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MRI negative advice on what to do now

Tiggerr888TTiggerr888 Posts: 7
Hello everyone. I'm a new member and am looking for any advice I can get. What has led me up to asking here is my right leg pain. About a year ago I started having pain in my right buttock towards the top of it. I went and saw my doctors PA and she diagnosed it as SI joint pain after making me stand, pushing on it, moving my leg around, and me describing the pain. She started me on an anti-inflammatory and oral steroids. Back then the pain was just annoying, but with the medications in a week I was pain free. About two months later it started hurting again so she put me on the same medications and again it cleared up right away.
Then February of this year I was unloading some glass soda case bottles from a truck up onto this platform then lifting them to carry inside. That night my leg and buttock started again worse than before. This pain starts at the top of my right buttock and travels down to my ankle on bad days. The best way to describe it is it feels like someone takes a knife that they've heated up, stabs it into my buttock, then slices down the back of my thigh and calf and ends either at my ankle or my foot. When the pain is really bad I have trouble getting my leg to do what I want it to (like lifting my foot off the gas when I'm driving). I went and saw my doctor two days after lifting the boxes. He did the pushing on it, moving it around, checked my reflexes (which are poor in my right leg compared to my left), and having me describe the pain. The pain was so bad I was in tears by the time he stopped moving my leg around and pushing around my SI joint. He decided it was my SI joint and said I needed an injection into it. My doctor doesn't believe in using guidance with the injection he just pushes until the spot I say hurts the most and injects it there. I've ended up having three shots into my SI joint, but haven't really noticed any improvement. For three months I got around on crutches because putting any weight on my leg made the pain worse. My leg finally started to feel a little better (enough to put weight on it) back in August. Walking long distances, standing for long periods, sitting in the same position, bending, lifting, and stairs all made it flare up so I tried to avoid things that made it worse. When the pain was bad I still had trouble controlling it so I didn't drive for fear of causing an accident.
About a month ago the pain started to get really really bad again. I went in for another SI injection, but didn't get any relief. My pain is the same down my buttock to my foot, but is becoming more intense. Even riding in a car when it's bumpy is excruciating. Now just moving the wrong way about brings me to my knees. The sad thing is the pain is that bad with 3 loratabs, 2 muscle relaxers, and two naproxen a day in my system. Last week my doctor decided that it would be a good idea to have an MRI of my lumbar spine done. I was really hoping that it would show what was causing all of this pain because I want my life back. I'd been let go from my job because of being on crutches so I had to pay for the MRI out of my own pocket without insurance (just told that to show how much I really want to find out what's causing the pain and how to fix it). So I had the open MRI done with no contrast last week. They had me laying on my back with my feet elevated about four inches up with a pillow under them. Laying in that position was hard because it was making the pain worse. However, today I got the MRI results and they didn't find anything wrong.
I'm sorry that this is so long, but I wanted to explain the pain, the findings, my medications, the MRI, and the shots. I'm kind of at a loss on where to go from here. I've only been seeing my general family doctor about this and not a specialist. My question is is should I go to a specialist? If so what kind of specialist might be able to help me? Or do I need a chiropractor? Since the MRI came back as my lumbar spine being fine what does that mean? Does it mean for sure that there's no nerve problems? Are there other tests that might be able to show what's causing this? Could they have missed something on the MRI? I have a copy of the MRI and watched videos on how to read them, but they are so complicated that I couldn't tell if it looked normal or not normal.
If anyone would be kind enough to answer my questions and give advice I would be so unbelievably grateful. I just want to figure out what is going on so that I can take steps to fix it. I want my normal life back. I feel like I should be to young, I'm 36, to be dealing with this. The thoughts even crossed my mind that I'd look good with a peg leg and that they should just cut this leg off if it might stop it from hurting. Thank you to everyone who has taken the time to read this and for any advice.


  • then imaging the lumbar spine isn't going to show the SI joints.......... An MRI of the lumbar spine only shows the lumbar spine, not the SI joints themselves.
    What kind of doctor are you seeing for this pain? Is it your GP ? If so , you may want to see a spine surgeon for consultation and proper diagnosis.



