Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

Notice
All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Confused by MRI and comments from doctors

manaleriemmanalerie Posts: 547
edited 06/11/2012 - 8:23 AM in Lower Back Pain
Ok, so y'all know I had an MRI of my lumbar spine. I have severe pain in my right hip, and down my right leg to my knee. Occasionally I get mild pain in my left hip. Sometimes strange sensations shooting down my left leg... not really painful, almost a funny bone sensation.

I've been told now by more than one doctor that I shouldn't be having pain in my right leg at all. I should be having it all in my left, because that's where the bulge and herniation are pressing. I am not a doctor, and have no experience reading MRI results, however, it does appear to me that there are issues with nerves on the right side also... not just the left. I'm going to post the MRI results again. I am hoping someone here can look at it, and tell me I'm not crazy.

Findings:

The vertebrae are normally aligned. The heights of the vertebral bodies are maintained. Disc desiccation and intervertebral disc space narrowing is present at L4-L5 and L5-S1.

The cous medullaris is in normal position and demonstrates normal morphology. The cauda equina has a normal appearance.

L3-L4: There is mild bilateral facet hypertrophic degenerative change. Subchondral cysts are seen adjacent to the left facet joint.

L4-L5: There is a diffuse disc bulge with an annular tear. This contacts the exiting right L5 nerve root and causes lateral displacement of the left L5 nerve root. There is mild bilateral foraminal narrowing.

L5-S1: There is a central disc herniation which contacts both exiting S1 nerve roots. There is minimal central canal stenosis.


It says there is contact at right L5 nerve root, displacement of left L5 nerve root. And the Herniation contacts both exiting S1 nerve roots. Why are they telling me that I shouldn't have pain in the right leg? What are they getting that from?? Any suggestions would be greatly appreciated.
advertisement

Comments

  • I am experiencing the SAME thing. Doctor says that my symptoms don't make since to him how I am having pain on mostly the right side of my body, when my herniation is on the left! Also, he said my herniation shouldn't even be causing the symptoms I say that I have. I think we are all doomed! DOOMED!
  • Hi Manalerie,
    I have a small far right L5-S1 herniated disc. I also had pain and numbness in first the left leg and now both. I still say the opposite leg is worse. I heard that both legs can be affected like mine.. You're not alone in this. And they can't tell you you're not having pain. From Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • This summer, I got a tattoo on the top of my right foot. It goes from about the second toe, and wraps around to my ankle. Through the entire tattoo process, I was fine EXCEPT near my ankle. The tattoo artist had me doing lamaze type breathing when working in that area. She was surprised at how well I was doing with the tattoo, but how extremely bad I did at that one spot. She told me I should look up reflexology... maybe there was something going on somewhere else in my body. When I got home, I did just that...

    Has anyone heard of reflexology?

    I looked it up, sure enough, where my tremendous pain was... low back and hip. Interesting??
  • I am not a doc either but this part makes me wonder if it could be the annular tare causing the right sided pain because I have had an annular tare and they are very painful when compresing the nerve root. Here is the part that makes me wonder:

    L4-L5: There is a diffuse disc bulge with an annular tear. This contacts the exiting right L5 nerve root and causes lateral displacement of the left L5 nerve root. There is mild bilateral foraminal narrowing.
  • I don't know about the reflexology, but I can relate to your experience with the Dr. I have a transitional L5, and a bulging disc at L4/L5 with an annular tear. Mt doctor says that it shouldn't be causing me pain. He doesn't deny the fact that I am in pain, but his attitude is 'here's 3 months worth of pain killers come and see me when your low'. Not what I'm looking for, I want someone who will work with me to try to fix it.

    I don't have access to another Dr right now, I am in Canada and right now there isn't a Dr withen 3 hours of where I live that is taking new patients. I think my best bet is to try someone in the US, once I've saved up the funds.
  • But at least they are helping you with the pain. Have you tried physical therapy? I think aside from surgery, and meds that is our only other option. I go back to PT next week...
  • The MRI states a couple times that both the left and right nerve are affected in one way or another. So I don't understand why they are saying that I should only be having pain in the left, and not the right. Like I said, I am not in anyway experienced in reading MRI results, but to me it appears I should be having pain in both sides.

