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Is it still possible for a small bulging disk causing sciatic nerve pain?
Report from MRI Lumbar Spine Without Contrast:
Technique:  At 1.5 Tesla, apprpriate pulse sequences were employed in multiple planes.
Findings:
Marrow:  There is a small hemangioma in the L1 vertebral body on the left side just beneath the superior endplate. There is no edema signal within the marrow.
Alignment: Alignment is within normal limits.
Conus: The conus medullaris shows normal position, contour, and signal content.
Small oval T1 hypointense and T2 hyperintense structures in the neural foraminia bilaterally at T11-12 and on the left side at T10-11, T9-10 and T8-9 are most commonly due to perineural cysts and usually incidental.  The visualized lower thoracic spine is otherwise unremarkable.
L1- L2, L2 - 3 and L4 - 5:  No sighificant abnormalities.  A tiny subchondral cyst is present in the left facet at L4- 5.

L3- L4:  Disk desiccation without significant loss of disk height is accompanied by small ventral osteophytes.  The canal, foramina and lateral recesses are preserved.

L5- S1 :  Early disk desiccation is accompanied by a central and bilateral paramedian annular tear with trace subligamentous herniation of disk material.  The canal, foramina and lateral recesses remain patent.

Soft tissues: A 46-mm oval T2 hperintensity exophytic from the lower pole of the right kidney may be a cyst, but is incompletely imaged.  The visualized retroperitoneal soft tissues and paraspinal soft tissues are otherwise unremarkable.

Impression:
1.  Shallow central and bilateral paramedian annular tear at L5- S1 with minimal herniation of disk material which is not causing any mechanical nerve root impingement.
2.  Disk desiccation without protrusion at L3- 4.
3.  46 -mm T2 hyperintensity in the lower pole of the right kidney may be a cyst, but is incompletely imaged.  Dedicated ultrasound or CT can evaluate this further.

Nothing was noted to my past history of slightly angulated sacroiliac nor rotated with minor fracture of coccyx.

I have been going for years to physical therapy and past injections on my coccyx and later on my disc.  This has worked to an extent.  However, doctors keep saying that there is no nerve root impingement but yet.  I know where my pain starts from my lower back and continues to my sciatic nerve on my buttocks, but the interesting thing is from there a feel it on the arch of my right foot.  Explanation from doctors is always the same that there is no nerve root
impingement?
For years I have been seeing a physiatry (physical and rehabilitation MD)- and they sent me to physical therapy and when I get to my worst.  They see I need to see pain management.  Now, I am experiencing new symptoms going down both legs-  sharp sudden knife pain.  Since, I am at my worst again, I can literally feel sharp-knife pain going down to my vagina.  And I am having pain again when I am sitting down as in the past.  I am now seeing a manual functional therapist and she tells me that my sacraliliac is slightly angulated and my coccyx is rotoated and that I have a small herniated protusion and that this small herniated protrusion is pressing on my nerves (sciatic and something about piriformis..?  I told her that I can feel some inflammation on my lower back.  Today she told me Something about soft tissues were tender and when she touch my tailbone it was painful.   She is working me first in aquatic therapy and pelvic traction.  She recommended me to see a neurologist.  What are my options if the MRI is explaning that there is no mechanical nerve root impingement?  Whatever is going on has affected pain from my hips and legs and root foot.  Possible due to my herniated disk, that's what I think.  Could someone please explain to me what are my options and what does the MRI is really implying?  Where do I go from here?  I am tired of the same treatments.  I am on Mobic- 15 mg and it is not working.  I was given prednisone- 4mg and it took some of my pain away.  I was
happy.  I think a higher dosage of prednisone would had taken away my pain completely.  The pain came back.  
Thank you,
Celia Robles
have always been put on  

    
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