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I don't believe my MRI results

I've had intense upper back pain since changing the battery in my car in February 2011. I've had all the symptoms of a herniated disc, but according to the MRI's I've had: "very mild posterocentral protrusion at T3-T4"

How could a "very mild posterocentral protrusion" cause debilitating pain? I often have extreme burning pain in the muscle under my arm and along the outside of my scapula. When this first started I was having heart palpitations and shortness of breath. Lately, I've began having muscle spasms and a permanently tight muscle in the front of my rib cage. Bending over, sitting in any position other than ram-rod straight, or lying on my side (either) makes the pain much worse. How could a "mild" protrusion cause all that? I just don't believe the MRI is giving a full picture of the problem. I don't know what other test to ask my doctor to do.

Has anyone else had the experience of having an MRI that shows a mild problem (or no problem at all), but then later having some other test that shows a more serious problem?

My doctor prescribed PT, but it hasn't helped at all. In fact, it tends to aggravate the pain. PT feels pointless anyway. I don't see how it could possibly fix whatever the problem is. When I do PT I feel as though I may as well be painting a barn with a toothpick.



  • Hi CM. I'm sorry you are frustrated. Living with pain is always hard but not having an answer (that you are satisfied with or trust) is even harder.

    Here's the problem with pain - everyone is different and everyone experiences it differently. Some people have pain receptors that are just more sensitive/heightened so what they feel is more acute. When your test results dont seem to match what you feel, i think people start to question themselves and wonder if the pain is in their heads (at least thats how i felt). But as we both know, a "mild" issue does not negate the "severe" legitimate pain we feel.

    Interestingly, there have been multiple studies done over the years with regards to disk bulges (protrusions). I remember reading about one where they several hundred people with back pain and several hundred other random using MRIs. They found that in some cases the pathology that presented in the people who complained of pain didn't always reflect the level of the pain they experienced. On the other had, they found many of the 'random' group had mild to moderate disk bulges, but had no idea and had no associated pain.

    I've been in that situation in the past. After my first lumbar fusion I was sill in agony, but nothing at all showed on my radiology. It turned out that I wasn't fused but for a number of reasons the doctors couldn't tell by any f my scans.

    My most recent radiology (from 2010) showed various mild to moderate issues at every level but I can assure you, the pain I feel everyday is SEVERE. In fact, I've just had a new CT and new MRI is on Sunday to see if there has been any further deterioration.

    We know our bodies own better than anyone. And if you have a good PMD, they will consider everything in their evaluation of your condition - not just radiology, but their clinical findings, your reactions to certain treatments, modalities, meds, etc

    Regardless of what your scan shows, you still need to treat your symptoms and continue the diagnostic puzzle. From my experience, you should try everything under the sun before you consider surgery. Not sure if you've already had back surgery, but I promise you, once they cut you will never be the same again.

    May I ask what kind of treatments you have tried aside from physio? One of the things you will read a lot on this site is that your treatment plan is a puzzle and there are any pieces that need to fit together. The right combination of physical therapy, manual therapies, electronic modalities, injections, medications, and the good old home remedies (ie: ice, heat, diet, etc). Like I said, finding the right combo will not only help your pain (hopefully) but can also act as a powerful diagnostic tool for your doc - in addition to the radiology which is only one piece of it.

    Sorry for the epic post, but I hope you feel a little better to know that you are not alone. Feel free to PM me if you want to discuss further.

    Good luck. Marni
  • jlrfryejjlrfrye ohioPosts: 1,110
    Mt mri of the lower spine came back just as yours. I could not even stand up! My PCP sent me to a neuro surgeon just to have him take a look. He saw my films and told me that my disc had herniated inwards instead of out. Not a word of that was on my MRI. So I was scheduled for surgery. If it would make you feel better ask to have someone else read your films. Maybe something was missed.
  • jlrfryejjlrfrye ohioPosts: 1,110
    edited 09/06/2012 - 3:41 PM
    Not a clue. Lol. All I can tell you is my surgeon said my disc herniated in a very peculiar and unusual way, he says it herniated inwards instead of out.
  • kamgramkkamgram Posts: 483
    edited 09/06/2012 - 6:17 PM
    Hi CM, I am so sorry you are having so much pain and not getting the answers you need. I also had mid back pain that wrapped abound left rib cage and upper left abdominal region. I first thought I was having heart problems but all tests were normal and with my past issues with lower back pain my GP did an x-ray and was concerned enough to send to NS who sent me for MRI which did show herniation at T7-8 which compressed the spinal cord.

    I only say this because even though problems looked bad on MRI, x-ray and CT scan once he got in he damage was much worse with tendon wrapped around spine which had to be moved and along with nerves and muscles cut and moved the recovery has stalled. I had to fight for NS to do another MRI which showed herniation at Cervical and lumbar levels which will have to be addressed next.

