I had a MRI done a few days ago, and for starters the doctor really scared me because he called me in to review my results. Some of you might not think that is a bad thing but this is my third one in 8 years and I have never been called back in. I am only 26 and have had back problems sine i was 15 it seems that it doesn't get any better. So now I have these new results and they weren't explained very well and it has went from the doc never reviewing them with me to calling me in and wanting to send me to a specialist.

So here are the findings:
Narrowing of the left lateral recess and forminal narrowing due to unconverterbral prominence. Narrowing of the left lateral and to a lesser degree the left exit foramen at C3-4. This appears to more likely be related to the left uncoverterbral joint than protruding disc.

T11-12 Shallow posteriot protrusion contacting anterior surface of the distal cord. T11-12 small posterior protrusion resulting in effacement of the CSF space anterior to the distal cord.

L1-2 Minimal central disc protrusion posteriorly.

If you walked out of that office not understanding those results then your doctor isn't doing his job. Either he's not spending enough time or you need to be more proactive asking what does this mean? Doctors sometimes get caught up in clinical detachment or scheduling and some just don't speak to patients in a way that we understand. Some have rotten bedside manners and some excellent. This might just not be the doctor for you.

You can request a copy of your scan and results and go to another doctor. More than likely the MRI came with a copy of a MRI specialist's report that works for the scanning facility (an expert that works with MRI's and gives an initial interpretation of the scans and points out any abnormalities or items of note). This is done for doctors that are not specialists in orthopedics or MRI interpretation for example. If your doctor doesn't understand the results ask him where you should follow-up.

Your results could mean almost anything. People with horrible looking spinal MRI's may not have any pain and some people with very normal looking MRI's may be in excruciating pain. You can either make another appointment with your doc to talk more about the results or call and ask for a return phone call to answer some questions. Ask what he suggests you do and why. Tell him how you feel (like I don't understand what to do and what this means about my source of pain and who I should see or what I should try for treatment). Know what you want to see happen-i.e. reduction in pain, reduce medicine, try a new form of treatment.

At some point you need to have in mind a result, the doctor needs to give an opinion of suggested treatment and risk vs. reward. He needs to tell you your options given your desired result, his opinion of the options, and what he thinks they will do for you. If he's not having these conversations with you then ask him to or go to another doctor.

I have a lot of freaky sounding things going on in my spine if you look at the writing on the reports. However, everything is pretty well under control now. I had two very successful surgeries and a lot of other treatments, physical therapy, massage, acupuncture, trigger point and steroid injections, etc. I know it's kind of scary to go in and ask for the bottom line but you need to do that or you've wasted a lot of time and money of several professionals and a lot of expensive machinery without any solutions.

I don't really know what your problem is-pain? numbness? or what. Your doctor needs to know in order to make some recommendations. If you don't like his options you are free to seek 2nd and 3rd and 4th opinions. I went to 10+ neurologists before I found one that finally figured out what was wrong with me. I also went to a dozen or so orthopedic docs for my back and neck.

Be prepared to ask what does it mean that I have posterior protrusion and is it something I should treat or monitor and is there a risk of treating or waiting. Where is my pain coming from and what should I do? Doctors should give you the time and respect to answer your questions in a way that you can understand them. If this doc isn't cutting the mustard then take your records and go to another. Be sure the new doc is board certified in orthopedic surgery or whatever specialty you need, check his background to be sure there are no complaints, and read the good and bad reviews. Yahoo has reviews entered from yahoo's search window.

There are free ratings/reporting systems like healthgrades and some you pay $10-20 for. Nothing beats a good recommendation from a friend or another trusted doctor and they are free. I usually Google the doc and read his schooling history, complaints, discipline, board certifications, etc. If he has any complaints or discipline history I keep looking. The more you know the better you will feel.

Call the office and ask-does this doctor spend a good amount of time explaining and answering questions? I really need help understanding. If the staff is nice and patient then most of the time the doctor is similar. Staff that can't be bothered with simple things usually work for a doctor that can't be bothered with questions etc. That's a bit of a generalization but they always seem to go hand and hand in my experience.

How you feel is the most important part of treatment. Some horrible sounding thing like my spinal stenosis sounds creepy (and can be BAD) but at the moment is not bothering me much because I'm doing what the doctor suggested and they cleaned it out in my 2nd surgery. Ask about alternatives, risk, etc. I finally elected to have spinal surgery because I was in so much pain. I tried a lot of other things first but finally I realized the surgery was my best chance at not feeling horrible all the time. When I woke up the doc said wiggle your toes...ah good you're not paralyzed. I know I signed all the papers that said death and paralysis were a risk but hearing it that way kind of gave me a creepy feeling. It all worked out very well as most surgeries do but there is a small risk often that it won't work. My brother decided not to have surgery and is doing very well with PT and exercise.

Unless you feel you understand all the risks, problems, suggestions, etc keep asking or take someone with you that will ask and can explain if you are uncomfortable doing so. Many doctors draw pictures of problems and surgical fixes. Even my dog's surgeon drew pictures of my dog’s orthopedic surgery called a tibial plateau leveling osteotomy. He actually operated on George Bush's dog and was on Animal Planet. Pretty cool.

These small protrusions you mention could cause excruciating pain or nothing at all. That you were called back in may or may not be significant. Ask why you were called back. Maybe they didn't get a good image. I've been called back in for mammograms 3 times and it freaked me out the first time but all were nothing. Better safe than sorry.

