Got my MRI results from lower back pain and numbness shoting in my left leg down to my foot. Had a physical therapist tell me I had 2 herniated disc, then had a Dr. tell me there is nothing in the report that shows I should be having pain. Can a Dr. that knows what he or she is talking about please tell me what the report really means, much appreciated. And I'm 26 years old by the way, is there anything I should be worried about? Thanks!
FINDINGS: Vertebral body heights are maintained. Marrow signal is normal.
There is mild disc desiccation at L5-S1 and L2-L3. The conus medullaris
terminates at T12-L1. There are congenitally shortened pedicles from L2
T12-L1: Broad-based left subarticular disc protrusion which does not cause
significant central canal stenosis or neural foraminal narrowing. Mild
ligamentum flavum hypertrophy.
L1-L2: Mild ligamentum flavum hypertrophy. No significant central canal
stenosis or neural foraminal narrowing.
L2-L3: Mild facet arthropathy bilaterally with associated ligamentum flavum
hypertrophy and mild broad-based circumferential disc bulge results in mild
central canal stenosis. Mild bilateral neural foraminal narrowing.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
Your MRI based on the report you provide suggests you have mild degenerative changes (that is wear and tear). It is difficult to discuss the results in more detail without the ability to view the images. However, mild disc protrusions are not an uncommon finding.
It is important to know that in most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people ever require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.
In a minority of patients, surgery needs to be done urgently. This often is the case when the herniated disc is pressing on the spinal cord itself. Surgery is emergent so that permanent spinal cord injury does not occur. Another indication for urgent surgery is if there is evidence that a nerve is being compressed on to the point that its function is impaired. Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.
One means of assessing whether or not the nerve being pressed on by your herniated disc is impaired is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers. It would be best for you to discuss surgical and non-surgical options with your primary physician.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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