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Can an MRI miss nerve compression?
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Can an MRI miss nerve compression?

I have back pain and nerve pain, consistent with L4 nerve compression, in both legs but worse in the left leg and left side of back.  My left knee reflexes are significantly weaker than the right.  My strength in the left toe is also weaker than the right.  My MRI shows torn bulging discs at L4/L5/S1 but does not show nerve compression or stenosis.  I've also had a nerve conduction test and Myelogram which came back normal.  Back in 2000, I began having nerve pain in my right leg along the L5 nerve path.  The early mri did not show stenosis or nerve compression, the myelogram and nerve conduction tests were also normal.  However, by 2003, another mri showed stenosis.  I had a laminectomy done and got significant pain relief until late 2005 when the problems with the L4 nerve began.  The pain I'm feeling in my legs is very similar to the pain I felt prior to the back surgery I had in 2003.  I've recently become unable to work and my insurance company approved disability for the first 12 wks but has now denied my claim on the basis that the mri does not show nerve compression or stenosis.  Is it possible to have nerve compression which is not evident on an mri?  The mri was lying down without contrast.  I'm trying to find supporting documentation to include in my appeal but having problems finding websites which talk about the limitations of mri's, nerve conduction tests, and myelograms in detecting nerve compression or nerve damage.  Any advice?
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176803_tn?1198543198
This is just my own experience as well as what I have seen and read.

YES!  Most doctors dismiss compression despite symtoms (symptoms) if it is not clearly seen on the MRI.  
    There are a few other things that get dismissed by US as well as the docs, but I also see alot of mis-diagnosis because of them.
    One is the possibily of the nerve allready being damaged.  I have suffered this, where after surgery still had all the symtoms (symptoms) of compression for along time even though the "disableing" pain was gone or less.
    There is also the possibility  of swelling still enough to press a little on the nerves at times. I have had that also.  This also ties into the scar tissue sometimes sweeling as well when I "over do it", and it might not take much. It still feels just like a hernited disc compressing, but goes away after plenty of rest, sometimes need anti-inflamatories and pain meds.
    There are new MRI's now that can take the images while on your side, or sitting down, etc...that where the laying down MRI don't show the nerves pinched, the other MRI's do or can.
    As for your workers insurance to refuse continued help, despite WHAT their docs. say, all you need is your surgeon or even family doc. to keep you under their care and take you off work or put limits on. SO don't worry about it too much. The insurance co. will try most anything to not pay..I been through that also.
    I have battled back injurys since 93, workers comp. issues, ect...even with the docs that treat me saying I am ok....they like to go by their textbook sometimes. I have been treated like I was lieing or exagerating 4 other times and have later proved myself right. On my 5th now.  Kinda sucks though. After they eventually say "oh yeah, no wonder your in so much pain", they don't write letters to the other docs or ER's you've been treated badly at to tell them.
      Good luck. Again, this is all from only my experience.  I have seen worse outcomes for those that give up fighting...what the insurance co's want...Don't give up.
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Avatar_n_tn
Hope theres someone like me Iam not crazy!!!!!people dont get it!!!!Iif they havent been here like us I had surgery in 10/15/05....I hurt my back falling into a puddle of water,concrete floor.at a shopping center, ect landed on my right hip,caused my tail bone to hairline facture, hernated discL5,had MRI  then surgery a week later..moroliumbar surgery&discectomy...which my orthopedic doctor said would fix me,!!!!!Iam worse now more MRI's w/dye to find the damage and soon after this nerve pain started+scar tissue was said to be the problem He said alittle P/T... and I could be up and working in no time now its 2007,Iam worse ,had to ended my career!!!!! I had no choice but to have this emergency surgery in 05, Iam sick of pain pills,muscle relaxers,and neurontin,which does help my pain level,and Iam tired of having to go to a pain clinic,for these meds and feeling like Iam some calf ready for a branded.... its the fact that its debilating,Iam on steriods at 4 times a year from when my nerve pain hits,right hip almost in my grion area down my leg causes a pain,I elevate my feet everynite on lay on my side with a pillow between my legs,and my best freind(MR HEATING PAD)  knowone undrstands unless they have been there its,like a nawing dull tooth ache,& Steriods are the only thing that helps me be able to walk,after that nerve flars up....when I get into this stage its hits me and Iam down for a week,or more,I have to take Norco&other meds to to take the edge off nothing ever takes it all away and the good days I do have I completely just go all day having my life back it feels..great when you have good days  then boom....2steps forward 3steps back....I wish I could have some type surgery that would help this all go away,Iam soon going to a nerosurgen,maybe they help me,has anyone been threw something like me a support group would be nice for me,I think I drivng my husband nuts...I just wanna be a nice woman again geshhhh...lol....sincerly,dramagone1974
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Avatar_n_tn
OMG,  I can totally relate to you....I was in a car accident .....I tried 6 months of grueling physical therapy and then had to stop. The PT has helped my muscles, joints, ligaments, etc....but has done NOTHING for this agonizing nerve pain. The MRI shows I have three ruptured discs, but they are trying to tell me there is no sign of nerve compression! HELLO!!!  It is MY body, and I am telling you, there is NERVE COMPRESSION, big time!  When it comes on, it is like gangbusters....a simple sneeze and it takes me 7-10 just to recover from it.
