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What Does My MRI Scan Test Report Indicate?
Question: Hi Doctor,
Brief Background :
- Had a minor disc bulge diagnosed in Jan'15 via aan MRI. Been to orthopaedics and physiotherapist for 3 months since then taking anti infammatory, nerve b12 supplements, IFT, ultrasonic and isometric excersise until march. The symptoms in Jan'15 were mainly sharp shooting pain in lower back left region. That persisted for a month or so. During the same time, I had an abcess come up just above te lower back near l3-4 region which subsided after about 3 weeks. The time of FEB-APRIL 15 , My symptoms of localised back pain abated, while heavines/tightness and partial numbness in right thigh/knee and foot persisted. From april 15 until may mid, I was fully into physiotherapy, where my doc was keen on mobilizing the spine and increase flexiblity and reduce protective spams. Around may second week, I was feeling quite good, with tightness and numbness reduced quite a bit and flexibility improved. But since mid of may, one sudden night, i had a really bad tingling on both my feet ( right > left ) , back/beaneath and front of foot. From then on till now, I experience this contstant sensation in my feets . The sensation takes forms like - vibration/static elec/very slight burning/ver slight chillness/creepy and ant crawling/puff of air blown, etc .. The pattern i have observed is that morning till evening its moderate to less ( varying between more and less ) . While from evening to night, The sensation gains in intensity. My physiotherapis is unable to exactly locate the region of nerve compression which is cauing the irriation and hence the sensations. The buszzing in feet is quite constatn throught the day ,very mild to very bad in a given day. This has been this way for about 15 days now. He has stopped all mobility stretches nad i am just doing lower back tension release stretches which mainly involves tuck in core muscles and tightening buttocks. The tingling is mostly ankle or below. Wen the tingling is high, I can even feel some mild tingling in thigh and back ( THis occuring during evening and onwards )
Please help me find out whats going on with my body. Where could the nerve compression be .. What is the severity of this ? I have plans of going abroad to US for MS studies in another month or so. Should i be taking this big gamble with my back in this condition ?? I am quite tensed everyday and my mind keeps thinking about the nerve irritaion. PLease help me deal with this. Is there a probability of disc gone bad. Or is it just a matter of right stretches to relieve the inner muscles tightness and decompress the nerve?? Should i be too worried here. Plase let me know if you need any other info to help your analsis/diagnosis.
Brief Background :
- Had a minor disc bulge diagnosed in Jan'15 via aan MRI. Been to orthopaedics and physiotherapist for 3 months since then taking anti infammatory, nerve b12 supplements, IFT, ultrasonic and isometric excersise until march. The symptoms in Jan'15 were mainly sharp shooting pain in lower back left region. That persisted for a month or so. During the same time, I had an abcess come up just above te lower back near l3-4 region which subsided after about 3 weeks. The time of FEB-APRIL 15 , My symptoms of localised back pain abated, while heavines/tightness and partial numbness in right thigh/knee and foot persisted. From april 15 until may mid, I was fully into physiotherapy, where my doc was keen on mobilizing the spine and increase flexiblity and reduce protective spams. Around may second week, I was feeling quite good, with tightness and numbness reduced quite a bit and flexibility improved. But since mid of may, one sudden night, i had a really bad tingling on both my feet ( right > left ) , back/beaneath and front of foot. From then on till now, I experience this contstant sensation in my feets . The sensation takes forms like - vibration/static elec/very slight burning/ver slight chillness/creepy and ant crawling/puff of air blown, etc .. The pattern i have observed is that morning till evening its moderate to less ( varying between more and less ) . While from evening to night, The sensation gains in intensity. My physiotherapis is unable to exactly locate the region of nerve compression which is cauing the irriation and hence the sensations. The buszzing in feet is quite constatn throught the day ,very mild to very bad in a given day. This has been this way for about 15 days now. He has stopped all mobility stretches nad i am just doing lower back tension release stretches which mainly involves tuck in core muscles and tightening buttocks. The tingling is mostly ankle or below. Wen the tingling is high, I can even feel some mild tingling in thigh and back ( THis occuring during evening and onwards )
Please help me find out whats going on with my body. Where could the nerve compression be .. What is the severity of this ? I have plans of going abroad to US for MS studies in another month or so. Should i be taking this big gamble with my back in this condition ?? I am quite tensed everyday and my mind keeps thinking about the nerve irritaion. PLease help me deal with this. Is there a probability of disc gone bad. Or is it just a matter of right stretches to relieve the inner muscles tightness and decompress the nerve?? Should i be too worried here. Plase let me know if you need any other info to help your analsis/diagnosis.
