I know this is an MS Forum but...

[Heather3418]

I have a couple questions, for you veterans of back problems.  When I had my recent spinal MRI it showed that I had disk protrusion and degenerative changes at C6-C7.  I showed a demyelinating lesion at T1-T2. (where it has been now for over a decade) I have degenerative changes and disk protrusion at T6-T7 with mild canal narrowing. And disk protrusion at T7-T8.  That disk is protruding on three sides.  Is that the disk that is most likely to rupture or let's say, the worst disk I have?  That is at T7-T8.

I also had degenerative changes that are most pronouced at L1-L2.  Which one of these areas is causing all my chronic lower back pain?  The L1-L2?

Please help me to understand more.  I know that I show degenerative changes, which is pretty typical of a woman in their mid-50's.  The disk protrusion I did not expect, although I do have some mid-back pain, but no pain in the cervical area. The report says that my cervical spine does not show the typical "curving" seen at that level but a straightening of that area.  But no pain.

Any hints would be helpful to better understand where the back pain is coming from.

Thanks in advance for you rhelp.

Heather
P.S.  This feels strange to ask questions about myself and my health...but when it comes to backs, I am a real dummy...

[Heather3418]

Can anyone offer me some words of wisdom?  

[spankyandrex]

Hi there woman!  AHA - see how, even though I have been diagnosed as "NOT HAVING MS", well, I can certainly offer information on our SPINES LOL!!!! I just happened to stop in today Heather!!! ;)

Well, sounds like you have quite the mess in your spine.  As you know, I am going through the same thing.  Well, do you have a lot of back pain/neck pain?  If not, I wouldn't worry about your results too much, but if you ARE, then I would make an appt. with an ortho surgeon or neuro surgeon.  They will run you through the gammit of PT, drugs, etc. to help calm down the nerves and then possibly surgery.  Surgery is always a last resort (pretty much where I'm at now).  

Your results - at T6/7, you have a disk pushing on the thecal sac which is causing narrowing of where your spinal cord runs through.  This can be very painful.  It's not so much as which disk is the worse, it's which disk is causing the most probelms such as stenosis, or narrowing of the foramina, or touching your spinal cord. Some people have ruptured disks and hardly have any symptoms at all.  Others, might have a tear (like me) and have horrid pain.  It's all in the individual..

Your chonic lower back pain - that certainly could be the l1/L2.    That is your lumbar spine which runs from L1 - S4 or S5 I think.  That is where a lot of my problems are as well. I have disks sitting on both Right and Left S1 exiting nerve roots. I also have major problems with my neck, disks touching the spinal cord.  I also have one disk at T7/T8 that has protruted into the sac and touches the spinal cord, - so I'm just about as bad as you LOL!  

I just spoke with my neurologist today and he has agreed FINALLY to refer me to aspinal surgeon.  (the burning feet, intense neck/shoulder/arm pain) weak ankles, legs and feeet and of course no reflexes in ankles or feet.  Anyhoo, you have a host of things going on - I would definately take your MRI report AND your MRI films with you to go see an orthopedic surgeon and go from there.  GOOD LUCK.

[monotreme]

Hi Heather,
    Does the MRI report say only mild stenosis or narrowing of the spinal cord?  Generally, back surgery is not recommended anymore unless there is moderate to severe stenosis and pain and loss of mobility.  Have you tried physical therapy for the specific spine problems.  Sometimes disks can be fixed with the right therapy, although I am not sure of the one protruding on three sides.

   Now this is just my opinion but I would see a neurosurgeon over an orthopedic surgeon any day.  Neurosurgeons tend to be more conservative in their approach and with your MS, I would think you would be better off in the hands of someone more in tune with the nerves in the spine etc.

   Orthopedic surgeons tend to view the spine in a more mechanical way and they tend to operate much more than neurosurgeons.

    There are always good and bad surgeons so you could go to an ortho and a neurosurgeon and get a feel for their different approaches.    In any case, people can come out worse after spine surgery or better, but it is highly dependent on the surgeon and the therapy you receive after the surgery.    

  In Delaware, back surgery is an absolute last resort.  Even in a huge orthopedic institute in Philadelphia, back surgery is a last resort option.  The approach is therapy, therapy, and more therapy!!  

   Since you go to UVA, maybe there is someone good in the neurosurgery dept.

Best wishes in your pursuit of an answer,
Elaine

  

[monotreme]

Sorry Heather.  I did not answer the pain question.  I would think the lumbar area is  responsible for your pain.  Could any of your back discomfort be muscular??
Elaine

[spankyandrex]

I agree with Elaine, see a neurosurgeon - that's who I am being referred to.  GOOD LUCK!

[Heather3418]

WOW...you all are great in your explanations.  I understand more from what you all said than any doctor could explain.

Elaine...my report says MILD canal stenosis at T6-T7 and slight canal stenosis at C6-C7, so surgery is not even on my list of worries.

