Help with lumbar MRI results-PLEASE HELP
 

Hi all,
I am a thirty-two year old female who recently was rear-ended in an auto accident and came out with a hurt back. Two weeks after the accident my lower back feels like its on fire and there is a stretching pulling feeling that goes down the back of my legs. There is sharp pain that extends down to my feet. And there are several areas on my back that feel like I am being pinched--one is in the middle of my back (like down my spine) and another is at the top of the back of my neck and the other feels like its right below my left shoulder blade. In the past few days I have started to feel sharp pains radiating throughout the left side of my body. My lower back and buttock feel like I'm being stuck with pins when its touched. I had Xray on the back twice and its normal, per dr.'s. Here are my MRI results, dr. basically dismissed the results and says they are normal too and that these results do not show that I should be experiencing pain. Can anyone help me read and interpret these results? I am in pain daily and I need to know if the dr. is missing something. Please help!

L3-4 No significant disk bulge. Mild facet hypertrophy
L4-5 Minimal disk bulge. Mild facet hypertrophy
L5-S1 Minimal disk bulge. Mild facet hypertrophy

Mild hypertrophic change and fluid seen in the visualized upper S1 joints. possible reactive marrow edema incompletely seen in the sacrum.

Mild lower lumbar degenerative changes. Mild S1 joint arthritis incompletely seen

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hi mommy
 

Hi mommy,
Sorry you are in pain.onmy nook so my typos will be around. I am not a doc, but I can help just a bit. You may be experiencingmore of muscle spasms from the injury. This and some trauma is enough to cause pain. Try conservative treatment, acue puncture,deep massage with a physical therapist. Any time your mri states, minimal or mild, count that as a gift. Surgery is a last resort when all else fails. Mri would have to say along the lines of, severe,chronic, nerve compression etc. For you to go the surgery route. Pt does work, not chiropractors, but physical therapy. This should help with the pain, and start you on the road to recovery. I wish you all the best. Ginnie

Dr didn't suggest any PT??:confused:
Seems like that would be a given or at least to try it..

Or,
If you can locate a highly skilled and expert chiropractor, they may be of help with your symptoms & pain levels...
especially if they also do soft tissue therapies..
Mine helped me so much for my muscle spasms and misalignments.

Re: PT
 

Mommyto6: Yes, I am doing PT 3x's a week with a chiropractor while I am having MRIs and Xrays done through an internal medicine dr. The PT is very painful. It consists of 15 minutes a day on a rolling massage table.

re:
 

Mommyto6: Thanks for the speedy reply. My MRI was w/o contrast, will a w/ contrast help see if there is any real damage or nerve damage? I am in pain and unable to work. Any idea why my Dr. would dismiss "marrow edema"? Doesn't that mean swelling. Any reading on the arthritis in the S1? Thanks so much for any help.

Is that rolling table the only thing ?
I was on a table like that a few times , supposedly it is to open up the spaces in the vertebra, so no real way to know if it really is doing that.. unless you do find you are having less pain after awhile..

I felt like it was a easy way for the place to make a buck..:rolleyes:
I really needed hands on therapy, not a machine that seemed to be waste of my time.. If that table is not helping you tell them.
Why pay for a treatment that is not doing you any good..?
If they won't listen to you. go somewhere else.
I've been to many PT places with repetitive injuries and some are much better than others. Same for chiropractors I'm sure.

Hi mommy
 

The swelling may be part of the injury. I believe this will go down. The one vertebra isn't bad enough to justify the pain you are in. I have a different opinion that Jo* Mar does for therapy. I am not a fan of chiropractic intervention. This is based on my own experience, and not from any one elses' opinions. I believe in PT, as my son happens to be one. He gets the patients that have had bad experiences with chiropractic. If you are slightly herniated, you don't want to make it worse, but have it calm down and go back into place. Massage, gentle excersises with PT do a great deal of good. I have had a lot of PT. I am fused C3-7. This got me into better shape so my mobility and pain is better after these sessions. Ask your doctor about PT. I sure hope you get some relief. ginnie

re:
 

Update: internal medicine dr says my MRI is "normal" and did not bother to elaborate each of the findings. He said 80% of us walk around with these findings on a daily basis and moved on to other things in my chart. He referred me to a Ortho Dr. who said MRI is "normal", gave me 2 more weeks of physical therapy and dismissed me. I was in so much pain that a few hours later I went to the ER (my neck hurts really bad in the back and on the side of my neck, shoulders hurt and pain is tingling and numbing down my arms). ER Dr. did a CT and said it was normal, but disagreed that my MRI from the other Drs was normal. ER said when other symptoms are present these type of findings are not normal and referred me to another Ortho for another MRI. ER diagnosis was cervical radiculopathy. I am in such pain and need to know what is causing it. My accident was low impact and there is barely any damage to my car. The pain, aches, and such did not start until after the accident. Any other ideas on what I can do to narrow down the pain, tests, other drs. By the way, I am seeing a network of drs my lawyer refers me to, these drs. are quick to dismiss me without asking about my pain, symptoms, etc. They just jot down notes and move on to the next client.

