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  • Normal MRI, NEED HELP!! PLEASE!!

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    Old 01-03-2010, 09:57 AM   #1
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    Unhappy Normal MRI, NEED HELP!! PLEASE!!

    I woke up on December 15th with TREMENDOUS debilitating back pain that shot down my legs like a burning shock. could not stand upright, bend over, pull up my own pants, put on my shoes, nothing, I was STUCK. Went to the ER and they told me that it was sciatica and started me on valium and vicodine (minimal doses really).

    Called the doctor the next day as the pain was excruciating and I needed help. The meds worked, but only for a couple of hours and I had to wait at least 2 more hours for the vicodine and 4 more hours for the valium. She added Prednosone (a 12 day pack) to the med cocktail and doubled both the valium and the vicodine as needed and added Naproxem when the Prednosone was gone. I then had XRays done that showed absolutely nothing.

    Wednesday before Christmas I had no relief from the pain without the meds and horrible pressure pain in my mid to lower back while on the pain meds or not, but no sharp shooting pains while on the narcotics. The meds bring my pain level from a 7 to a 4.

    I can now move around and do basic tasks on my own but can only stand upright for short periods of time. When I stand too long (more than 3 minutes), my legs begin to shake, the pressure pain increases and I feel like I am going to lose my balance (even with the medications).

    The Wednesday before Christmas, I had a doctor's appointment and went in without taking any meds so she could see exactly what was going on. I had the sharp shooting pain down my left leg while in her office and the pressure pain in my middle and lower back was intolerable. That was the last time I had the shooting pain in the leg. She ordered an MRI which I didn't get until the following Tuesday. Those results came back normal.

    I am frustrated beyond belief. I still have the huge pressure pain in my middle to lower back and my left hip, but even without the meds first thing in the morning, I don't have the shooting electrical burning pain in my leg anymore. It has been 19 days now. I tried this morning to not take any pain meds and see if I could do it, but I only lasted 1 hour (I have tried this a few times and I can't go without the meds).

    I see a new Doctor on Monday morning. (The last one was a nurse practioner and I am uncomfortable with her for various reasons one of which she has prescribed me 4000mg of acetaminaphine a day and I think that's WAY too much, when I asked her to change the Hydrocodone dose to 10/325 instead so that I was getting the same amount of vicodine but less acetaminaphine, she told me no, just cut out 2 of the pills a day, well that still makes 3000mg of acetaminaphine a day and I think that is still too much. I also asked her to try me with Lyrica since it is non-narcotic but works for nerve pain and I would prefer not to be "fuzzy" in my head and she said no again because my current pain management was working and she didn't want to mess with that).

    Is there anyone out there with similar issues and/or is there a doctor out there who might want to give me some direction on where to go from here? I know it's only been 19 days and there are lots of people that go much longer than this, but I just can't take not being able to function normally anymore, it's making me crazy.

    Thanks for ANY help anyone has to offer.

    One other thing about my medical history, I do have Factor V Leiden as well (which makes the Naproxem a little scary for me), so i am not sure if a blood clot in the right spot would cause all of this or not, but I thought I would throw that out there in case it might be a factor.

    PS. I had NO injury, lifting, twisting or anything that would explain this, I just woke up like this.

    Last edited by rhike; 01-03-2010 at 09:59 AM. Reason: left something out

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    Old 01-03-2010, 04:56 PM   #2
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    Did you get a copy of the radiological report of your MRI? You should call the facility where you had the MRI and ask for a copy of the report. Then review the findings and especially the area under "impression".
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    Old 01-03-2010, 07:18 PM   #3
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    I am supposed to pick up a copy of the results tomorrow. They said they wouldn't be ready until then. The new doctor I am going to also had a copy of those reports delivered to him as well. I am not sure what I am looking for on it. The Nurse Practioner I was seeing just said the report said the findings were "normal". So I must have pulled a muscle.

    Old 01-03-2010, 11:20 PM   #4
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    [QUOTE=rhike;4155133]I am supposed to pick up a copy of the results tomorrow. They said they wouldn't be ready until then. The new doctor I am going to also had a copy of those reports delivered to him as well. I am not sure what I am looking for on it. The Nurse Practioner I was seeing just said the report said the findings were "normal". So I must have pulled a muscle.[/QUOTE]

    I am glad you are getting a copy of your MRI. Sounds like this is too much "something" to be nothing. Maybe they can do a CT scan as well. Hope your pain eases up. I have been in constant pain since Nov. 19, so I know about the issue of pain.