    Reason I mention this is so that you don't just take their word that this is all that is wrong. You know your body and the pain you suffer. Keep after them and be the "squeaky wheel" as my husband says...it always gets the grease:)

  • The nervous system is very complex. As far as I know, a small fissure on the spine could cause lots of pain, depending on where it's located. Hope you are feeling better.
  • CM said:
    I just don't believe the MRI is giving a full picture of the problem. I don't know what other test to ask my doctor to do.

    Has anyone else had the experience of having an MRI that shows a mild problem (or no problem at all), but then later having some other test that shows a more serious problem?
    I'd have to look up the exact difference between what a MRI and a CT Scan shows, but it seems that a CT Scan might be the next step. Anybody have better info than my vague answer, or an example of a test which showed cause of pain when an MRI did not?
    Take the high road. There's less traffic up there.
  • PinkSh00zPPinkSh00z Posts: 21
    edited 09/13/2012 - 1:10 AM
    Hi. I'm sorry you're in so much pain & aren't getting any answers from your doctors. It is frustrating, to say the least.

    Did you MRI include your neck as well? The arm/scapula issues sound like mine and stem from C5-C6-C7...the C6 nerve is the one that extends through the shoulder down the arm & causes that maddening arm/shoulder nightmare. My disc protrusion is flattening my spinal cord in that area and that's causing my pain/weakness/numbness down the right arm.

    Good luck to you!
    C5-C6-C7, T3-T4-T5: disc protrusions, spinal cord & C6 nerve root involvement, tear at T3-T4
    C6 nerve root injection 10/12/12 and at-home traction
  • I know how you must feel, and im sorry for your pain. What i would suggest is having someone read your MRI film, and depending what is causing your dr not finding much wrong, you might have to go outside of any possible conflict of interest.
    I had suffered tremendously and risked causing more harm, fell and knocked my teeth out, because all the drs i have seen through my employer or workers comp. were paid to not find anything seriously wrong with my spine after my accident. Turned out after 15 years i was suffering with herniated thoracic, lumbar and cervical discs, punctured Dura, compressed spinal cord and myelopathy. You have to make an effort to make sure your MRI is read out correctly. For your piece of mind, to hopefuly ease your suffering. I was told by number of company and workers comp drs. that its nothing or nothing serious or urgent even when i called 911, it was just panic attack and depression, etc. From my horrible experience and suffering till this day i can tell you that some companies and drs will lie and cover up and have no regard what so ever for your suffering. It does not mean that "mild" injury cannot cause all the symptoms, but there should be clear explanation why so much pain. After all the cover up even when my employer and doctors were exposed for torturing me for years they are still taking advantage of the fact that i have no insurance and are trying to tell me its FIBRO, CRPS2, forge and modify my WCAB file and dr reports, and who knows what. It does happen, it happens just to hide extend of your injury and save money, and send you down the road suffering with minimal treatment. My thoracic MRI is "unremarkable" and there are several herniated discs, muscle atrophy, punctured Dura, 10mm of leaked out disc, and untold suffering for years and years because it seemed impossible that all those dr. would lie and cover up and torture. Good luck!
  • The problem is that there is hardly any room in the thoracic spinal canal in the T4 area, so a small bulge can cause severe pain.

    CM what kind of doctor is this? A NS or OS would probably not order pt for the TSpine my guess is that you probably went to see your pcp and he ordered your MRI and is running the classic PT for 6 weeks before referring you to a real specialist. Hopefully the pt will get you a tens unit. I loved mine would still be using it if I could, then get into pain management for some esi's. Mine have helped tremendously lately.

    Also go see a new doctor if you do not think the care you are receiving is adequate. We are looking for new doctor for my daughter (19) since no one can find out what is wrong with her (female issues). Some of the newer doctors are much more open then some of the older docs when it comes to trying new treatments and tests.

    Good luck,

  • JulieAJJulieA Posts: 1,420
    edited 09/15/2012 - 12:34 PM
    anelsen15 said:
    jlrfrye, do you mean a smorls node which herniates up into endplates rather than into spinal cord.
    I bet he herniated antiorly instead of posteriorly. I had some huge ones like that. So with out going into the spinal canal, but completely flattening the disc, crushing the nerve roots....

  • CMCCM Posts: 100
    edited 11/12/2012 - 10:50 AM
    Marni, Susan, anelsen15, Kelli, AndrewESP, Fire_And_Water, Lori, PostACDF, and Julie,

    Thank you all very much for taking the time to reply. I can't explain why, but I did not check my post for replies until today - over two months since I posted my complaint. I'm sorry. I know, I know. I can't explain why I do or don't do a lot of things nowadays. I procrastinate on everything until the very last minute, and sometimes past that. I filed for an extension my income taxes and I still haven't gotten around to completing it! Also, my apartment is close to looking like one of those hoarder's nightmare homes you see on TV. I don't want to pick up or put away anything. I just don't seem to care. I guess it's the medications + pain + depression + daily stress. Anyway, I apologize for not replying sooner. Thank you again for your replies.

