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What Does My MRI Scan Result Of Lumbar Spine Indicate?
Question: I was having chronic pains since almost 6 years in the groin area and in my left testicle. Until recently I thought my symptoms can be related to urology. Except to one urologist in the past, who said once I have chronic pelvic and pudendal nerve entrapment symptoms. Recently, I had an MRI scan of lumbar spine done and according to the report of radiology it seems I have herniated disc (L4-5, LS-S1)! I have the CD and the report in my hands. If you wish I can share with you the images CD. Now I am wondering, if the herniated disc can trigger my chronic pains in the suggested area? It gives me a new hope that I finally found the origin of my pains!? I feel the pains as burning sensation mostly in the left testicle and some times on the tip of my penis. I have to urinate 2 times at the night and some nights my penis is erected without stimulation or anything. I would appreciate the answers of the specialists in this subject. Thank you in advance.
Brief Answer:
Central disc herniation at L4-L5, L5-S1 can simulate pudendal neuralgia.
Detailed Answer:
Hi XXXX,
Thanks for being here on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist to answer your query here.
Rightly said by the urologist you consulted that your symptoms of chronic pain in left testicle,tip of penis and groin area along with the bladder problems (night time erections can be physiological also), can be manifestation of Pudendal neuralgia. However,with your MRI spine showing L4-L5 and L5-S1 disc herniation inclines the possibility of disc herniation as a cause of your symptoms rather than pudendal entrapment. Central disc herniation at L4-L5 and L5-S1 levels can compress many of the nerve roots running past that level including S2, S3 and S4 which combine to form pudendal nerve, thus causing the symptoms simulating pudendal nerve entrapment. ,this can very well be a cause of your symptoms. However, if disc herniation at the said levels is posterolateral rather than central, then it is unlikely to cause these symptoms as in that case S2, S3 and S4 nerve roots will not be compressed by it.
Please upload your MRI CD, and I shall be able to guide you further well. Wish you good health.
Dr.Ajay Panwar,
MD,DM(Neurology)
Central disc herniation at L4-L5, L5-S1 can simulate pudendal neuralgia.
Detailed Answer:
Hi XXXX,
Thanks for being here on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist to answer your query here.
Rightly said by the urologist you consulted that your symptoms of chronic pain in left testicle,tip of penis and groin area along with the bladder problems (night time erections can be physiological also), can be manifestation of Pudendal neuralgia. However,with your MRI spine showing L4-L5 and L5-S1 disc herniation inclines the possibility of disc herniation as a cause of your symptoms rather than pudendal entrapment. Central disc herniation at L4-L5 and L5-S1 levels can compress many of the nerve roots running past that level including S2, S3 and S4 which combine to form pudendal nerve, thus causing the symptoms simulating pudendal nerve entrapment. ,this can very well be a cause of your symptoms. However, if disc herniation at the said levels is posterolateral rather than central, then it is unlikely to cause these symptoms as in that case S2, S3 and S4 nerve roots will not be compressed by it.
Please upload your MRI CD, and I shall be able to guide you further well. Wish you good health.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi XXXXXXX
Thank you for your detailed answer. I appreciate it very much. I tried to upload MRI CD to this website but without success. This file is 48 MB. Is there a limit of size, which can be uploaded to this website? If it is so, I can share this file via Google Drive with you but I need your email address do this. Please advise how to proceed further. Thank you.
Regards,
XXXX
Thank you for your detailed answer. I appreciate it very much. I tried to upload MRI CD to this website but without success. This file is 48 MB. Is there a limit of size, which can be uploaded to this website? If it is so, I can share this file via Google Drive with you but I need your email address do this. Please advise how to proceed further. Thank you.
Regards,
XXXX
Brief Answer:
You can upload it on Google Drive.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and you are welcome for the day.
I remember one of the patients who uploaded the MRI CD on Google drive and shared the google drive link here itself in the follow-up query. I think you can do the same.
Please upload it and share the 'google drive' link in follow-up query.
Good Bye.
Dr.Ajay Panwar,
MD,DM(Neurology)
You can upload it on Google Drive.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and you are welcome for the day.
I remember one of the patients who uploaded the MRI CD on Google drive and shared the google drive link here itself in the follow-up query. I think you can do the same.
Please upload it and share the 'google drive' link in follow-up query.
Good Bye.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hi XXXXXXX
I am sharing the link of Google Drive below. I hope it will work.
https://drive.google.com/file/d/YYYY/view?usp=sharing
Please advise me if you face any problem. Thank you.
