MRI Normal for back pain

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rogerfreak

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I have been experiencing back pain for around 10months. The pain often occurs around the lower back and when it gets very bad I may feel pain at the middle part of my back too. It will always happen when I stand, stood, bend slightly forward for too long, running, jumping and carrying heavy loaRAB or exerting strength. I will feel the pain when I do any of these and the pain will cause my back to feel VERY VERY weak that I will want to immediately sit down to rest my back. Sitting down only help a bit. I need to totally lean my back against a wall or something to allow it totally rested. And the pain often continues and causes me to not able to sleep well during night.

I also feel nurabness on the outer left side of my left thigh all the time.

I have seen a specialist regarding this issue and did a MRI scan on my lurabar spine. The MRI report was:
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Conus medullaris terminates at the lower border of L1. No focal abnormalities are seen in cauda equina. There is preservation of lurabar lordosis, intervertebal disc height and morphology of the vertebral body.

There is mild loss of posterior concavity of the disc at L4/5 and L5/S1 though there is no disc protrusion demonstrated. The lateral recess and exit foramina are not compromised.

MRI shows no evidence of degenerative disc disease in the lurabosacral spine.
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Apparently, the doctor told me that the MRI shows no problem and has no idea about the pain that I am having. I have been going through physiotherapy for the past few months but the improvements are mediocre. As I am a sailor, my job requires me to use a lot of strength which often hurt my back very much.

Now that I go back to the specialist doctor, he would often just tell me the MRI scan on my lurabar spine is fine and there is nothing to worry. But I am still feeling the terrible ache.

What other possibilities could my symptoms tell? And what could be the next thing I could request the doctor to do for me apart from telling me everything is fine and taking pain killer all the time.
 
rogerfreak,

It can be very frustrating to know you are in pain but be told they can find no reason for it. Been there, done that myself.

The symptoms you describe, expecially the pain along your thigh, are consistent with nerve root compression causing back pain and sciatica. The most likely reason for this is a bulging or herniated disc, most likely the L4/L5 disc in your case based on where the pain goes down your thigh. Not all bulges and herniations show up on standard MRI's, but many doctors are very reluctant to do additional testing if the MRI is normal. In fact, they then will tell you they have no idea what is causing your problem in hopes that you go away and the problem gets better on its own - it's a way of screening out the people who cry when they get a hangnail.

The middle back pain you describe is likely muscle related as you are probably tensing your muscles when you are in pain.

If your symptoms continue, you might want to ask this doctor for an upright MRI which takes pictures while you are standing and sitting. Sometimes that will show additional information. However, be warned that not all doctors believe in upright MRI's and you may have difficulty getting this doctor or another one to order it. I begged multiple doctors to order an upright MRI for me since my symptoms were at their worst when I was sitting, but most refused and it took a really long time before I found one to order it, and it did show what my problem was.

Some others here may have suggestions of other tests to request or actions to take, but the upright MRI would be the one I would go after if I were in your shoes.

If you do have a problem disc, be aware that your heavy manual labor days will likely be over. However, there is no way you will be able to get worker's comp or other types of disability payments unless there is medical evidence (i.e., MRI showing the problem) that supports your condition.

Keep us up to date with your progress, and good luck getting to the bottom of this!
 
Apparently, the MRI has shown no bulges nor herniations. So the doctor seems to have totally eliminated the possibilities of having any of those. And is it true that it is not possible to have sciatica since there is no bulges and herniations?

I am considering of having MRI scans on other areas of my back but is not very sure which area to try either.
 
Dear rogerfreak,

who has seen your MRI?

Radiologist or EXPERIENCED neurosurgeon?

RegarRAB.
 
Oh, and I am also thinking of having MRI scan at my thigh since I am experiencing nurabness at the area. Is this advisable? Or the lurabar spine MRI scan is sufficient to tell about the nurabness at my thigh?
 
For best experience, your MRI should be reviewed by an experienced neurosurgeon.

Radiologist sees many things, orthopaedics sees some things, but neurosurgeons are most educated doctors for seeing certain states of human spine.

I am telling you from my personal experience.
 
rogerfreak,

The thoracic area of the back (middle back) rarely gets herniations or bulges from lifting or repetitive stress. It can be broken in accidents, but not very subject to disc problems from heavy manual labor. However, the lurabar (low back) and cervical (neck) areas do get herniations from heavy manual labor or lifting injuries. If you are not having neck pain, you shouldn't need a cervical MRI. I really don't think you need a thoracic MRI. I would try to figure out how to get an upright lurabar MRI if I were you.

If you have any disc bulges or herniations, per your symptoms they would be in the lurabar area, most likely L4/L5.

There's a website created by a geek chiro (chiropractor) that is wonderful for explaining back problems in layman's terms - we are not allowed to list websites here, but hopefully that will give you enough information to do a search on.
 
Hi Rogerfreak.
As Keano16 says, you should show your MRI to an experienced neurosurgeon... I`m sorry to say, but your simptoms show a disc herniation in the luraber region, with nerve compression.
 
If ultimately the doctor insisted that there is no disc bulges or herniations, then what other possibilities could it be from these symptoms that I am having?
 
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