    What I suspect is that I have spondylolysis but it isn't showing up in the images. Those images are done while I'm either lying FLAT on my back or sitting straight up. In either case, I am perfectly still. The pain occurs when I bend over or walk or lie on a soft surface, or sit in a chair that doesn't provide good support (my car seat).

    You wrote, "Here's the problem with pain - everyone is different and everyone experiences it differently. Some people have pain receptors that are just more sensitive/heightened so what they feel is more acute." I completely believe that. I must have super-sensitive pain receptors.

    The only treatment I've had is limited physical therapy (limited because I couldn't tolerate it), and medication (gabapentin, tramadol, baclofen.

    One of the doctors I saw told me about those studies you mentioned. He said that the level of pathology shown by an MRIs show does not always correspond to pain level.

    Isn't it amazing that your MRI didn't show your inwardly ruptured disc (by "inward" I assume you mean anterior)? How is that possible? I just don't understand. I have an appointment with a neurosurgeon tomorrow. I am taking all my images on discs, but I doubt he will find anything new.

    Wow, what a mess. I'm sorry you are having such a complicated problem.. At least your MRI showed a real problem, even if it did not show the full extent. The problem with being a "squeaky wheel" is that I think my doctors think I'm a hypochondriac, especially since the MRI doesn't show anything "significant".

    I've had cervical MRIs too. Based on the dermatome maps, though, the symptoms I am having are consistent with a thoracic spine problem. I am about to have another cervical MRI very soon, though, because I have neck problems too. (I've had one cervical lami and two cervical fusions, and I wish I'd never had a fusion at all!) Maybe it will explain part of the problem.

    You wrote, "The nervous system is very complex. As far as I know, a small fissure on the spine could cause lots of pain, depending on where it's located." I believe it!!!

    What happened to you is criminal, IMHO. I hope you have an attorney and are able to successfully sue all those worker comp miscreants for everything they are worth.

    It was a neurologist that ordered the PT. I have seen a neurosurgeon since then, though. Still, no answers.

    Thank you all again.
  • I have had the same problems as you, same underarm and scapula pain for over a year. I have also been diagnosed with Tspine degenerationfrom CT, Xray and MRI scans plus a battery of blood tests. I too doubted the diagnosis given that the most excruitating pain was under my arm and around my scapula. However after a lot of reading and the trial of many different drugs, I have come to the conclusion the results are right and that I have myiofascial pain in addition. The clue was at cortisone helped more than opoids for the extreme pain. I am now on a long term anti inflammatory, Plaquenil and Tramadol at night when lying down makes it particularly painful. Although my whole ribcage feels tight when I lie down, I have found the best sleeping position is on my belly. I am also starting rolling therapy which I can do at home without additional cost.
  • Meryl, I'm sorry to hear that you were diagnosed with disc degeneration and myofascial pain. Did your CT, Xray and MRI scans actually show degeneration?

    As for sleeping position, when my pain first started I could not lay on either side at all. Then after a while I could lay on one side but not the other. Since they increased my Gabapentin, I am usually able to sleep on either side because the medicine helps dull the pain. However, like you, sometimes lying on my stomach helps ease the pain. I've never heard of rolling therapy. I'll have to look that up.

    You said your whole ribcage feels tight when you lie down, but you didn't mention anything about your breathing. Do you ever have the sensation that something is squeezing your chest accompanied by a slight burning feeling? I used to have that symptom whenever my pain back acted up. Sometimes it was so sudden and strong it made me cough, but then it stopped for no apparent reason.
  • Just 18 months ago, I started having radiating pain from between my spine and scapula on my right side -- started shortly after I awoke in the night coughing -- probably swallowed wrong or inhaled a cat hair.. Both a cervical and thoracic MRI at the time showed only mild to moderate protrusion of the C7-T1 disk to the right and mild to moderate protrusion of the T1-2 disc to the left. Over the course of the next 7 months the pain under my right shoulder blade intensified, radiated down the back of my right arm and my ring and pinky fingers started tingling and going numb. After 3 epidural injections in 6 months to try and control the pain, I ended up having the posterior micro-discectomy and foraminotomy at C7-T1 last March. The surgeon was astounded to find when he got in there, that it was the single largest disc herniation he'd ever seen in nearly 30 years of practice!! I can only assume that the condition worsened over those few months?