I have been large-chested all of my adult life and I believe that has probably caused some poor posture.  I also was a ballerina for 8 years and you can probably guess the extremes, we dancers put our spines through, especially in ballet.

Thank you SO much, for all your knowledge.  You've really helped me to understand more.  I think by strengthening my abdominal muscles, I may be able to improve my back pain.  Certainly can't hurt...

HUGS to you both,
Heather

[gollie]

Hi Heather
Im very sorry to hear your having this problem.
I have had cervical surger c5-6   herniated disk   and L5-s1   no disk there at all deteroated.    I used a nero surgeon  over the orthopedic.  Im happy with my results.
i still have buldging disks in those area but are not concidered surgical at this time.
if you would like to get more detail from me (as i have to go out right now) send me a message id be more than happy to answer anything i can for you. Gollie

[Heather3418]

I could use as much information about spinal problems that you are willing to share, when you have time.

I do apologize to the MS forum members for posting a sugject that really has nothing to do with MS.  I just happen to have MS and spine problems.

Thanks for your understanding.

Heather

[young at heart]

JUMPING IN LATE AS USUAL,PLEASE OH PLEASE FIND A NEUROSURGEON WITH A SPINAL FELLOWSHIP.THEY SPEND THEIR TIME ON THE SPINE.

I HAVE HAD 2 FAILED BACK SURGERIES,L3,L4,L5. I HAVE MORE JUNK IN MY TRUNK.

WITH HERNIATED DISK UNLESS THEY ARE SEVERELY IMPINGING THE SPINAL CORD,MOST GOOD OR GREAT DRS. WON'T TOUCH THEM TODAY.

THE THORACIC DISKS UNLESS THEY ARE SEVERELY CAUSING IRREVERSIBLE PAIN,THEY WILL NOT OPERATE,TO OPERATE ON THE THORACIC THEY MUST GO THROUGH THE FRONT,WHICH INVOLVES CRACKING THE RIB CAGE.

I HAVE A DISK RUPTURE,WITH SIGNIFICANT CORD INDENTATION AT T6 AND IT CAN STAY THERE,

WITH THE PAIN RADIATING DOWN THE LEGS ,HAVE THEY DONE A EMG TO CHECK FOR RADICULOPATHY,NERVE PAIN OUT SIDE THE SPINAL CORD.

A MRI WILL SHOW THE HERNIATED DISK,A MYELOGRAM WILL SHOW ANY NERVE ENTRAPMENT.

AS WE AGE WE DO GET DDD TO SOME DEGREE.

BESIDES THE HERNIATED DISK AT T6-T7 I HAVE BULGING DISK AT T7-T8,T8-T9 AND T9-10.PLUS THE ARACHNOIDITIS.

PLEASE SEE A GOOD DR,NOT ONE THAT WANTS TO BE A CHOP SHOP DR.

ONCE THEY DO A SPINAL SURGERY THEY CAN'T REVERSE,SOMETIMES DISK CAN REPAIR THEMSELVES,I KNOW THAT SOUNDS OFF THE WALL,BUT THEY SAY STRENGTHENING THE STOMACHE MUSCLES WILL TAKE THE PRESSURE OFF THE SPINE.

T

[gollie]

HI Just got back, lol I just read threw my last post here my typing/spelling is terrible.
please forgive me all it just happens when i get tired lol which doesnt take much these days.
Any way Heather i have read the above post on this subject and it seems there is alot of good advice and info up there so far. I'll tell  you some of mine.
I had a herniated disk at C6-C7 leanning on the spinal cord. very painful in neck arms and hands. in 2002 had to have surgery anterior cervical fusion. (ouch they use screws and actual hardware stuff also doner bone.) so its not a fun surger at alllllll. I really waitted till i had absolutely no choise. I also had lower back problems at the same time
L5-S1 The disk had been deteroating since i was about 21 years old. by the time 2003 rolled around it was gone completley. so therfor that left me in huge amounts of hip leg and foot pain, so had to have that surgery done (bilateral decompressive lumbar laminoctomy with fusion and instermentation)  Yea big name for the surgerys. but once again, tho pretty heavy dutie healing time. I think it was a good year and a half before i actually saw my maximum benifit from pain but i was up and back to work under restrictions for some time, meant time i was to learn That there is  a central disk bulge at C3-C4 and C5-C6 there is a small disk herniation causing indentation on the right C6 root and foraminal narrowing ofn the right side..    There are a couple more bulging disk in lower back L2-L3 L3-L4 . T1 Degenerative disk disease  or DDS Mild to moderate spinal stenosis .  Now the small herniation and the bulging disks that  are still there
do not require surgery at this time (main reason being) is that they are not actually putting any pressure onto the spinal cord. thank goodness. and in all actuality can be painful at times but not like the ones i had surgery on. I tolerate the pain with these with pain meds if it get to bad.  some of that pain is also caused by dds and stenosis.
Now your L1-L2 start your low back (lumbar area) = L1-L5.
L1-L2 in your case with degeneritive changes certianly can cause pain and or discomfort.
and as it states in your post, it most pronounced at L1-L2 I take that to mean you probabley have it in more that just the one area, but it is just more so at that disk level.