Regards,
XXXX
I am sharing the link of Google Drive below. I hope it will work.
https://drive.google.com/file/d/YYYY/view?usp=sharing
Please advise me if you face any problem. Thank you.
Regards,
XXXX
Brief Answer:
L4-L5 and L5-S1 central disc herniation is causing your symptoms.
Detailed Answer:
Hi XXXX,
Thanks for the follow-up.
Your MRI quality was really great. I could play the CD without any difficulty. You are having 'Central disc herniation' at L4-L5 and L5-S1 levels, which as I discussed above, very well explain all your symptoms.
With one obvious cause, we don't consider the possibility of any peripheral pudendal entrapment now.
Management points-
1) Bed rest in intial 2-3 days of the symptoms(You are out of that period, so not needed in your case).
2) Physiotherapy - Meet a physiotherapist so that he can teach you 'McKenzie back stretches' and other relevant spinal stabilization exercises. Some exercises must be avoided are - weight bearing, games like hockey, soccer and cricket.
3) Medicines - Non steroidal anti-inflammatory drugs(NSAIDS) like Ibuprofen, Naproxen will help reduce inflammation. Short course of oral steroids may be of help in case of severe symptoms. Anti-neuralgics like amitriptyline, Duloxetine and Pregabalin may help.(PLEASE TAKE MEDICINES ONLY UNDER THE SUPERVISION OF YOUR PHYSICIAN OR NEUROLOGIST).
4) If your symptoms do not improve, or worsens within 6 weeks of following the above management plan, you need to consult a Spine surgeon.
Hope I have answered your query. If you still have follow up questions, I shall be glad to answer them else, you can close the thread, please rate it and write a review.
If you ever want to send me a direct query, you can do it at my HCM link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Wish you good health.
Dr.Ajay Panwar,
MD,DM(Neurology)
L4-L5 and L5-S1 central disc herniation is causing your symptoms.
Detailed Answer:
Hi XXXX,
Thanks for the follow-up.
Your MRI quality was really great. I could play the CD without any difficulty. You are having 'Central disc herniation' at L4-L5 and L5-S1 levels, which as I discussed above, very well explain all your symptoms.
With one obvious cause, we don't consider the possibility of any peripheral pudendal entrapment now.
Management points-
1) Bed rest in intial 2-3 days of the symptoms(You are out of that period, so not needed in your case).
2) Physiotherapy - Meet a physiotherapist so that he can teach you 'McKenzie back stretches' and other relevant spinal stabilization exercises. Some exercises must be avoided are - weight bearing, games like hockey, soccer and cricket.
3) Medicines - Non steroidal anti-inflammatory drugs(NSAIDS) like Ibuprofen, Naproxen will help reduce inflammation. Short course of oral steroids may be of help in case of severe symptoms. Anti-neuralgics like amitriptyline, Duloxetine and Pregabalin may help.(PLEASE TAKE MEDICINES ONLY UNDER THE SUPERVISION OF YOUR PHYSICIAN OR NEUROLOGIST).
4) If your symptoms do not improve, or worsens within 6 weeks of following the above management plan, you need to consult a Spine surgeon.
Hope I have answered your query. If you still have follow up questions, I shall be glad to answer them else, you can close the thread, please rate it and write a review.
If you ever want to send me a direct query, you can do it at my HCM link-
http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273
Wish you good health.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear XXXXXXX
Thank you for your comments and suggestions. I hope we found out the real causes of my chronic pains after many years... I will follow your suggestions and consult a physio therapist here . I shall inform you about the devolepments. Thank you for your help again. You are great.
Happy new year to you!
Regards,
XXXX
Thank you for your comments and suggestions. I hope we found out the real causes of my chronic pains after many years... I will follow your suggestions and consult a physio therapist here . I shall inform you about the devolepments. Thank you for your help again. You are great.
Happy new year to you!
Regards,
XXXX
Brief Answer:
Thanks a lot for appreciation.
Detailed Answer:
Hi XXXX,
Thanks for the follow-up and a lot of heartiest appreciation.Even,I shall be curious to know about how you carry on in future.'Merry Christmas' and 'Happy New Year'.
Wish you good health.
Please close the thread,rate it and write a review if you have no further questions.
Dr.Ajay Panwar,
MD,DM(Neurology)
Thanks a lot for appreciation.
Detailed Answer:
Hi XXXX,
Thanks for the follow-up and a lot of heartiest appreciation.Even,I shall be curious to know about how you carry on in future.'Merry Christmas' and 'Happy New Year'.
Wish you good health.
Please close the thread,rate it and write a review if you have no further questions.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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