    Then on the Sunday following this last Thanksgiving (2012) and only 8 months after the other surgery I sneezed three times hard. (Now remember, just 16 months prior, the disc was "mild to moderately" protruding to the left.) Something didn't feel right when I sneezed and the next day I had "muscles spasms." or so the pain felt like, under my left shoulder blade. The next day was worse, the third day I was at the chiropractor's office because I thought I had "a rib out of place." Recognizing that the symptoms were eerily similar to last year, she ordered yet another MRI. Can you believe I blew out an 8-9mm chunk of disc at T1-2? The fragment was migrating to the nerve root and to the spinal cord itself. Within weeks my left leg became weak and I was starting to stumble and fall -- not to mention the HIDEOUS pain I was suffering. I had a two-level discectomy and fusion from C7-T2 on December 23 and am THRILLED to report that I'm recovering quite well and the pain is gone! I was actually one of those patients that, while being aroused in post-op recovery, had "THE PAIN IS GONE!!" as my first thought. (My second thought was, give me some drugs for the operative pain!! Hee hee....)
    I'm not even three weeks post-op and yesterday and today I've gone with NO pain meds -- not even a Tylenol. Right now, life is good!!
    Gotta tell you though, the first onset of pain was after a bad coughing fit, and the second disc blew with a sneeze. I'm scared to death to burp, fart or hiccup knowing that from C4 on down I've got bulging discs!! Gosh darn it!!
  • Hahahaha, you cracked me up and was afraid I would blow out a disc :) I actually did re-herniate 3 weeks after lamenectomy from sneezing so I know what you mean. I am so happy that you are doing well and not experiencing any pain. That is awesome. Gives us all hope :)

  • So, CM, I know exactly what you are going through. In 2004, I had an arthroplasty performed on my L5/S1 (Flexicore by Stryker). My doctor in San Francisco (OS) was awesome. I am technically 50% disabled, but he signed me off as 100% good to go so that I could join the Army as an officer (they laughed at me!). However, around this time last year, I started having some numbness again in both of my legs while I sat. I did my usual acupuncture visits to get well.

    Over the summer it got really bad, way worse than my first rupture. Since then I've been munching Norco tabs like they are candy. I had an exam by the Dr.'s PA and she told me that I needed to wait 5-Years without surgery because there are some awesome treatments coming out. OK...I guess that was the plan. However, after about two months of hell, I decided enough was enough. We did the MRI, oral steroids and then an epidural injection two weeks ago through my tail bone (that was fun, but way better than going through the facet joint).

    I'm running between a 5 and 8 everyday on the pain schedule even when popping Norcos, severe numbness/loss of control in both feet after sitting too long, numbness in my groin, and I crapped my pants once! Today I was told that my disks all look good, the prosthetic is in place and that I need to do 6-weeks of PT, see how I do, then do a diskogram, then ALIF. Basically, I walked away (more like hobbled away) with the feeling all of a sudden, after a 12-year relationship with these folks, that they thought I was full of it and making the whole thing up. I drove 4-hours this morning there and 4-hours home for a 15 minute conversation where the surgeon told me that there was no evidence of anything going on.

    I agree with everyone that has posted that sometimes you need to find a different doctor. I'm looking for a new neurosurgeon next week. I'm also going to be looking for a sitting MRI. Something is going on that isn't coming up when I lay down (I get immediate relief from laying down, duhh!). I'm so frustrated, miserable, and feeling betrayed. Ya, I'm making this whole thing up, missing work from my $115K per year job (now in jeopardy) so that I can stinking lie about being in pain. Give me a break. Thank God for forums like this where we can vent. Keep up the fight and don't let doctors, even those that are world renown, tell you what your body is doing. Trust me, someone out there wants to make the $100k from your surgery if that is what you want. If you don't want surgery, there are also lots of other great things that can be done, like MUA (manipulation under anesthesia, had that 14 years ago and worked great!), DRX9000, acupuncture, or, even smoke some weed if you live in California!

    Good luck brother and thank you everyone for your support to each other; makes a big difference to be in community in times like this :)
    Matt B
  • TdubTTdub Posts: 1
    edited 12/22/2015 - 8:26 AM
    CM, it was as if you wrote your post about my back issues! Mid to upper back burning pain radiating to the front of the body. Difficulty breathing and catching my breath.... Actually had a cardiac cath due to chest pain. Turned out I did have blockage which they fixed - but the chest pain and breathing issues did not go away. Seems to come and go with back pain. Had an MRI done that only shows disc herniations in lumbar spine which are only mildly problematic. T spine is where my pain is. Have you had any luck resolving your issues?

    Please keep in mind, this is a very old thread. Started back in Sept 2012. The original poster is no longer a member here. When you post always check the last update that was made. You are not going to get any feedback from people who have long gone away. Its better to create your own thread, this way it will be active.
    Take a look at Posting to old threads

    -- Ron DiLauro, Spine-Health System Moderator 12/22/15 14:25
  • SavageSavage United StatesPosts: 5,427
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