    Old 01-05-2010, 08:31 AM   #5
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    ditto on getting that actual radiology report from where you had this done. in all honesty it really depends upon quite a few differing factors as to what actually ends up in any actual rad report. just how clear were the films, did they use a contrasting agent? AND the rad who interprets your hard films just HAS to be really experienced and knowledgable on everything spinal, you could have had a read by someone NOT real knowledgeble or experienced as someone who has done this for like ten plus years? and what your actual doc or whoever is telling you what was even IN that report may NOT actually be telling you everything that is even IN the summary at the very end where all the hard findings are located in any report?but this crappy stuff usually tends to occur more with certain specialists. unfortunetly it does happen way too much to us patients who are not actually told about incidental findings that pop up that really ARE crucial in some cases.

    and the bigger thing here is that not every MRI will even actually SHOW everything that could be wrong in there either. some findings can be somewhat hidden from certain angles/views and other little oddities as well factor in there too. this is why using a contrasting agent really can help to bring out certain findings that would otherwise not be as noticed or noticed at all? what really does help is seeing any ortho or neruosurgeon for what really is kind of like their 'second' read of your hardfilms. these are specialists who look at your films for very specific findings based upon YOUR symptoms and their own eval of you when you see one for that consult and eval? they just know alot more than most radiologists ever could about what they actually cut into and just see with eyes right at spines vs only reading about it in textbooks like a radipologist would? VERY different type of second read on your hardfilms there, trust me.

    your symptoms are just VERY profound that i cannot imagine 'something' not having been found on that scan? but seeing that report for yourself is what you really need to do here. anything that is in that summary at the very end of the report IS where any finding just goes that any rad sees during their 'interpretation' of your films. just please let us know if there is ANYTHING actually in that summary that IS a hard finding? but DO keep in mind that not everything that can be wrong or a finding will just always naturally show up on ANY given scan. thats just the true limitations that scans have. so finding nothing does NOT mean nothing is wrong if you are feeling symptoms. its seeing a good ortho to get that eval of YOUR body and responses during the neuro exam and consult and reread of your films that would matter more once all those particular pieces are put all together. hang in there rhike, marcia
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    Old 01-05-2010, 07:48 PM   #6
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    Ditto, get a copy of your MRI report. There are many medical professionals who really do not have much training dealing with back problems and just read the report that may say you have "mild" problems and think there is nothing wrong. On top of that if they themselves have never experienced the pain associated with these problems then they just seem clueless.

    In fact there are many people based on their own anatomy that even mild problems can cause very bad pain . Post your report here and let's see what it says! I am also shocked that they would not want to try some non narcotic alternatives like Lyrica - that really makes me wonder about this office.

    It does sound like sciatic radiculopaty. It has a very specific path it takes along your back, butt and leg - it can even go al the way to the toes. A trained medical person should be able to recognize it as different from a "muscle" pull. There are at east two other things besides disc bluges/herniations that can cause sciatic pain - called the piriformis muscle syndrome where it can squeeze the same sciatic nerve. Also you can have a pinch or compression in your SI (sacroiliac joint).

    If you don't mind could you give me a better description of where you are feeling the pain. You do not need to have a perceived injury to have a problem - it can come from anything from sneezing to getting out of bed wrong, to twisting in getting in the car - to lifting something seemingly harmless.

    Have you tried heat and/or ice where you hurt and did it help?

    Last edited by PNo; 01-05-2010 at 07:50 PM. Reason: sp

    Old 01-06-2010, 12:09 PM   #7
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    Smile Re: Normal MRI, NEED HELP!! PLEASE!!

    I did not have the MRI's done with contrast.

    My new doctor said this is clearly NOT a pulled muscle, it is DEFINITELY nerve compression from somewhere, we just don't know from where yet and he is baffled by the MRI results. He is going to ask the Radiologist to go back and look for any blood clots in the spine as they may show up in the MRI without dye, but if he wasn’t looking for that, he may have missed it. That wasn’t the purpose of the MRI so it’s very possible it was an oversight.

    He had me stand up for a few minutes and could visibly see my legs shaking as a result. (I wasn’t sure if it was noticeable to the naked eye or not). It also caused tingling in my legs and feet when I stood that long. He had me standing up for about 6 minutes while he examined me and no matter where he pushed on my back or spine or buttocks, I didn't feel pain from him pressing. When he hit the part of my spine where the pressure pain starts, he said that is the thoracic, not lumbar, which usually doesn't get disc issues unless it's from trauma of some sort.

    He is starting me on Lyrica (which will only work if this truly is nerve pain and this is not a narcotic, so I won't feel all doped up, but a powerful drug for relieving nerve pain, it also is used for seizures and given to people with fibromyalgia). He feels the results from this drug will help him to answer some questions he has pending in his mind.

    He doesn’t want to send me to a specialist at this point because so many things are unclear right now and he doesn’t want to send me on a wild goose chase with numerous tests that would be frustrating, time consuming, physically straining to my body and possibly irrelevant right now. He changed around my meds to help me function better and said to give myself about 48-72 hours to start feeling more functional on this new pain management plan.

    He also apologized that the Nurse Practitioner handled things the way she did and said it is clear that although she didn’t know what was wrong with me and admittedly he doesn't know for sure either, she shouldn’t have tried to sweep me under the rug and hoped it got better on it’s own and that is what he felt she did to me.

