MRI results - help to understand. Bulging discs/hypertrophy management

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Hi, I'm in a complete muddle and wonder if you can help?

I've been having back and leg pain since the end of April. After seeing 4 GP's and a prescribing nurse, I had an MRI scan. Meanwhile I have been on and off work (learning support - secondary school). I have also been to an NHS physio who discovered my sacroiliac joint was out of place and effecting my lower back, she put it back into place. After coming out of place a few times, it is now where it should be and the leg pain is much reduced, so that's great.

Anyway, I got a phone call from my GP with the MRI results, saying I have a bad back (!) and to take Naproxen (I can't because of the anti-depressants I take), so he said to just take the Cocodamol he had prescribed for me previously.

MRI results:

MRI:Spine Lumbar

Normal alignment of the lumbar spine. From L3 to S1, there are mild degenerative changes with bulging of the discs together with mild facet joint hypertrophy with mild facet joint effusion. The conus medullaris and the cauda equina are normal,. A haemangioma is noted in the L3 vertebral body. No nerve root involvement is seen. No foraminal or spinal canal stenosis. No disc hernis. No evidence of nerve root compromise at the other imaged levels.

Conclusion 

Mild degenerative changes are not resulting in nerve root impingement. No disc hernia compressing a nerve root. Mild facet joint effusion from L3 to S1 bilaterally.

The summer came and went (due to physios annual leave I didn't see her all summer) last Tuesday I saw my physio - the first time since I received the results, she said there was nothing she could do about it, but put me on an Advanced back course (6 exercise classes) to strengthen core muscles to help support it. I have to wear supportive shoes with air cushioned soles and suggested the use of a support belt (I bought a Serola belt).

From what I understood (I did start to panic a bit, so didn't absorb all the information she gave me) my lower back is not good. They can't operate on the bulging discs because of the number of them effected. The facet joints have grown a bit of extra bone to help stabilise it (too much heavy lifting in my early 20's injured my back and had to cease the work I was doing - nothing was ever really diagnosed back then, an injection in my lower back by the GP and a course of physio)

My back had improved over the summer holidays, but has got painful again on my return to work (I do a fair bit of walking, standing, sitting and bending over when assisting students sitting at desks) I am now off work again and cannot continue like this.

I'd like help to understand, please, my MRI results and what they mean for the future. Can anything else be done? Is it likely to get worse? How do I manage myself at work as I'm in a different classroom each hour - which positions are best for my back and which should be avoided.

Sorry about the long thread - my head is a shed.

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  • Posted

    Hi Jane

    Unfortunately, I am no expert in interpreting your MRI results, but totally understand your need for this information. I have only had X-rays but they have never been explained to me. In fact, I have never actually seen the X-rays only someone's report on them. I too need to know how to manage my back: whether it will get worse and so on. I have had Cortisone injections, but they haven't worked. All I ever get it now is to be told to exercise my back and take pain relief tablets. I simply cannot believe that in this day and age, with all the modern technology, so many people are allowed to simply suffer on their own like this.  I hope you get the advice you need. I will watch for any posts you may get. Good luck,

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    • Posted

      Thank you Valerie, I forgot, I too had an xray on my pelvis before my MRI as the pain was from my lower back, hip, leg and into my ankle and foot. (thank goodness the physio managed to identify and treat the out of place sacroiliac joint!) but the xray showed up nothing abnormal. I never saw the xray, the only thing I did see was the GP's computer screen saying 'normal'. 

      It is so frustrating. I now feel like I need to get as much information before I return to the GP, so I can almost lead the conversation.

      Good luck with your back too Valerie.

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  • Posted

    I don't know if you could use it but Gabapentin is used for back pain. It is normally used by those suffering epilepsy and “suppresses” the nervous system. I have been using it and I’m sure it has helped. My latest specialist has taken me off Naproxen and Gabapentin as part of his diagnostic process and my back has been worse during this period.

    Those reports can be frightening, so much technical stuff. I have “moderate degenerative changes” in my lower back and neck and I think the good news you can take from this no nerve root impingement, there is no compression of the nerves radiating from the spinal cord. The facet joints are the bone spurs that help stabilise the spinal column and you have some form (injury/age) damage.

    The SI may still be a cause of pain if that hasn’t been “signed off”. There is a wealth of information out there on treatment and causes; if inflammation cannot be treated with Naproxen then ice packs may help.

    I’m guessing that the GP will read the results as just part of the ageing process. Of course, that doesn’t really help us; it doesn’t make the pain away! Posture may help reduce the pain, sitting on one of those big balls, getting the physio to check out your gait when walking etc.

    Hope it helps.

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    • Posted

      Hi Spinworm, 

      Thanks for your comments. I was having a rant/moan the other day and should have commented on my luck that there is no nerve impingement or compression, for this, I am glad.

      I managed to have a good chat on the phone with the physio and she has booked me in to see her this afternoon as I'm off work again. I have also been to see my GP (the fifth one!) this morning and he is trying me on Diazepam for a few days as he says my whole back seems very knotted. He has prescribed me some less strong Co-codamol too (as the full strength ones effected my stomach) and signed me off work for a week while I'm on the Diazepam, for me then to return to work on a phased return. He commended me on all the proactive things I'm doing to aid my recovery and make myself as comfortable (!) as possible (credit too needs to go to my physio for the sound advice). I'm so keen to get back to work though, the last few months I've had too many false starts.

      Changing position at a maximum of every 20 minutes has helped and walking with sturdy, supportive shoes has also helped, so I will continue to do this. My physio sees no reason why I can't improve, but I will need to exercise every day to maintain maximum core strength (first I need to build that up!)

