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  • Making sense of my MRI

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    Old 01-12-2012, 06:43 PM   #1
    wishingwell1
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    Making sense of my MRI

    Hey guys,

    A bit of background. I was diagnosed with an overactive thyroid about 6 months ago, and since then I have had a few health issues, some of which have been associated with my back. I have had a very tight neck and upper back, which has probably been exacerbated by my full-time job (desk job at a computer all day), and I have also had sporadic lower back pain, although this has not been particularly severe. The upper back/neck pain has subsided to a degree because I've just had two weeks off, although now I'm back and I can feel it coming back on. Also, more recently I have also had pain through my left leg and occasionally in my buttocks. Specifically, I have had an outer calf cramp on and off (more on) for the last three weeks, as well as general weakness/heaviness.

    So, after that long preamble, last week my GP ordered an MRI, and I have the results with me, but I can't make sense of them! I had a cervical and lumbar MRI, and these were the results:

    Cervical - "There is very minor desiccation of the C2-3 and C3-4 discs but no significant disc bulge or protrusion. The remaining cervical and upper three thoracic intervertebral discs also demonstrate no disc bulge or protrusion.

    Lumbar - "L4-5 - Disc desiccation with mild reduction in disc space height. There is a mild to moderate central disc protrusion which indents the thecal sac with mild narrowing of central canal. Neural exit foramina are capacious. Subtle associated annular tear.

    L5-S1 - Disc dessication with minimal reduction in height. There is a mild to moderate left posterolateral disc protrusion. This indents the thecal sac with mild narrowing of the central canal and contacts the left S1 nerve root as it buds off the thecal sac without direction compression.

    Conclusion: "Degenerate L4-5 and L5-S1 discs. Mild to moderate central disc protrusion at L4/5 and on the left posterolaterally at L5-S1. There is an associated annular tear at L4/5 and there is mild narrowing of the central canal at both levels. At L5-S1, disc contacts but does not displace or compress the traversing left S1 nerve root.

    So, basically, my questions are: Can someone please explain this to me in plainer English, and is it possible that these degenerate discs are causing my upper back and/or lower back and leg pain? If so, how would I go about rectifying these problems?

     
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    Old 01-12-2012, 07:47 PM   #2
    WebDozer
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    Re: Making sense of my MRI

    Your cervical looks great. Any number of people here would love to have that MRI.
    So your neck and upper back problems do not seem to be rooted in the cervical spine, at least not the way the radiologist has described it.

    Your lumbar does seem to correspond better with your symptoms.

    Some explanations:

    - Radiologists use a standard set of adjectives to indicate severity, to wit, minimal/mild/moderate/severe. While "moderate" does not demand action, it should receive attention. After all, one radiologist's "moderate" might be another's "borderline severe".

    - Disk dessication, while not good, is a normal part of the aging process. It does not directly cause problems, usually, but it may contribute. Dessicated disks lose height, and are prone to bulging and tearing (your "annular tear" is a tear in the tough outer layer of the disk, which may turn into a herniation, where the softer inner material escapes, and in turn impacts your spinal cord or peripheral nerves.

    - The thecal sac is a membrane which vertically fills your spinal canal. Inside it is spinal fluid, and inside that is the cord. The sac can be indented w/o affecting the cord, because of the protective layer of spinal fluid.

    - Neural exit foramina (or just foramina) are openings through the bone of the spine through which peripheral nerves pass after leaving the cord.

    If I had just read your radiologist's report, I would say there's a very good chance that you're asymptomatic. Your canal is indented, but only mildly/moderately. There's no mention of the cord itself being impacted. The S1 nerve is touched, but not compressed.

    But, of course, you a NOT asymptomatic, and your lumbar irregularities match up very well with your symptoms, What does not match is the severity of the irregularities and the severity of the symptoms. We see this a lot. Does it mean that the radiologist is understating things, or maybe missing something? Does it mean that, for some reason, you are just more sensitive than average? Or maybe something else?

    I really doubt that a surgeon will want to operate, at least not until you've tried some PT. Sitting all day at a computer is death for your lower back, and there are stretching exercises that you should be doing that may help a lot. Maybe also stretching/strengthening/posture exercises for the upper back, as well?

     
    Old 01-12-2012, 08:00 PM   #3
    wishingwell1
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    Re: Making sense of my MRI

    Thanks for the prompt response, WebDozer, it is most appreciated

    I should also add that I am a 25-year-old male, and I'm 6'1" and about 80kg, so I'm not overweight or anything.

    I have had mild lower back issues in the past, but I've never had any problems in my legs. I'm still not convinced that it is my back pain causing my leg symptoms, in fact, I'm more inclined to believing they aren't. But I have also been having numbness and tingling through my arms (especially when waking up in the morning), and that was the main reason my GP ordered an MRI.

    I don't think my pain warrants any kind of operation or invasive treatment, and I'm sure that with better posture/stretching, my back trouble will probably clear up fairly quickly. Are there any particularly good stretching techniques that I should adopt? Or any other treatments that I should seek out?

    Thanks again in advance for any responses

     
    Old 01-13-2012, 12:24 PM   #4
    WebDozer
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    Re: Making sense of my MRI

    You need to stretch your legs from top to bottom, plus your hips. Also, strengthen your lower back and abdominal muscles and upper-back "posture" muscles. Probably lots of stuff online or in the library about it. A course of PT would probably teach you enough, too...

     
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