Hi Mommy
 

Hang in there, and do the PT. Your pain should be addressed however. You may need to seek a pain specialist until the findings are clear. Your PCP can give you a referral. Also a neurologist, as a second or third opinion. I sure hope you heal. ginnie

re:
 

Update: Thanks all for your responses. I seen a neuro dr today who looked at my MRI report, films, and chart and says he believes he sees the problem. He didn't say what that problem was only that he would send me for some more test that may confirm his opinion. He was in a hurry as there was a line of patients in the waiting room and his cell was buzzing. He jotted some notes in what seemed to be a book worth of papers, tapped my knees (no initial reaction and then left leg shot forward), did a quick exam over the areas that hurt. He is sending me for another MRI w/ contrast this time. He is also sending me for EMG. He did mention the sensory nerve may be a problem. He also tried to quickly explain something about a ball and an opening at the top of something while looking at my lumbar MRI films. He was comparing one of my MRI films with another and said that could be causing me some discomfort. Not sure what he was explaining as I was in pain and trying to follow through his hurried consult. Any ideas on what he may have been explaining? Thanks all.

re:
 

Mommyto6: Neuro wants me to stop all physical therapy until we get results from the MRI w/ contrast and the EMG.

Hi mommy
 

I hate it when doctors are busy and you don't get the benefit of a full explaination. Next time, bring a friend with you into the office. They can pick up anything you might miss. Also the doctor has a tendency to listen and do a better job of talking if you have back up. Do this for all appointments next month OK? This is really important, and it will help you in the long run. Without the exact words of your doc. I would only be guessing, which I shouldn't do. I sure hope the following appointments go well for you. Keep a pain journal and hand it to your doctors as you see them. ginnie:hug:

Oh, I thought the 1st post info was a current MRI.

But If you are having upper body pains now too, a new one for C spine is a good idea, and a newer low back MRI too?:confused:


You might have had a low impact but can still get some whiplash after the fact.

re:
 

Mommyto6: Don't want to confuse anyone. And I really appreciate all the help. The first MRI was current (within the past 2 weeks), but was only of my lower back. I had been complaining of pain in my upper back and neck as well, but those areas have not been getting any attention (except for the chiropractor rolling massage table, which hurts). Now, to recap, I am having unbearable pain in my back and neck that is starting to extend to my arms and legs/feet. Just want to make sure the Drs are not missing something as the first MRI was not indicative of this type of pain. Will keep you updated and if anyone can offer any more advice or suggestions I would appreciate it. I would like to keep tests at a minimal if possible.

Hi Mommy
 

My son is a physical therapist. Both of us, ask you gently, not to engage in any chiropractic adjustments. If you do have an issue in the upper neck, that isn't a good idea, without a neurologist saying it is OK to do. You don't want to make worse any trouble you may have. You will need another MRI, of the upper neck if that is where this latest trouble is. No one likes tests, or the expense of them.
Try to avoid any steroid injections if at all possible. Most of the time they hurt to get, and the relief isn't worth it. Just my own opinion as I have had a number of them. As a rule, if something hurts Don't do it OK? I am here, any time you need to talk. I hope you get in to see your doctor for re-evaluation of the upper neck. ginnie:hug:

re
 

Mommyto6 Update: Just got results from MRI w/ and w/o contrast of thoracic and cervical spine. For some reason, they did not repeat my lumbar MRI w/ contrast like I wanted them to. I have so much pain there. Please tell me what these results could mean as it will be a few days before I can see Dr. and I am worried.

I won't bother putting the stuff that seemed "normal"

FINDINGS FROM T SPINE REPORT: T4-5 level is a focal central disk protrusion indenting the ventral subarachnoid space and mildly flattening the ventral surface of the traversing thoracic spinal cord the depth of this disk herniation is apprx 2-3 mm

FINDINGS FROM C SPINE REPORT: C7-T1 Small bilateral foraminal perineural cysts measure 5 mm each.

Please help. I will also search online. Does any of this relate to my having leg and back pain and sciatic type nerve pain?