I am doing EVERYTHING that I am suppose to do, and nothing I am not suppose to do. I exercise and walk and do strength training, etc. When I have a good day, I take full advantage of my "leisure" - wow, a trip to the grocery store, pick the kids up from school and I am done. I want to dance and golf and go to ballgames. It hurts so bad just to sit down! Nobody wants to touch me because they don't want to be named to testify in a lawsuit...I just want to be better...I don't care about any money I may receive. I WANT MY LIFE BACK. I can't work and was forced to drop out of the Spring 07 semester because I can't sit down or walk very far.
I have been on the heating pad (my best friend, as well!) every single day and night. It is getting so old! My best regards to your health and hope you find comfort soon!
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Avatar_m_tn
I know EXACTLY what you're going thru. I've been suffereing for 4 months every day, all day. (I'm already on permanent disability for a herniated disc L5/S1). But I recently had a nerve study done (after my 3rd podiatrist told me the MRI is negative), and the nerve study says I have"mixed-diffused bilateral sensorimotor polyneuropathy in the lower extremeties". I've never suffered like I'm suffering the past 4 months. The only time I have some relief is when I lay on my side in bed with a head pillow between my knees a certain way (has to be a certain angle to help).....Thank God for that at least, but I can't live my life in bed. I sit with pillows under my feet, cause just having my feet lightly touching the floor hurts.. The pain shoots up thru the heel, thru the achilles area behind the ankle, up the back of the calf, and behind the knee. Sometimes also behind the thigh and the groin area too. Unbelievable, the situation I'm in here. And the podiatrist had the nerve to tell me, I'm sorry, the MRI came back normal!.Aaarrghh!
Frank P
***@****
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Avatar_f_tn
Iam not the only one. In 2000 I was hurt at work. It took them 1.5 of games is what i call it. To give me back surgrey (workmencomp approval and put downs)  I had a fushion in  S-1 L-5. I expressed to my doctor from the beggining that my left leg hurt. and he said he didnt understand that. That it should be my RT. Blasted scary we now where we hurt. It has been 7 years. I have asked for retraining and no answers. Iam a hairstylist. I reinjured myself just stepping down from a counter to a chair fixing a sign. Now its on again. My doctor said my cylinder are fine. He suggested pain management. Or a nerologist  and their was nothing more he could do.So he released me. That when scf of az step in and sent me to their doctor    what a rude doctor that their job to discredit me. so iam waiting for a hearing.which could take 90 days.mean while its not getting better. Mean while no money coming in. I asked for a lump sum of my money do to me. I started a new career and need it to survive. this has been 2 months now. I get a small check a month. Iam so scared ive always been a go getter. Ive had 2 doctor say hairstyling is not a good idea. someone with a normal back well have problems. Their along with back surgrey. I was a truck driver and that were i got hurt. Hiring a lawyer is  is rediculous they want to much of youre money do to you. Iam scared. Thank you all for sharing cc
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Avatar_f_tn
Forgot to put in It is my left leg. My doctor told me that they do not do bone graphs from the hip anymore because of the complaints. Which was never addressed. from 2000.