    I am seeing my PM tomorrow for an epidural. I will ask him if he can explain it to me.
  • I am an interventional pain physician and it is not uncommon to have abnormalities on MRI that do not "marry up" with your physical symptoms. Remember that it represents an image, not physiology just as when someone says "smile" and takes your picture, that does not mean that you are happy. With disc herniations, there is also chemical irritation from the herniated disc material that may cause pain on the site of the herniations that is not specifically mentioned as having compression in the MRI image. This disc material can cause pain into the buttocks or legs. L5 level pain causes pain into the buttocks, down the outside of the leg and across the top of the foot. S1 level pain causes pain across the buttock and down the back of the leg to the outside of the foot and sometimes the bottom of the foot. Facet pain can cause some pain along the spine into the buttocks and into the back of the thighs, and much less commonly below the knees.

    A treatment option to sort out what is going on is to either have an electrodiagnostic evaluation (EMG) to see if your herniations are resulting in changes at the muscle level as nerve conductions are usually normal in lumbar radiculopathies as well as to undergo selective nerve root block/transforaminal epidural steroid injections to identify the nerve root level that is bothering you. These treatments are both diagnostic and therapeutic. If your leg pain is resolved but your back pain persists, a facet block can identify this pain. Radiofrequency ablation/neurotomy can then treat this pain which will improve the back pain for 6 to 18 months if this is one of the sources of your pain. I, myself, have had this treatment and it helped me for 16 months before I had it repeated as the nerves often grow back and then transmit their pain again.

    If none of the above helps your pain, it is possible that your pain is coming from the disc itself. This is best diagnosed with a discogram. It is somewhat of a controversial procedure if you undergo "provocative discography" where the painful disc is pressurized and if this reproduces your pain, only now worse, and other non-painful discs can be identified with this procedure, then this can be a helpful test. A newer and much less painful discography procedure is Functional Anesthetic Discography (F.A.D.) in which anesthetic is injected into the discs and the disc is numbed which identifies the painful disc by removing the pain source.

    One can either undergo disc replacement or spinal fusion for disc pain. For nerve root pain, but no weakness in the legs or bowel/bladder control issues (the true surgical indication), non-surgical management (meds, P.T., injections, etc..) has the same outcome at 5 years as does surgical management.

    I hope that some of this information helps.
  • Hey amanda

    It can also be that they look at the actual image and the nerve root doesn't appear impinged on the right even though there is contact - if that makes sense. Like when they talk about displacement and of the nerve root as opposed to "mere" contact.

    I have had annular tears and they tended (in me) to give more lower back spasm and pain and no referred pain which you mention down your leg - that's tends to be more nervy for me personally.However the extruding disc material from an annular tear can of course irritate the hell out of the nerves.

    But caveating all of this with the fact you are a woman and hebce your pain is not as real or important - and its all in your head ;-). (Not!!)
  • I see the word bilateral -- last time I looked, that meant both sides!!

    Linda
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • But it seems to me that it affects both sides???
  • Hi Linda - Sure bilateral means both sides - but in this context they have referred to bilateral facet hypertrophy at the L3-4 and bilateral foraminal narrowing. They don't say bilateral impingement of the nerves.

    I was just trying to suggest a reason why they might have said this to amanda - I know often my ns will look at the images before he reads the imaging report cos the pictures tell him more - if you get what I mean.

    At the end of the day pain isn't 100 per cent about what a report or image says anyway its about what you feel - almost fifty percent of people would show up with disc herniations under mri - so why do some feel the pain more than others? Its not fair!

    Amanda - have you got any clarity from your doc about it?

    N
  • Piperdoc,

    Welcome to Spine Health and thanks for providing some awesome information and in a very understandable way!

    Sorry that you yourself suffer from time to time, but glad that the RFA helps you.

    I'm psyched that they have finally come up with a possible alternative to the discogram. That sounds intriguing!

    Have a great day,

    "C"
advertisement
This discussion has been closed.
Sign In or Register to comment.