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Having low back pain extending to buttock after injury. Had MRI. What does it indicate?

DOCTOR OF THE MONTH - Apr 2014
Apr 2014
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I'm having low back pain going down into right buttock sense injury. Had MRI which shows "axial T1 an interval mild central to right subarticular disc protrusion associated with a small annular disc tear/fissure that is slightly indenting the thecal sac". I'm wondering, can be causing my low back pain? I thought T1 was higher. Injury happened in an elevator fell about 6 feet with me and a sudden stop. It's been about a month now and it's not getting better, maybe worse. Please help
Posted Fri, 13 Dec 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Indu Kumar 1 hour later
Brief Answer: Pain is due to traumatic disc prolapse. Detailed Answer: HelloXXXXX Thanks for writing to XXXXXXX Low back pain is due to traumatic disc prolapse that you had from elevator fall. You have mild central to right protrusion of disc with small tear in annulus fibrosis.It is also slightly indenting thecal sac.MRI report didn't mentioned vertebral level of prolapse.It also didn't mentioned about nerve status,whether it is compressing nerve roots or not. From history it seems that there is involvement of nerve,so you have low back pain and sense problems. You should consult neurosurgeon for your problem. Treatment options are physiotherapy and surgery. Now a days,percutaneous endoscopic disectomy is widely done.It is a day care procedure and patient is discharged on same day. You should take rest and avoid lifting heavy objects.Don't abruptly bend forward. You can take Pregabalin capsules for pain relief. Get well soon Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Follow-up: Having low back pain extending to buttock after injury. Had MRI. What does it indicate? 11 hours later
So even though T1 is well above the area that hurts it could be causing the pain? What is Pregabalin? Over the counter or prescription. I've been taking Aleve and it does help some. There was also a mention of: "There may be a mild interval increase in size of a still small 7.5 mm focus of high signal intensity on T1/T2/STIR images in the mid to posterior L2 vertebral body suggestive of a vertebral body hemangioma." My doctor told me this was nothing - do you agree? "This study is somewhat limited. The axial T2 images could not be performed." I got sick (having trouble with closed in spaces sense elevator accident). Sense the problem was found at T1 should I try to go back and try again (try to find an open MRI)?
 
 
Answered by Dr. Indu Kumar 19 hours later
Brief Answer: You should go again.Let the investigation complete Detailed Answer: Hello Thanks for writing back Yes,you are right. Disc prolapse at T1 level doesn't cause low back ache. Low backache is due to problem in lumbar veretebra.You need MRI of L/S spine. If MRI of lumbar spine is alright then other causes of pain should be ruled out. I misinterpreted you earlier because T1 is also used for sequence in MRI. You have claustrophobia(phobia due to closed space) so you can take help from psychologist and counseling can be done. I suggest you to again go for MRI and let the investigation complete. It is very difficult for any one to interpretate from incomplete investigations. Open MRI are inferior in quality of images than closed one. You doctor has rightly said about hemangioma.It is an incidental finding and it can be ignored. Pregabalin capsules are helpful in neuropathic pain so you can take this. It is better than Aleve for you. Pregabalin are sold with doctor's prescription. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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Follow-up: Having low back pain extending to buttock after injury. Had MRI. What does it indicate? 3 hours later
I am seeing counceling (3 days a week) and psychiatrist. Some of my meds were changed this past week from Ativan to Xanax. I really think it's going to help. My memory has been like swiss cheese on the Ativan and I think I'm having fewer physical symptoms from the anxiety with the Xanax. So T1 injury will not be causing low back pain. You say other causes should be ruled out. Can you give me some examples of other causes (please remember this low back pain started only after accident). I have had back aches and pains for years (bulging disks at L4&L5 level that the MRI said there was no change to) but never pain this low. I did get them to X-ray the sacrum (two weeks after the fall) and they said no acute problem. I wish I could show you (or describe to you) exactly where the pain is. I sorry I keep asking questions. I'm just having so many problems with pain and anxiety (I was put in psychiatric hospital for 3 days after accident) sense the accident. Before this I use to help my husband map caves that were miles long, far under ground, now I can't finish a MRI (I started vomiting and couldn't breath in the machine). Do you believe the hospital would ever lie or play down my injuries? The elevator that fell and hurt me is one in this particular hospital, but I do believe it is the best hospital anywhere around.
 
 
Answered by Dr. Indu Kumar 19 hours later
Brief Answer: Pain may be due to low calcium level. Detailed Answer: Hello Thanks for writing back If possible, please send me the reports of MRI L/S pine if you have. You mentioned about bulged disc at L4&L5 level but you didn't mentioned whether it is causing nerve compression or not. Pain is subjective thing and it has many components. Some patients have great pain but little findings are visible in MRI. Pain has psychological component also. Other causes of pain may be low calcium level. Osteopenia is common in ladies. You should estimate your serum calcium and vitamin D3 level. You can also do physiotherapy. Hospital and doctors will not tell lie. You should have faith on those people. Bony fractures are best seen in CT Scan and doctors would have told only after confirmation.So,don't worry about this. Sorry, I don't have idea about hospitals in your place. You can search online. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu Bsushan
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Follow-up: Having low back pain extending to buttock after injury. Had MRI. What does it indicate? 5 hours later
Calcium is good. Vitamin D is low and I'm taking supplement. It's just that this pain started after accident. As I was reading back over (multiple times) your responses I noticed you mentioned I needed a L/S MRI. The one I had was just lumbar: "Noncontrast T1, T2 and STIR sequences of the lumbar spine followed by noncontrast T1 images of the intervetertebral disc spaces from L1-L2 up to L5-S1." "axial T2 images could not be performed" (I started throwing up) I'm just wondering if I should try to get another MRI? What can they see on the L/S MRI that wouldn't be on the one I had? You said that an open MRI was inferior to closed - that stinks. Maybe I could ask doctor for something extra to help with nerves for one time thing. Could my husband sit at end of tunnel and hold my hand or something (this was his idea and I'd like to know if possible). Again sorry so long. Can someone sit at end of tunnel and hold hand or do doctors sometimes give something extra to help with nerves? Can they see something on the MRI you suggested that was not on the one I had?
 
 
Answered by Dr. Indu Kumar 15 hours later
Brief Answer: You need to check thyroid profile also. Detailed Answer: Hello Thanks for writing back You should continue taking vitamin D supplementation. Your thyroid profile also need to be assessed. It can also cause backache . If possible,get MRI of L/S spine done so that all possibilities can be rule out. You can consult your doctor for claustrophobia.MRI after sedation can be tried. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Having low back pain extending to buttock after injury. Had MRI. What does it indicate? 5 hours later
Thyroid level OK - on synthroid. I'm in therapy and seeing psychiatrist sense accident for anxiety. Thanks for all your help. I will ask about getting a L/S MRI and asking for something extra to help with anxiety before procedure.
 
 
Answered by Dr. Indu Kumar 2 hours later
Brief Answer: Welcome Detailed Answer: Hello Thanks for writing back Nice to know that you are taking therapy for your anxiety problem. I am sure it is working for you. You may ask the MRI technologist to make you calm before procedure. It will take only 20 minutes and you can choose to listen to some music to keep your mind busy when getting scan done. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by
 
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