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Neurology  (Expert Forum)
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MRI & EMG Results
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MedHelp Member's Question

MRI & EMG Results

by yorkieville, Mar 25, 2007 12:00AM
I have had burning/stinging in my legs for 3 years. Then, I had a car accident in 6/05, irritated a previously herniated disc at C7. By  11/05 I began experiencing back pain, rectal pressure, etc. By Spring of '06, back pain became unbearable. By 12/05, the nerves in my spine began to sting, and I have neuropathy related constipation.

My D.O. ordered an MRI in 1/07, and an EMG 2/07.

MRI:
1. Mild central bulging of the disc at L4-5 and L5-S1 with no evidence of compression.
2. No bony stenosis is noted.
3. Otherwise MRI of lumbar sine is unremarkable.

EMG:
1. Minimal sensory neuropathy.
2.Questionable mild S1 radiculopathy on the right side, given and absent H-reflex.

My D.O.'s nurse told me I have a compressed nerve and referred me to a Pain Management Doctor.

Can you tell by these results, which nerve is being compressed, and how can Pain Management help me?
Doctor's Answer

by Forum-M.D.-SH, Apr 13, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    From the symptoms and story that you present, it is not possible to narrow down your pain to one nerve compression.  The tests that you have had, would seem to indicate a S1 radiculopathy given your disc bulge at this level, changes on EMG that suggest right S1 radiculopathy (pinched nerve), and the loss of the H reflex.  However A S1 radiculopathy cannot explain all of the symptoms that you have described (especially the neuropathy related constipation).  I would suggest that you see an neurologist that specialized in EMG/neuromuscular to determine if you have a generalized sensory neuropathy (which can be caused by diabetes, collagen vascular disorders, monoclonal gammopathies, vitamin deficiencies, etc) and if there is any contribution of your neck (ie the C7 herniation, etc) in your symptoms.  That being said, pain management can be very useful and should be pursued at the same time as you pursue your diagnosis.  Pain management specialists have a variety of techniques to relive the symptoms of pain (but do not address the cause) these include drugs for neuropathic pain, epidural/facet steroid injections, intrathecal delivery medication pumps and spinal cord stimulators.  
I hope this has been helpful.
Member Comments (10)

by yorkieville, Mar 25, 2007 12:00AM
Correction: I meant to say that by 12/06, the nerves in my spine began to sting, not 12/05. Sorry.

by JCmcc, Mar 25, 2007 12:00AM
To: RE:
I am not a doctor.

You may want to consider Atlas Orthogonal Chiropractic as some people in your situation have found great reflief. Any neurologist worth his weight will tell you that operations are always a last resort. You may also want to look into the DRX9000 which is proctored by doctors of chiropractic, but, is also supported by many neurologists.

Hope this helps. Sorry for all of your pain.

Peace.

by yorkieville, Mar 25, 2007 12:00AM
To: JMcc
Thank you so much for your reply. The pain came on so suddenly, in the fall of '05, that I went from being a busy, active person, to near invalid status. I went to 6 weeks of PT last spring, learned stretching exercises, increased my range of motion, but did not stop the pain. My D.O. prescribed Celebrex, which only takes the edge off the pain.

I am wondering if the pain management doctor will know how to de-compress the nerve, or if is he just going to "manage" my pain, with medications.

by JCmcc, Mar 26, 2007 12:00AM
To: RE:
Hi,
   Absolutely. I think that DRX would work for you, but, a general doctor may not agree. You need to simply go and see them. Google it.

JCmcc.

by yorkieville, Mar 26, 2007 12:00AM
To: JCmcc
Hi, JC.

   Sorry for getting your name all mixed up, Lyrica has me in another zone. :(

   I agree, I think the disc compression would help me. I need to find out if my insurance covers it, because it can be very expensive.

   I am curious to find out, what treatments the PMD recommends. I am not committing myself to anything, unless I am convinced he can help me.

   I don't want my pain "managed", I want the reason for it, fixed.

by yorkieville, Mar 29, 2007 12:00AM
To: Update
For anyone this information might help,, I saw the Pain Management Doctor, on Monday, and he reviewed my Lumbar MRI, and EMG report, and said these tests are not diagnostic in, and of, themselves; they only point him in a possible direction. I am having a Lumbar Epidural Steroid Injection 4/12, as a diagnostic tool, to determine if the pain, is coming from my back.

by lizanh, Apr 20, 2007 12:00AM
To: neralogical
I have had pain in my head (left side) for almost two years now. I have been told it is occipital nerualiga. the pain I am having is getting more severe. It feels like someone is pouring boiling hot water on my head and sticking a thousand needles, when I bend down it feels like rushing water.  This is all on my left side of my body the past few months I have been to many doctors. I have a burning sensation in the back of my neck the pain and it is now working its way down my back to my shoulder. and when I sit I feel so much pressure, my left are feels so heavy and tingly, and lately my left leg gets numb, my finget tips also get tingly, my left side of my face hurts. my left eye waters and pulisates, I have had two MRI,  I do see a waht looks like to be a polyp in the back of my left nostril(DR said thats nothing) and there is some white parts on my brain where I think is should not be. Iwas told it was normal! back&neck X-ray. I have been to a chiropractor well over 10 times. I am in constant pain I have this pulling sensation when I turn my head to the right. I aslo went to a bone DR, He told me I have tendenitiuos in my left shoulder, but that is not the cause for all the head pain I am having  in my head. I went to a therapist and was told I need to calm down its all stress!! NOT I do not have a stressful life. I have stopped working after 20+ years because I can not focus and there are days I just lie in bed. the pain