MM, got the MRI report questions?

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donna70

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Hi,
I posted the thread about my MRI showing nothing but disk degeneration, now I got the actual report and the impression basically states Disk degeneration at all levels but no herniation or central canal stenosis. The actual report body states that I have mild bulging at L-5, S1 where I think the pain is actually coming from and also at L4-5 bulging disk endplate spurring, facet arthritis and ligament hypertrophy. I know it isn't that bad but the pain did come back yesterday and just wondering how could something that sounRAB this minor cause so much pain? should I just keep plugging along as my dr said and tough it out? I did have 4 days relatively pain free but it is back not as extreme as I originally had it but I am wondering besides taking prednisone and Ultram and my RA meRAB, what other people have done and how long you wait before you go to a pain dr or someone who might give you exercises or some other form of therapy. Glad it is nothing crucial but funny when you can't get stuff done it cramps your life. My leg is still nurab so I feel that even though the MRI didn't show it a nerve got pinched. Someone suggested to me in the other thread about getting a CT scan but my dr will not go for that, she didn't want the MRI done. thanks in advance for any input.
Donna70
 
Hi Donna ~

i'm sorry, I just noticed your email. I guess I would get your MRi and make an appointment with another doctor. I went to 8 different ones before finally settling on one for my surgery. They really don't seem to mind, and, indeed, seem to expect that you'll want other opinions.

Your MRI doesn't send up any red flags to speak of, but the fact that your leg is nurab warrants getting another opinion, IMHO!!

I just bought a good book today at a half-priced book store. It is The Good Back Book by Renita Fehrsen-du Toit. It is an older book, but I liked it because it does a good job of explaining the anatomy of the spine, with very good photos and diagrams. It explains the problems caused by faulty posture, exercises to strengthen the back and to prevent back pain, and a section on the most common back ailments--nothing too complicated. I believe the author is a physiotherapist in the UK...it also shows good stretches. I don't know that I would have paid full-price, but if you can located it used, I think you'd find it useful to educate yourself more about your condition.

The thing that is important to remeraber is that back injuries take forever to heal. It sounRAB like your situation will probably clear up with the use of an anti-inflammatory, ice and rest...but it could take 6 weeks to start to feel better, and that's assuming you aren't doing anything in the meantime that will aggravate it further!!

Look for a fellowship-trained orthopedic or neurosurgeon spinal specialist for another opinion. They will refer you to PT or a PM doc. if they think that is appropriate for your condition. You could have a spondylolisthesis that is causing the nurab leg, and that wouldn't show up on a MRI. That usually shows up easily on x-ray.
 
Hi,
Thanks again, MM. I am trying to see if it will go away but the pain came back after I got out of a chair wrong and twisted so I know what you mean about not doing anything while you are waiting for it to heal. I appreciate your input and all the other responses I have had on my threaRAB. That book sounRAB good, I might see if I can get a used version. They did mention spondylolisthesis but it was minimal at L3 and L4. When my dr said my results on the phone she just said I had normal degeneration of disks for my age, nothing about the bulging etc. If this doesn't clear up I am going to a pain specialist who might refer me for some PT or other forms of pain management but for now I am trying to see if it will clear up with the meRAB and ice. It is much better than when it started. Thanks again for the input!!!
Donna70
 
Hi Donna. I'm the one who mentioned a CT scan because my MRI didn't show anything serious whereas my CT scan showed very serious problems. Not all pain is caused by direct nerve impingement. In my case the CT scan showed L5/S1 completely collapsed on one side, resulting in bone on bone contact. That can set up constant inflammation because your spine is unstable. In fact, that instability is one reason why taking an MRI one day showed minimal problems and a CT scan taken a different day showed completely different vertebrae alignment.

Case in point, as I was waiting for surgery I started getting more and more severe sciatica pain. I was convinced L4/L5 had herniated, as I was familiar with the feeling since I had suffered a herniation there 25 years ago. We didn't take new films but my doctor said he'd check it out while he was doing the fusion. Sure enough, it had NOT herniated, but the severe inflammation from the collapsed disc mimicked the pain of direct nerve impingement.

The first neurosurgeon I saw was only interested in the MRI, whereas my second doctor, an orthopedic surgeon (with far better credentials) said it was important to evaluate both because the two different images highlight different types of problems.

I agree with the others, I truly think a second opinion is worthwhile.
 
Hi Paula,
Thanks for your input!! I love your location just makes a beautiful picture for the mind!! I am going to get a second opinion if the pain gets worse, right now just hoping it will clear in time. My dr is my rheumy and she is great, she is better than my primary who I am in the process of changing at this time. The rheumy helps me with problems my primary should be helping with. So, I will definitely get a second opinion but hoping that this will just go away, don't want surgery, when my pain was acute for 2 wks I just wanted an injection somewhere!!!LOL! Reading this board, my troubles are nothing compared to many of the people here. Thanks for all the input, sometimes persons who have had similar problems come up with better solutions than the drs treating others!! thanks!
Donna70
 
Hmm, Donna I see you're in Baltimore. My Orthopedic Surgeon did his fellowship at the University of Maryland, with Dr. Charles EdwarRAB. It seems he and the University have spun off the Maryland Spine Center, and they're right there in Baltimore!

As for my location, it really is beautiful here. A trial in the winters but the summers are outstanding. Course, living in the mountains (I'm actually at the top of one of the tallest peaks in PA) makes it difficult for me to do outside walking as therapy. Good thing I have a treadmill.
 
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