the only comment i can make on the thoatic area is that i as well have heard alot of the same commets above, 1. its rare to have a herniaton there, and 2. its a pretty extensive surgery having to go in pass the rib cage ect...   my neck surgery was done threw the front of the neck and low back surgery was done in the back.  so Thoratic disk surgety would be somthing to stay far far away from unless of coures it was unbareable at some point in time.  I know you mentioned there is leision in your thoratic area i am not sure if or what afecct this would have if any.
I would get an opion from a nero surgen about your film and discuss ms as well he will probabley want to send you to pt and they will report back to him on your progress.
if it is not operable such as my bulging ones (just not bad enough not compressing or leanning on spinal cord) It will be a case of pt and pain killers which is somthing i keep doing at home any way pt copays can get to be killer for me. so i do it at home nowl
any way i am so tired almost cant see, so if after reading all your post and find a specific  question feel free to ask if i dont know the answer maybe i can look it up on some of my of spinal sitesl   meantime take it easy on yousefl and get some rest. Gollie

[LLWB]

Well, I'll chime in too. I agree you should see a neuro-surgeon. Much better than orthopedic. They are okay for broken bones, bursities, etc.,but neurosurg much better to diagnosis & treat spinal problems. With mild stenosis, that isn't too bad. and your Cervical didn't sound too bad. The T7-8 is a problems. They generally will not operate on the thoracic because it involvs so much in front. Ribs, heart, lungs, you name it! Even totally blown discs. Unless it it pushing the spinal cord causing paralysis, loss of bowl or bladder. The L1-2 are probably the ones causing your lower back pain. The first line of treatment is usually PT, anti-inflammatories, for aat lease 6 months of "conservative" treatment. If that doesn't work, then they further evaluate if surgery is necessary. When I had my neck fused in June, after the 6 mos conservative therapy, which did nothing for me, it has been fine. As far as that area hurting, its about 75% better. I have more range of motion, even with it fused and a plate installed. I had blown disc, and foraminal stenosis. The dr removed some of the stenosis along with the disc, and from the foramin above & below. The only pain I have that I can isolate as being from the surgery, is the right side of my neck still hurts. The muscles have to learn to stretch two sectins of disc instead of one disc. I have stenoisis on basically my whole spine, a bulging disc at T8, and a bulging disc at L4-5. Isn't it the pitts to have so much wrong with us!!! Hope this helps you understand some, feel free to ask any questions you might have...........Maggie

[Heather3418]

I have shown degenerative changes in my spine for quite some time.  What I have not shown is the number of disk problems.  This has just started in the past two years.  It's hell getting old....

I am not seeking out any kind of surgery. What I am looking for, is a doctor that betters understands spinal problems, because my GP and my Neurologist don't seem concerned at all, despite sharp pains in my back at the bra line and chronic lower back pain especially when I lay down for too long.  Always worse in the morning.

I DO know that strengthening the stomach muscles can go a long way to helping the spine and posture.  With winter now fully upon us, I am not outside working around the yard like I normally do, which seems to keep me in pretty good shape.

I was extremely overweight for many years and as I said before and large chested most of my life. I am sure that has contributed to my problems.  I am now within 30+ pounds of ideal weight and my "balloons" have lost their volume (LOL) when lost over 125 pounds. That I am sure, has helped my spine.

I don't have any real family hisotry to go on, since I just found out I was adopted at birth 3 years ago.(Thanks to my WICKED step-mother. I was never to find out according what I was told by "relatives)  I can only go by what I endure now in my own life with spinal problems.

I suffer from chronic tightness and spasms, burning and tingling in my legs and the Neuro's always thought the pain was coming from my thoracic MS lesion.  I guess that it ALL factors in.

I SO appreciate all of you chiming in to help me better understand the spine.  I am a real dummy, when it comes to such things...

Thanks again to ALL,
Heather

[essdipity]

One low-tech thing you might want to consider: How old is your mattress? You may need one newer and more suited to your body as it is now. Back pain in the morning could partially be explained by this.

ess

[Heather3418]

I don't know if you remember meeting my sweetie at my father's funeral, but maybe I need for you to write him an email and tell HIM that you think we need a new mattriess.  I have been trying to tell him that for 3 years.....LOL  Tell him his baby is suffering...Big Time.  Or maybe Heather needs to get ahold of the credit cards and just order one myself.  The bed belonged to his parents and I think dates back to the 1970's or older.  Gee I wonder if the mattress is that old....oh Lordie...

All kidding aside, you may be onto something here....no wonder my back hurts so bad when I get up in the morning....