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MRI question

Quick question since my doctors don't seem to be full of useful information lately....

My MRI shows a moderate disk bulge at L5-S1 with no nerve impingement, however I have had had some pretty bad nerve pain in my leg and my EMG does show nerve damage to the L5-S1 nerve. Does this mean that the MRI May not be telling the whole story? My surgeon would like to do a discogram to see if I'm a candidate for surgery but I'm terrified because I've heard they're very painful.

Thanks everyone!


  • The MRI is a snapshot of a moment in time........and it may be that due to positioning, etc, that the bulge is not in contact with the nerve at the time that the image is taken...., but it is a bit strange to want to order a discogram for a bulge or herniation ( two different things) , with no sign of a annular tear or leaking of disc material on the images.
  • The nerve pain shows up a few different ways. I'm the beginning it was in my foot and ankle, it ran up the back of my ankle and into my calf. I thought I had injured my achilles tendon and it was only after an injection for my back that we identified that as nerve pain from my back. Over the last two years that pain has continued (goes away with ESI) but is now also in my heel sometimes it feels almost like I've stepped on a nail. And then I have a general aching pain through the back of my leg as well as weakness that is best characterized as my leg just feeling tired all the time.

    As for the discogram, both my surgeon and the PM doc made it sound like the only way it could be determined if I was a candidate for surgery would be if I had a positive discogram. That's why I'm so nervous.....I'm clearly in a lot of pain but my imaging doesn't seem to correlate with my pain levels.
  • sandisandi Posts: 6,342
    edited 06/03/2014 - 2:48 AM
    Nerve pain is usually described as stinging, burning, electric ,zaps, numbness, or tingling........is it possible that you might have a bone spur in your heel? Have you tried any of the neuropathic medications like Lyrica, Cymbalta, or gabapentin to see if that helps? Or topamax since you said that you also get migraines? Any of those medications might help if it is nerve pain.
    Has anyone suggested or discussed an annular tear? Usually that , if found on imaging is the basis behind requesting a discogram....The annulus is the fibrous covering on the disc, and if there were a tear, that might be the basis for the test, but if not, then it is a bit unusual for them to order that particular test for a bulge. It won't show if it is impinging the nerve......a myelogram might.
  • I have had bothnumbness/tingling and electrical type pain in the past but ESI has controlled that. The pain in my foot felt almost like my tendons were tearing. All of my doctors have agreed that my symptoms were/are nerve related. I take topamax for my head but I'm not sure it's helping with my leg/foot quite yet.

    The surgeon said the the discogram would help determine if there was a tear. Right now I'm putting that off and having medial branch blocks to see if I'm a candidate for RFA. I'm really scared of back surgery.
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