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Neurology (Expert Forum)
Translation of MRI and Chronic Back Pain
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Translation of MRI and Chronic Back Pain
by celine149, May 15, 2006 12:00AM
Thank you for taking my questions, I'm a 53 YO Female. I have had OA since in my 20s. I recently had TKR which seemed to make all other areas of arthritis worse. I had an MRI of my LS 2 weeks ago. After looking it over the OS said it is all arthritis and there is not anything to be done about it. He also said to get ready because this pain is going to get worse. Important point for me but I don't think important for my Drs. is I can take NO arthritis meds or aspirins because of Barretts esophagus with strictures. I wanted to get your opinion of my MRI and any suggestions you have for me or is it just as simple as my OS make sit out to be? He did inject both hips with cortisone and will be setting up appts. for spinal epidurals. Are epidurals usually successful at pain control? I
MRI report:
"Advanced disc degradation is noted at L5-S1 with discogenic end plate changes, dimimished disc signal, broad-based disc buldge and osteophytosis resulting in bilateral foraminal stenosis worsened by facet arthropathy.
there is also disc degradation at L4-5, L3-4, L2-3 of a moderate extent. No neurocompressive HNP, midline lateral recess or foraminal stenosis is noted despite facet arthropathy bilaterally at L4-5. Periarticular inflammation of the left facet joint is noted at L4-5 level and bone marrow signal alteration campatible with stress reaction."
Would this make my left leg, all the way down to about 3 in. above my ankle, have deep burning pain and numbness? At times my leg will even start jumping as though trying to get out of the fire.
Thank you for any advise.
MRI report:
"Advanced disc degradation is noted at L5-S1 with discogenic end plate changes, dimimished disc signal, broad-based disc buldge and osteophytosis resulting in bilateral foraminal stenosis worsened by facet arthropathy.
there is also disc degradation at L4-5, L3-4, L2-3 of a moderate extent. No neurocompressive HNP, midline lateral recess or foraminal stenosis is noted despite facet arthropathy bilaterally at L4-5. Periarticular inflammation of the left facet joint is noted at L4-5 level and bone marrow signal alteration campatible with stress reaction."
Would this make my left leg, all the way down to about 3 in. above my ankle, have deep burning pain and numbness? At times my leg will even start jumping as though trying to get out of the fire.
Thank you for any advise.
Doctor's Answer
by CCF-Neuro-M.D.-PW, May 23, 2006 12:00AM
I cannot give you a specific opinion on your case without knowing what the scans look like
Based on the report (whose accuracy I cannot confirm), there are changes associated with wear and tear on the spine and discs. There are narrowings reported in the spaces that the nerve roots from the spine enter through on their way to the leg. Compression of these nerve roots can cause pain or numbness radiating down the leg, and potentially muscle weakness and wasting in the leg. The leg jumping or twitches in the muscles may add to evidence of nerve root compression. An EMG needle exam of the left leg may be useful to look for any damamge to the nerve
Most of the time these findings and symptoms do not require sugery and response to conservative treatent, like PT and injections. Surgery is indicated if there is evidence of progressive neurological loss of function such as progressive weakness of the legs or compression of the spinal cord causing difficulty walking or loss of bladder control. Surgery for pain or sensory symptosm alone is risky as it may not relieve the symptoms and may make things worse - the pain may be also from muscle,ligaments, tendeons,soft tissue etc.
Based on the report (whose accuracy I cannot confirm), there are changes associated with wear and tear on the spine and discs. There are narrowings reported in the spaces that the nerve roots from the spine enter through on their way to the leg. Compression of these nerve roots can cause pain or numbness radiating down the leg, and potentially muscle weakness and wasting in the leg. The leg jumping or twitches in the muscles may add to evidence of nerve root compression. An EMG needle exam of the left leg may be useful to look for any damamge to the nerve
Most of the time these findings and symptoms do not require sugery and response to conservative treatent, like PT and injections. Surgery is indicated if there is evidence of progressive neurological loss of function such as progressive weakness of the legs or compression of the spinal cord causing difficulty walking or loss of bladder control. Surgery for pain or sensory symptosm alone is risky as it may not relieve the symptoms and may make things worse - the pain may be also from muscle,ligaments, tendeons,soft tissue etc.
Member Comments (3)
by celine149, May 15, 2006 12:00AM
I should also say that I have had elevated WCC for atleast 5 years. started out around the 13,000 mark. At last blood work 2 months ago was 18.9. Also at that time i had an ESR of 32 and CRP of 3.7..I have never seen a rheumatologist. But I have an appt with one coming up soon. I sometimes think this all seems like an autoimmune illness. Does that seem like an option?
by celine149, May 23, 2006 12:00AM
To: CCF-MD
Thank you for your information. I appreciate it.
