MRI & EMG Results

[yorkieville]

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?

[yorkieville]

Dear Liza. I am sorry I don't have any answers for you, but I think you may get responses if you start your own thread.

[yorkieville]

Dear Doctor, somehow, I missed your reply. I apologize for my lateness in responding, and I thank you for taking the time to reply. I know that you are very busy, and I appreciate that you volunteer your time to help so many people. That's an amazing thing in this world today. The Pain Management Doctor looked over my MRI & EMG results and did not feel they were diagnostic of anything. So, 3 weeks ago, he did a Lumbar Steroid Injection; no improvement in pain. He felt that ruled out discs causing my back pain. Tomorrow morning, he is doing a Lumbar Nerve Block, to see if he can "shut off" my nerves. He feels, based on my having had 6 Gyne surgeries over the past 20 years (including two major surgeries in the past 10 months), that scar tissue may be causing my nerve pain. He has promised me that he would hold my hand and walk this path with me, until he gets me a diagnosis. I agree with you, that I need a Neurologist.

[lizanh]

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 is so severe I cry. I have always had a high tolerence for pain I got my left pinky finger cut off and did not feel it. (it was just dalgling by some skin)
When the Dr amputated it I watched it was cool to see your bones. anyhow that is why I know I am in pain. I have had four nreve blocks on the left side of my head in the back that did not help. It gave me a numbing feeling for a few days and then the pain worsened.  
The meds I have been on are..... tegretol, indomesion,nerurontin,amitriptelyine, topamax,imitrex,percaset,naproxen,tremedol,skelaxin, now cymbalata. nothing is working. I was denied SS disability because they feel I can do light duty. NOT I am in pain right now just typing this blog. I also get a pressing feeling aroung my skull thats all the way around, like a migriane with needles and burning sensation. I have passed out and I get very light headed and have to lie down. CAN ANYONE HELPME
liza.***@****

[Forum-M.D.-SH]

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.

[yorkieville]

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.

[JCmcc]

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.

[yorkieville]

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.

[yorkieville]

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.

[yorkieville]

Correction: I meant to say that by 12/06, the nerves in my spine began to sting, not 12/05. Sorry.

[JCmcc]

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.