    I am doing physical therapy now to help relieve my pain and cope with how to handle the pain while doing daily tasks and self care as well as learn how to protect my back. He suggested that 6 sessions may be enough for me. My first one was yesterday and it was pretty brutal and exhausting, but she assured me the next ones will not be as bad, she just needed to see exactly where I was at with what I could do. She said I was a perfect candidate for "traction" based on symptoms, but with the possibility of a blood clot in the spine, she didn't want to do that and take a chance of dislodging a clot.

    The doctor said he can’t say for sure, but he TRULY BELIEVES it’s a blood clot that is pressing on a nerve in my thoracic area. He believes I will start to recover and he wants to see me in 2 weeks so we can re-evaluate what the physical therapy and medication has done for me and hopefully have an answer from the Radiologist as well on the possible blood clot in the spine. (He will call me right away with anything like that or from my lab work he did)

    He ruled out Kidney stones entirely because my symptoms don’t point to that. He did take full lab work to see if anything shows up in my blood that might point to something he is missing.

    That's all for now. I have started the Lyrica and can already tell a difference in the level of pressure pain in just 4 doses so that has me feeling very hopeful and indicates that this is clearly nerve compression from somewhere!

    The doctor said my MRI results show that I have an amazingly healthy spine for a 40 year old woman who is overweight.

    Here are what the 2 MRI results say:

    MRI results #1.
    Dorsal Spine MR
    Sagittal T1 T2 imaging performed.
    Revealing dorsal vertebral body marrow signal to be uniform. No endplate degeneration or canal deformity. Dorsal Cord displays uniform intramedullary signal throughout, no extra dural deformities are apparent.

    Impression 1. Normal dorsal spine MR

    MR results #2.
    Lumbar Spine MRI
    There are five lumbar type segments anatomically aligned and displaying uniform marrow signal.

    The conus terminates at the L1 level and the spnial canal is average in caliber. The L2-3, 3-4, 4-5, and L5-S1 discs are all uniform in signal, there are no focal bulges or frank herniations demonstrated.

    There is no facet arthropathy, lateral recess or foraminal stenosis.
    Impresssion: 1. Normal study.

    None of that makes any sense to me at all, but maybe someone out there knows what that means. LOL

    I am in better spirits today as some of this pressure pain has been alleviated and is now at least tolerable. I have a very high pain tolerance according to my previous doctor of 12 years but this doctor doesn't know me at all, so I was concerned that he might think I was just a hypochondriac because my MRI results were normal. I am SO glad he took the time with me and treated me like a human being with compassion. I would appreciate anyone's feedback on if you think I am on the right track here or what your thoughts or feedback on my situation is.

    I like to be proactive in my own healthcare because my personal belief is that the term "practicing medicine" means exactly what it says. I research my medications and anything that might be going on with me or my children because I have been burned by doctors before and I think they are all human and therefore DO make mistakes. I don't say that to be judgemental, just realistic.

    My new doctor also changed my Hydrocodone because he said I was getting WAY too much acetaminaphine for 20 days and that was a large assault on my liver. I am now on Hydroc/Apap 10/325 every 6 hours, 4mg of valium every 6 hours and of course the Gabapentin (generic form of Lyrica because Lyrica is EXPENSIVE) 300mg twice a day (that is apparently a strong dose). I recheck with my doctor in 2 weeks. The goal is to wean off of these narcotics if the Gabapentin is going to work alone.

    In case I failed to mention it before, I do have a genetic blood clotting disorder, so his "gut instinct" makes sense to me.


    PS. I did do heat and ice for the first week, then went to just heat because that seemed to provide a little relief but the ice didn't seem to be helping me.

    In answer to your specific area of pain. It starts at about the bottom of my rib cage in the middle of my back and the pressure goes all the way down into my hips. My legs and feet don't hurt, but the first day I had the shooting burning electrical type pain down my left leg and partially on my right side but not as far down. When I started the medications, I didn't have that pain, just the pressure pain from the mid back to my hips and my legs and feet would get a tingling sensation periodically like they were going to "fall asleep". If I stood for more than 3 minutes, my legs would shake and I would begin to feel like I could lose my balance although I never fell, I just sat down as quickly as I could and the shaking would stop right away as soon as I got off my feet. Hope that explains it well enough for you.

    Last edited by rhike; 01-06-2010 at 12:16 PM. Reason: needed to add a PS. forgot to answer a previous question.

    Old 01-06-2010, 07:54 PM   #8
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    Re: Normal MRI, NEED HELP!! PLEASE!!

    Do you have any rash at all? If not you may want to watch for one. I had this same kind of crippling pain also with normal mri results and then got a small cluster of blisters - shingles! Also took longer than the usual amount of time from onset of pain to the outbreak of blisters. Not a fun thing to have but at least I got an answer. Just something to watch for. Hope you are feeling better soon.

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