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Avatar_n_tn
  I was searching for symptoms of slipped discs and so forth and I ended up reading your comment.  I have the same exact problems with my back as you described about yours. I am 24 years old and a lot of my ammediate family have disc and vertebra problems.  Although, I am in pain management right now for my hip (i have bursitis in my right hip), but I am still trying to figure out what is wrong with my back.  The first MRI I had done, it was too blury to read and the radiology report was not up to par.  The doctors couldnt even read it and said it was very fishy! Although, I did not have health insurance when I had it done, so I think that had something to do with it.  So I am going for another MRI and so I am hoping that this one will show what is wrong.  I am in alot of pain everyday and it's just seem as though its getting worse.  I cant hardly bend over, as if my back is constricted and wont let me.  But I was wondering if MRI's can actually miss results some of the time? And if back problems are hereditary?
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667923_tn?1266738793
Really this is to ANYONE who is suffering like we are!!
When, I read this...I knew, I wasn't alone in this agony and IT is EVER SO hard...when, u r alone. IT seems like we are alone, when there is no one who understands. I have been like this for so long, I am beginning to think that I will always be like this. I pray that...that is not so. I still have hope, which keeps me going, but...and yes, there is a but. I just can't find anyone who will find, what it is that is causing this agony and get me to someone who will fix it. I am so tired of the incompitant Docs that I have run accross, during my desperate attempt in finding the answer...that I am just apalled, at how they could have this "care less" attitude that, they do.
I have been to so many Neurologists, trying to see IF they have the answers, but so far all that I have...are a bunch of dx's that is not getting me anywhere.
I have got to find A GOOD ONE somewhere. IT seems that they are either afraid to touch me, due to the complicated nature of it or IS IT because some other Doc did this surgery and don't want to get in the middle of it?
I don't understand...haven't Docs taken a hypocritical oath to help us? or do they get the option to chose WHO they help? I wonder..sometimes what in the world is going on, when a person who is suffering can't get someone to tell them what is wrong...and WHAT should be done @ it.
It seems that while going through this complicated horrific situation...I have found that I am at the mercy of others, for I can't take great care of myself...not like I want. I can't stand long, for my legs are just too weak and my arms won't let me use them because they just don't have the strength to be able to use them. Shoot, I can't even stand...without crying that is, to just brush my teeth.
I hate to say it, but it's bad and as we lay in our spots...getting through another day of agony...they are those out there..living, breathing that fresh air..and enjoying life, BUT everyone has problems and we just have to face them head on and keep on going..if possible w/out fainting.:P
This all started right after surgery of my ruptured petrusion of my C5-C6(ACD & F spinal diskectomy/fusion)I was told that I needed the surgery or could wind up in wheelchair. They gave me a 50/50 chance...that is all they told me So, after the second opinion...I went on w/ the surgery, BUT wish NOW that I would have just left it alone. My life is such a nightmare and IF, I could go and do...I might could make it better, but this just laying in one spot..not being able to even take the clothes out of the washer and put them into the dryer...ohhh, that is not working. Literally, I can't do anything or i PAY for it!! I am so wanting to feel alive again and pray for u guys too, for I know what pain is and I can read between the lines...so, I know when someone is decribing agony and can relate
God Bless u guys and just keep strong. Pray, for The Lord helps me get through it. He gives me strength to just keep my head up and fighting to get through another day...and pray that soon, we can get to the bottom of all of it. Although, I have more added to that problem now, since I have my neck surgery, in which...I know is NOT right and 4-5 disk heniations in my Thoracic(T7-T11 w/hypertrophy)...which feel like they are killing me, but somehow gonna make it.."Lord Willing" that is:D
Remember FAITH, HOPE AND LOVE..they, conquer all. Just be strong and I will try to do the same. I will check back to see, if there is anyone else out there that is in what seems like a "hopeless" situation...but never give up. We have to keep trying to find the root of the problem, then we will be able to get back up...on our feet. :))<3 Karen
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Avatar_f_tn
Karen it is now 2014, I have read so many like us, I can't help not to cry. I so tired of the pain, trying a accuputure monday 55. Dollars but no insurance wont pay for this. There is 100's of use BEGGING for help. An dthese blasted doctor's made 100 of thousands and egnore us after they have made there money. I so agree hope faith and LOve will see us through.  I thank this site for allowing us to come together.  I feel laws need to change a option for patients to leave phone numbers so we can call each person on a list. They protect there blasted selfs by the privacy act hippa, you know It would make me feel better to fight back.
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