MRI results for lumbar spine....thoughts?
 

At L5-S1, disc narrow and dehydrated.
Modic type 2 endplate spinal change (in the two vertebrae).
Left paracentral disc protrusion displacing the transversing left S1 nerve root posteriorly.
Swelling of left S1 nerve root ganglion.

Basically I have a slipped disc of some type (herniated? Protruding? Prolapsed?) and type 2 modic changes. Modic changes are a change in the bone structure of the two vertebrae, replacing healthy bone marrow with infected fluid. There are 3 types, 1 is worst. Treatment is tricky, experimental and confused.

I have to wait now (of course :rolleyes:) to see a spinal specialist, but will see the physio next week. Obviously with the CRPS everything is complicated, so I'd really like any advice or thoughts from those with experience of spine problems themselves, or knowledge of correct treatment protocol I should expect. I've had my share of treatment that turned out to be wrong in the end, and I don't want to risk making this worse now...

The pain is variable. Overall I think it's improved from the early days that got me on the morphine hell-ride in the first place. I'm just taking paracetemol now, because I want to know if I aggravate it, not do more damage by doing any old thing in a drugged out haze. Mornings are worst, mentally and physically, afternoons probably better. Evenings uncomfortable. I struggle to settle down in any position, so I alternate between standing and walking, sitting and lying down. By night I'm knackered and strangely I'm sleeping ok.

Any ideas on stretches, exercises, positions etc would be very welcome. I'm walking as much as I can, which isn't much at any one time lol.

Thanks guys. Hope you're doing ok today.

Bram :grouphug:

Hi Bram! Sorry, but I cannot help in this area. I have three buldging discs in my lower back, but they are not really problemsome for me. I just wanted to say that I am glad you found out what is going on, as much as it sucks it is good to know what you are dealing with. I also hope you can get in with the spine specialist very soon and that he can help you.

Take care,
Nanc
:hug:

Hi Bram, I am sorry you have all these problems and pain. I don't think what I with my back is similar, but I will put my two cents in hoping it may help you. I had an MRI a few weeks ago and they found bulging discs in my lower back. I already have had ddd in my neck and I can barely walk sometimes because of my hips. I was diagnosed with ostepenia about a year go in my right hip after a bone density test and osteoarthritis in my hips and lower back from my MRI. My dr said there was not much they could do except tell me to see a pm dr which if they read all the papers they had me fill out prior they would already know that I see one. My pm NP says to see my rhuematologist so I am at a loss for words with that right now. But I"m straying off topic. Sorry. They also recommended PT which if they read my papers they would see I already have a HEP becaue my insurance cut me off from PT. AGain I"m straying. Maybe try pt but if you have infection I wouldsee someone who can take care of that right away. especially with rsd in the mix. I am praying for you Bram to feel better. You always make me laugh and you are such a good person. I"m probably not helping much but do care and am here if you need a friend. I know it's hard , but try to get some rest. With love. Renee.

Thanks Nanc and Renee :)

Don't worry so much about what you're replying with....just the fact that you've read it and care enough to write something supportive always means so much. And any information and thoughts are useful ;)

Take care both of you, I know you're having a rough time too. No comparisons here...

Bram x

Hey Bram,

I'm so sorry you are suffering from horrible back pain in addition to what CRPS throws at you!

Obviously I am not a doctor but from my experience with my own issues this is what I get out of your MRI. I wanted to ask if this was the all that was written in the 'impression' section at the end of your report?

It looks like you have degenerative disc disease. The disc narrowing and dehydration is a common finding with that as is other findings on your report.

The modic type 2 changes are most likely a result of the acute inflammatory response to the DDD.

The protrusion on the left is most likely leaking the center disc material (nucleus pulposus) out onto your left S1 nerve root causing the swelling/inflammation around that nerve - that would cause pain down your leg in the form of 'radiculopathy'.

As far as what to do - Pool walking would be the best and least painful for you, I would think. I would caution PT until after you see the spine doctor, they would likely write the best PT order for you. Keeping really hydrated is really important for the spine when we are short on fluids our bodies pull it from the least important areas first.. one of those areas is our discs that hold an enormous amount of water and aren't needed to support life. I'm not saying that is the cause of your disc dehydration just mentioning it because it was shared with me along the journey with back pain.

I really hope things calm down without the need for surgical intervention!!

Take care,
Tessa

Oh Bram! I wish I had some helpful suggestions. I'm glad you have some answers and are on track to get the right treatment, even though it is always frustrating to have to wait to see a specialist.

You are doing really well toughing it out with just paracetamol. I think you are absolutely right that you need to feel what is going on so you don't accidentally do any damage. You've got quite enough damage already! Poor thing!

Hang in there!

Kim

Try using an inversion table. I find it to be very relaxing and tension easing...

Oh Bram, how complicated & frustrating for you!!
I know nothing about spine issues sorry! Right now you need a team of very knowledgeable specialists. The only thing I can think of is my P.M. Dr. has me
on Vit. D3 drops and magnesium citrate for bone support. Because I'm developing osteopenia (bone shrinking and contracting in my CRPS hand).
I know you need WAY bigger help than that &
I really want to see you get it! :hug:

Great advice Russell! I had forgot to mention the benefits of decompression therapy - might be something to ask your spine doctor about.

Thanks everyone...:)

I want to see the physios next week anyway and ask what they can do for me, I'll ask about decompression tables etc. I'm not doing any exercises or stretches unless I've double and triple checked that they can't do me more damage....I've been bitten before by well-intentioned physios...

I'm taking a multivitamin at the moment to up my levels of things like vitamin D, magnesium etc, and I'm drinking a lot of fluids - I'm well aware of the hydration issue with discs lol, all this time I'm waiting I've been reading up on discs and health! I'm keeping as healthy a diet as I can, and apart from the odd crappy day like today :rolleyes: I'm overall increasing my activity levels of walking. I'm doing a few careful core exercises like bridges and side leg lifts, clams, pelvic floor exercises, glute squeezes, etc. Looking to increase the amounts gradually...

The paracetemol thing is going ok so far, surprisingly enough. I prefer to know what's going on with my back, and it certainly let's me know if I get it wrong!

Tessa, I've had DDD for at least five years in both my lumbar and cervical spine.

The rest of the report says:

Lower spinal cord appears normal, conus at L1. Upper 4 lumbar motion segments normal. Facet joints look normal, central canal capacious, no sign of central stenosis. No vertebral collapse or marrow infiltrate. Normal retroperitoneal structures. Conclusion: single level degenerative spondylosis at L5-S1 with a left paracentral disc protrusion displacing the swollen left S1 nerve root.

Bram.