Hi Mommy
 

I just did a bit of research on what your MRI says. There is some good news even though it sounds kinda bad. when it says FOCAL central disk protrusion that means a SMALLER intrusion on the disk space. Any time something as a herniation goes into the disk space they kind of rate it with that hard language.
Google up what is focal central disk protrusion and you can get the % of the disks that are involved. Don't be afraid to look up these words. You want to be fully educated before you make any kind of decision on treatments. Different doctors sometimes offer different treatments. You can also look up words like the ventral subarachnoid space. that is the place where the nerves run through your spine.
If your MRI had said SEVERE which is a key word in these readings, I would be more worried. If you have other degenerative conditions, the neurologist will be able to tell you, how much risk there is to further injury to the spine if you do nothing, or if he decides that you need surgery. Always get more than one opinion no matter what you do. I am here to listen anytime. ginnie:hug::grouphug:

re
 

mommyto6: Thank you Ginnie for all your help. I will do some research as soon as the pain wears down.

Oh,ho,
Tarlov cysts, also known as perineurial cysts...

https://www.google.com/search?q=fora...-a&channel=rcs

re:
 

mommyto6: Jo*Mar could these Tarlov cysts be the result of a low impact car accident? I have been searching, but can hardly find anything about what causes these. Thanks.

Try a forum/site search using tarlov , it will bring up other post/threads here, there may be a cause mentioned in those..
a search link is in my siggy

re:
 

mommyto6: Just had a consult with an internal medicine Dr. who looked at my MRI's and said they are all "normal". When I asked was he sure, he said "nothing clinically significant or causing your pain". When I asked about the cysts, his response was the usual "all normal". I know my findings are not severe, but could they all really be normal and not related to a low impact car accident? I was really hoping to see the Neuro who ordered the second MRI's--this is the Dr. who said he thought he seen why I was having problems, but did not elaborate as he wanted to get the MRI results back first. I am concerned I am dealing with a network of incompetent Dr.'s that my lawyer is referring me to. I need to know what is causing my pain as I have a family who needs me and a job to get back to. I will seek a second opinion from a Dr. who is not in this small circle of Dr.s I keep getting referred to. Thanks for all your help.

Seems like the lawyer would try to send you to good drs.:confused: as it would help the case??
Internal medicine dr?? I don't understand that choice..:confused:

Prob need a spine related or musculoskeletal expert -like a physiatrist, DO, neuro to best read the films and assess your sx(symptoms).

Did your Tarlov search come up with any type of drs mentioned, or what may cause it?

It is easy to forget all our sx so make a list- brief & to the point, drs won't take time to read a long wordy page..:rolleyes:
Maybe the worst to least ..or some sort of order

Especially if going to more than a few docs it gets tiring to repeat all the same things and easy to forget something that might be important..

Hi Mommy
 

An internal med. doctor isn't the kind of doctor that should be reading or doing your MRI. Jo*mar is very correct on that. You need to seek a physician outside that doctor group. A neurologist would be the one I would pick. You are having pain for a reason. It isn't in your head, and your doctor basically dismissed you saying everything looked fine. Well that isn't the case is it? You might just have to look into a different physician, one who is highly qualified with these issues. If you post and ask for people to try to give you names of a doc. in your area they will. Someone on NT, would know of a good neurologist. The thing is most of the time you do go to your primary for the referral. Since he doesn't see an issue, he would not be inclined to give the name of a neurologist. Ask on line for someone good where you live, pay out of pocket, whatever it takes, to get you back on track. Don't do any chiropractic things unless you get clearance from a neurologist OK? I do care, ginnie:grouphug:

re:
 

mommyto6: Thank you so much. I really appreciate the support. It makes the pain bearable! I have reached out to a neurologist I have seen in the past for migraines and I have an apt for next week. I'll bring along my medical file and my hubby (to listen, take notes, and ask questions). In the meantime, I am doing my homework on all my symptoms and medical tests. I want to be as informed as possible.

Disclaimer: I am not a medical Dr., but from my own research and experience I have found that Tarlov cysts a.k.a. perineural cysts are abnormal sacs filled with cerebrospinal fluid. They may be found near the tailbone along the spine using a MRI scan. There is limited research on the cause of these cysts as well as the treatment. There is literature that suggests some people have them and have no symptoms, while others have them and have symptoms such as radiculopathy and pain the S1. If no symptoms, it seems treatment is not necessary. If there are symptoms, treatment may range from injections to surgery to remove. There are reports that injuries, such as a fall or accident may cause them, and there are reports where individuals have reported no injuries and accidents and still have them. It is when these cysts affect a nerve root that a individual may experience pain that ranges from dull aches in the lower back to sharp pains down the legs.