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  • Posted

    Hi Jane 

    Sorry to hear about your back problems. I'm not a proffesional on the subject, but from personal experience ( lower back and leg pain(sciatic like pain) with no obvious structural cause) I may have a lead on the problem. In my case I diagnosed a systemic fungal/yeast infection which was causing many problems ( have a look at my previous discussion Mycotic Artiritis) back pain and gradual damage to the spine and joints, depression, food intolerance, especially wheat and sugar. 

    It may help to relieve the symptoms and give you some indication as to the problem by cutting out all sugars(including fruit) and wheat products from your diet for a period of time and add coconut (perhaps 100g per day, then less so) to your remaining diet (including lots of green veg esp spinach and kale and some lemon juice). If this helps, then it may be good to discuss further with your gp, though, in my experience, there doesn't seem to be an official understanding or treatment of the problem. 

    Best of luck.

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    • Posted

      Hmm that sounds interesting, I shall talk to my physio this afternoon about diet. I initially had blood tests too, which showed a vitamin D deficiency (not enough for the doctor to prescribe for, but advice was to take supplements) This deficiency is odd as I spend a lot of time in the garden and looking after my many chickens and I'm more likely to be told off for not wearing suncream. I have found though, that other aches and pains are greatly improved, so that's a positive.

      Thank you.

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    • Posted

      Hi jane 

      I had some blood test done 2 weeks ago and mine came up as having low vitamin D levels also. Could be a meaningful. 

      Also, I read recently that fungal infections can be aquired through birds. Possibly by breathing dust. Maybe another lead to look into.

      Regards

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  • Posted

    hi jane sorry to hear about your problems your mri results are quite normal we all have bulging discs although at differant levels ive had the same sort of problems and after years of phyiso and back ops i now have to do what gps call pain management which is basicly manage my pain with different pain killers rest and exercise as for the future yes you might need an op then agian you might not but if you can manage your pain then life should be normal hope this helps all the best graham
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    • Posted

      Hi Graham 6214,

      Thanks for your post. I suppose I'm just starting to get support/answers off professionals now. I feel I maybe taking a step in the right direction the last 2-3 days as I'm starting to get constructive support. I feel a bit more empowered. The problem is that because it's such a 'global' area, my physio says they wouldn't be able to operate on the discs.

      Take care

      Jane

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  • Posted

    Hello Jane, I am a little envious of your MRI as it's so nice!!  Mine was a lot worse with considerable nerve root involvement and moderate to severe stenosis.  Glad they found the joint problem and can pop it back in. However, this all takes some getting used to and you need to get over the depression of it - I wasn't clinically depressed but for a while I thought this was curtains to all my plans when I got my diagnosis.  But I now take a little amitriptyline and some gabapentin and this helps with the pain around the house and walking is a bit easier, but you just have to find ways around the rest.  I am seeing a consultant surgeon tomorrow for the first time and expecting to be told I am inoperable too because of the extent of it - I'm not keen for spinal surgery anyway though it may get so bad that....  For the time being it's weight loss for me and living as usual.  I note you talk about antidepressants and you mention your work and it comes across as very hard for you.  I guess you need to clear this problem up as it is something you can do something about and living with it ...well you say you can't continue like this. I'd ask the gp if he reckons you should see someone (I used to be a psychologist and one of my profession might be best) to discuss how your back pain and work interact and what you could do?
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    • Posted

      Hi Rob,

      Sorry my MRI was great in comparison to yours, but I'm in pain nevertheless and have been keen to be proactive, but it's taken the medical profession 4+ months to be able to get any answers to my simple problem. I have sympathy to those - like yourself - who have complex issues.

      How did your consultation with the surgeon go?

      It has taken yet another appointment with the GP this morning and a phone conversation with the physio to get much more constructive support. I have a physio appointment this afternoon to get me started on strengthening my core (the back classes don't start for another 3 weeks). I was complimented on the positive approach I was taking and following the advice I have so far been given. I have however, been struggling to get the right support to enable me to continue to work. It's all very well saying I can do something about it, but finding the correct strategies has been a frustrating long haul.

      It's been frustrating as I want to go to work, work have been asking how they can facilitate this, but I have not had the information and answers to give them - as I say though, I feel like I have made in roads the last few days. The physio said she had been treating my pelvis previously, but will now see me as a new case and concentrate on my back! 

      Happy days and all that

      Jane

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    • Posted

      Hi Jane, Your head doesn't sound like a shed any more! You sound very focussed and more on top of things - congratulations on your assertiveness. I think my involvement with the NHS trumps yours time wise, but only just; the waiting seems to go on forever, and in the initial stages I didn't feel believed. However, I have to admit, rather grudgingly, that though the media scream about how the service is always in crisis, it seems to do a good job by very ill people, and with 'lifestyle' issues like crumbling spines, though it takes longer, it does a good job there too, eventually. Thanks for asking - the surgeon I saw was very brisk and businesslike and offered me some surgery, with a good chance of success and he said my problem wasn't too bad, and showed me the mri on his screen; this is the positive upside of the nhs, that I feel one can trust the chaps in it as they don't gain personally from individual patients. I have a long wait for the knife but am quite happy about that. I hope your problems resolve too; so much of this is in the mind, I find.  Regards, Rob
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  • Posted

    It sounds from the mri that a slight spinal degeneration may be leading to trapped nerves in the spinal column causing the pain.  The physio work will have aligned any obvious problems such as your sacrum.  Have you thought about some alexander technique lessons to align your back in everyday movement (at work for example).  These are usually taught privately and a teacher can be found through online searches. Otherwise the physio sounds a good bet to stick with.

    Richard

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