Back Pain

[enoughpain]

I am a 39yo female with a long history of back pain. I recently had an MRI and the results are below. My physician stated that the results appeared "fairly normal" but recommended an Epidural Steriod Injection. Please help me understand what "fairly Normal" may mean. These results do not seem normal to me.
MRI LUMBAR SPINE WITHOUT CONTRAST
CLINICAL HISTORY: Low back pain, stress incontinence, right leg pain, numbness and tingling with weakness.
TECHNIQUE: Images of the lumbar spine obtained using non-contrast sagittal T1, sagittal T2, sagittal STIR, axial T1 and axial T2 weighted sequences.
FINDINGS: Alignment is normal. Lumbar vertebral bodies are normal in height. Conus medullaris is at L1. Visualized paraspinal soft tissues are normal.

Between T12 and L3, there is no disc herniation or stenosis.
At L3-4, no disc herniation or stenosis.
At L4-5, there is disc dehydration. There is a small posterior disc herniation. There is mild central canal narrowing. There is no foraminal stenosis.
At L5-S1, there is disc dehydration. There is a small posterior disc herniation. There is mild central stenosis. There is no foraminal impingement. Disc herniation contacts, but does not displace right S1 nerve root.
There is mild to moderate degenerative disease involving both sacroiliac joints.
IMPRESSION:
1. Disc dehydration with small posterior disc herniations at L4-5 and L5-S1. There is mild central stenosis at each level. Disc herniation contacts right S1 nerve root in the subarticular recess at L5-S1.
2. Mild to moderate degenerative joint disease involving both sacroiliac joints.

[enoughpain]

Thank you Kalvin for the feedback. You were correct in that this was evaluated by a Family Practice physician. This physician did recommend an epidural lumbar injection that was completed 4 days ago. The leg pain has been dimishing since the injection but the low back and hip pain has not lessened but I am associating that to the SI joint issues. The SI joints frequently displace and require manual manipulations to be reset only to have them displace again in a matter of hours or days- never more than a week at a time. The family practice physician has referred me to a neck and spine speciality center so I am hoping to hear more specific details about my treatment and rehab at that time. Thank you for your feedback- it is much appreciated!

[Kalvin]

This Doctor must be a primary or family Doctor, probably doesn’t want to worry you.

Between T12-L3 looks good
L3-4 is fine
L4-5 disc dehydration happens with age; our discs lose water and dry out as we get older.
You have a small disc herniation at this level that’s probably causing the mild spinal narrowing; this isn’t a big deal either.
L5-S1 Here you have another small disc herniation and the disc has lost water, you also have mild spinal canal narrowing at this level. Additionally, at this level the disc herniation is contacting the right S1 nerve root.
Your SI joints on both sides have mild to moderate degeneration, probably from arthritis. These joints are located at the very bottom of the back. You have one either side of the spine. These can cause a lot of pain to the left or right of your lower back. The pain can be sharp or aching .

The trick is to correlate the findings of the MRI to your symptoms, because the majority of things note on the report, probably aren’t causing any symptoms.

Your low back pain could be discogenic (caused by the deteriorating discs) or it could possibly be caused by your SI joints. I would do a search on SI joint pain, and see how your symptoms match up.

The right leg pain, numbness and tingling is a little easier to correlate. It’s more than likely being caused by the disc herniation contacting the right S1 nerve root. Your symptoms are fairly typical. Do a search on S1 radiculopathy if you’re interested.

As far as the MRI being normal, it isn’t exactly, but it’s not the worse either. Have you had any treatments for any of this? Make sure you try the injections, they might help.


Take Care