  • Sandi thank you so much for your quick reply. I think my doctor wanted the MRI because he thought with the pain traveling all the way down my leg that it couldn't be from my SI joint. At least the last time I saw him he told me that if it was my SI joint it should only hurt in my buttock and wouldn't travel all the way down my leg. He hadn't told me that on any of the visits before that one though. He is just my GP so I'm thinking that I'll look for a spine surgeon in my area. Is that the best doctor to see for leg pain? Thank you so much for all the links you provided. I'll be reading everything I can on those links and this website :)
  • Tiggerr888TTiggerr888 Posts: 7
    edited 10/29/2014 - 3:48 PM
    I was also wondering if someone could explain in laymans terms Something that was on my mri report.
    "L4-5 shows some minimal flattening of the thecal sac with mild ligamentous and facet hypertrophic changes, but no central, foraminal or lateral recess stenosis is present at this level"
    Can someone give me an idea what this means or somewhere I can read what this means? Thank you in advance

    Moderator Comments

    No one is permitted to provide any information on any medical testing/imaging reports. It is a violation of the forum rules to ASK for, or to Provide information regarding any medical testing.
    Post edited by Sandi- It is a violation of Spine-Health's forum rules to ask for, and to provide analysis, or interpretation of medical tests.
    You agree not to ask for any analysis or interpretation of diagnostic tests (ie MRI, CTScans, EMG, etc.),
    You agree not to respond to any request for analysis of diagnostic tests (ie MRI, CTScans, EMG, etc.)

  • Hi. I know it's all very confusing. There are a few different things that can cause your pain. As Sandi said, they didn't look at your SI. Firstly, I have whole leg pain from my SI joint. I know this because I have had diagnostic shots into my SI joint. It took well over an hour for the specialist to get the needles into the correct position WITH imaging! I know my SI joint is a wreck (I suffer with a lot of bone spurs) but I wouldn't trust anyone to get a needle in there without imaging. It sounds like he's doing trigger point injections (search at the top of the page). That's how mine are done.
    To properly diagnose SI joint problems a SPECIALISTS should inject, with GUIDANCE, a diagnostic numbing agent (it completely takes away a certain pain I have but it wears off after a few hours) if it works they inject steroids & hope that reducing the inflammation will help.
    Trigger point injections will numb the muscles that are spasming around there. Reducing pain. I have muscle spasms & they really hurt. I feel a relief from the injections.

    Just to complicate things... My husband suffers from Piriformis syndrome. It's the muscle that touches the sciatic nerve playing-up. It feels exactly like sciatica! & steroid injections help him!

    You've had an MRI which you say rules out sciatica from your lumbar. I think it's way past time to see a spine specialist & get some proper diagnosis & treatment. So far your diagnostics have ruled things out. That information is as important as tests that show things, not a waste of money. A lot to do with spines is trial & error.

    Even though you know you don't have lumbar damage I'd still not go to a chiropractor & wouldn't let anyone do adjustments on me until a board certified spine surgeon tells me he recommends the treatment. Chiropractors are NOT spine specialists. They don't have the training & in some circumstances can cause permanent damage.

    Id want to see an Ortho (bone) probably but I'm very happy with my Neuro (nerves) at the moment. I know people very happy with both types of spine surgeon. Mostly, they don't do surgery. It's more to make sure it's not a surgery emergency so it can be treated with conservative things. Mine then referred me to other specialists for therapies & treatments. I have a Pain Management Doc who co-ordinates everything for me & writes prescriptions.
    They should want to test your SI joint to confirm if the pain comes from there.

    Osteoarthritis & DDD.
  • First I want to apologize about asking about the mri wording. I thought that I couldn't ask someone to look at my mri pictures. I do apologize for not reading the rules carefully.
    Second thank you so much for the advice and sharing your knowledge with me. I asked my doctor when he did my first si injection about that I had read that most doctors use a machine for guidance. My doctor is nice, but older (in his 70's) and set in his ways. His response was that if a doctor can't locate the si joint without a fancy machine they shouldn't be a doctor. I guess I didn't really want to argue because by then I would have done anything for the pain to stop. I'll definitely be finding a specialist in my area now. Hopefully they'll be able to figure this out so I can't get back top a semi normal life again
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 11/01/2014 - 5:42 PM
    Ugh! I'm glad your doc didn't try to do nerve blocks or burning on your facet joints to sort them out without guidance! Good luck with a specialist!! ;-)
    Osteoarthritis & DDD.
  • Definitely time to see a spine specialist, a neurosurgeon would be my choice. I'm not really sure what you could be experiencing, but it is way beyond a GP scope. I'm actually surprised that as a GP he was injecting near your joints. I've had the piriformis syndrome, very horrible.
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