If you've had these problems since a young age then maybe a different kind of doctor is what you need. I don't know what kind you see now but maybe go back to your GP and ask should I see a rheumatologist or a surgeon or a doctor with training in immune disorders or bone growth abnormalities. Getting to the right kind of doctor will help. And it may take a few doctors to find the right one.

We have to be our own advocates . If we are not empowered to demand the respect from the doctors that we pay so much money to help us then we might as well not go see them. I spent many frustrating years finding a GREAT pain management doctor and I love him to death. I had to find out what the options were and get a referral to the right guy who meshed with my personality (I ask a LOT of questions). If the doc isn't willing to answer I go to the next and next and next. Sometimes that's what it takes--as frustrating as that may be. In the end you're paying for this-or your insurance is and if you still have problems then you need to be more proactive in seeking explanations, asking questions, researching answers, calling back to clarify (respectfully realizing that calls back may take a few days if not emergency).

I don't think that 3 MRI's in 8 years is bad for any reason-I've had 20-30 in the last 15 years for various reasons. Head, neck, back, hip, knee, foot, hand, shoulder....what does matter is if you are in pain and desire a solution or the doctor feels you are at some kind of risk if not treated. The MRI of my knee was a bad one because there are old steel screws in it (which they don't use any more) and they caused a bad image. It looked like I might have bone on bone hence my knee pain. The X-rays were crystal clear though showing my meniscus was intact and all was fine on that front. Most likely my knee pain was due to a slight injury from walking wrong due to a hip injury. So I walked with a cane for a bit and did some physical therapy to strengthen things up. Made a huge difference. The hip still really hurts so I'm going back for more PT.

Don't try to interpret your results as they are written or expect someone to do so on the Internet. That's going to be impossible unless an MD gets to see you and do a hands on exam. Don't get scared and freaked out - just don't go there until you have to. I've done a lot of worrying over nothing like being called back in for a mammogram which turned out to be nothing three times. There are many many treatments available to someone especially as young as you are. Start with the least invasive (if deemed safe) and work up. Remember surgery is risky and the risk of death and paralysis is small but there. If you can do something less like steroid shots (which I did for years) or exercise to strengthen your muscles, walk correctly, keep strong and use proper form to lift, sit, work, drive then the whole world might change.

If you have nerve pain maybe some medication for that type of pain would be more appropriate--if it's inflammation then anti-inflammitories, nerve impingement might be helped with steroids and very careful correct exercise. It all depends on what is causing your pain. With backs it can be one thing or a combination. My brother has rheumatoid arthritis so he has to use steroids -- he's in remission now so things are good. I am very careful to get up out of bed the RIGHT way and pick up things correctly. I DON'T do things I'm told not to do.

So find a doc you are comfortable with, take someone with you if you feel that would help, ask them to draw pictures or show you models...most have bones and nerve models in their offices to show people where things have gone wrong or are injured. I've often asked if I were your sister, daughter, etc what would you do?

If you have to call the place where you got the MRI and ask for the best orthopedic back doc in town do it. Sometimes you get information from the unlikeliest or sources. I told a great many people in Texas about my story and recommended doctors I thought were awesome. If you know someone with a back issue ask them, ask any of your other doctors. I goggled top docs central coast California board certified neurologists recently and found some with very good rankings from their patients and made three appointments. I'll find out what I find out when I go. I've been to a couple of rude condescending twits and one superb doc and I'll see what I find with some more.

The point is I'm looking because I'm new to the area. I call my old docs in TX and ask if they know anyone in Calif-call them-if they are too far I ask if THEY know someone closer or I take a drive to go see them. One of my docs is in LA and another in Santa Barbara. It's your body--they work FOR YOU.

I tend to not complain or trash previous doctors because a bunch of negative talk makes a new doc think "oh boy" I don't even want to listen to this person who just can't be pleased. I have said I prefer a less invasive approach or to try non-surgical methods first, or if you've had it and are in such pain that surgery is worth the risk (as it eventually was for me) then say so.

If you want to try different medications or testing or approaches like acupuncture then say so. Ask if the doctor thinks a, b, or c will work. Ask why not if he says no and ask why he thinks option d is right for you. Google medicines and side effects --- to check on side effects and express concerns. Not to the point of being paranoid but you need to educate yourself to a certain level to make informed decisions. The doctor can be the best but you are the one that knows how you feel and must make all of the final decisions about your body. You do have some responsibility as a patient to ask questions. The doc won't think you're dumb...you're not a doctor. 99% of the doctors I go to respect me for asking questions and answer them to the best of their ability. They may dismiss some of my concerns and investigate others. I asked for certain blood tests on my last doctor's visit and he agreed to do them. So it's a bit of give and take in an ideal situation.

To be fair the doctor needs to know if you just don't understand so he can explain. Write the questions down if it helps. Good luck. I know how awful back issues are. Taking the right care of your back now will make a huge difference when you get to 50 as I now am. The solutions may be very simple...if not get more than one opinion.

Thanks so much you have provided alot of in-sight on some things. I went tmo my FP and he doesn't really explain himself well. I live in a small town in Alabama and it is hard to find doctors that are actually intrested in treating you, most of them want to see how many they can treat a day. So thanks!!

alishanix,

Happy having you come to be with the whole family. Just let us know if we can be of any help. There are great and caring friends here to assist you. Our shoulders are here for support in many ways. Seems you have been through some ruff times.

Again welcome, looking forward to seeing you around. My thoughts and prayers are with you.

Darlene