI's and spinal blocks. For me the blocks last from 3 days to 2 months depending on how well it's administered and how physical I get, everyone is different so I wouldn't say that will be your experience. My mother had to have them for 2 years and hers lasted for 3 to 4 months at a time. I have lost 30 pounds in the last year and that is the one thing that has given me a huge margin of relief, more so than all of the other "fixes" combined. The reason is, the more fat that is built up around the tissue at the discs the more pressure there is and the more the sciatic nerve is pinched which is what causes the lower back and leg pain, and quite possibly the hip pain as well. Everyone is different, I realize this and a compassionate caring doctor is your best avenue, however you can do a lot toward your own pain relief by not necessarily exercise, but by relieving as much pressure from that nerve as you can. Don't lift anything with your back, use your legs, change positions often when sitting and don't sleep or lay for long periods on your back as this puts a lot of pressure on your discs. If you already do these things then I hope I have helped a little. I don't know your situation but if you have any excess weight at all try shedding if possible and you will see a big difference in your pain level.
Good luck I wish you the best!
Joy

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is Off
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 03:28 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!