Brief Answer:
possibility of increased disc herniation
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns. According to me you may be having lumbosacral radiculopathy caused by compression due to disc prolapse.
As initially you were having lesser symptoms and further improvements with physiotherapy but now possible there is deterioration in your condition. One possibility may be increased disc bulging.
Now the approach is to again go for Mri lumbosacral spine to see for lumbar canal stenosis as symptoms are bilateral increasing on prolonged standing or walking.
Physiotherapy has to be continued with bed rest.
Surgical decision is made on imaging findings, pain severity and duration, plus presence of neuro deficit.
You can continue pain modulator drugs like amitryptiline or pregabalin or gabapentin with muscle relaxant.
Hope you found the answer helpful. Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
possibility of increased disc herniation
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns. According to me you may be having lumbosacral radiculopathy caused by compression due to disc prolapse.
As initially you were having lesser symptoms and further improvements with physiotherapy but now possible there is deterioration in your condition. One possibility may be increased disc bulging.
Now the approach is to again go for Mri lumbosacral spine to see for lumbar canal stenosis as symptoms are bilateral increasing on prolonged standing or walking.
Physiotherapy has to be continued with bed rest.
Surgical decision is made on imaging findings, pain severity and duration, plus presence of neuro deficit.
You can continue pain modulator drugs like amitryptiline or pregabalin or gabapentin with muscle relaxant.
Hope you found the answer helpful. Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Shanthi.E
Is it highly recommended that i take oral drugs which you mentioned above ?? Or i can still do away with that ? .. Do those just target pain block ? Or do they help reduce the source causing the symptoms as wel ??
Do you strongly suggest an MRI scan to be done at this stage ???
Is there a possiblity of any deficiences which might be causing symptoms ??
Do you strongly suggest an MRI scan to be done at this stage ???
Is there a possiblity of any deficiences which might be causing symptoms ??
Brief Answer:
consult neurologist and get examined again
Detailed Answer:
Hello XXXX,
I will advise you to consult your neurologist or neurosurgeon who can examine you properly and look for any neurodeficit like weakness, sensory loss or loss of ankle reflex.
Repeat Mri may be required in presence of objective or subjective neurodeficit.
Drugs are pain modulator which decreases perception of pain and improves some nerve degeneration but the prolapsed disc is not reverted by drugs. In some cases physiotherapy and posture Care may lead to spontaneous disc regression.
Hope you recover early.
Wishing you good health
Regards
Dr Neeraj Kumar
Neurologist
consult neurologist and get examined again
Detailed Answer:
Hello XXXX,
I will advise you to consult your neurologist or neurosurgeon who can examine you properly and look for any neurodeficit like weakness, sensory loss or loss of ankle reflex.
Repeat Mri may be required in presence of objective or subjective neurodeficit.
Drugs are pain modulator which decreases perception of pain and improves some nerve degeneration but the prolapsed disc is not reverted by drugs. In some cases physiotherapy and posture Care may lead to spontaneous disc regression.
Hope you recover early.
Wishing you good health
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi doctor,
Any idea whether which expert neurologist I can visit in Apollo/fortis/ XXXXXXX hospitals .. bannerghatta road XXXXXXX who can help.me with my specific condition .. Its better to see an experience doctor rather than any generic one .. I fear that less experienced ones will Unnecessarily ask for MRI , surgery and increase my fear levels .. Any way through your network you can identify an expert doctor in these hospitals who can soecifically help me ..
Any idea whether which expert neurologist I can visit in Apollo/fortis/ XXXXXXX hospitals .. bannerghatta road XXXXXXX who can help.me with my specific condition .. Its better to see an experience doctor rather than any generic one .. I fear that less experienced ones will Unnecessarily ask for MRI , surgery and increase my fear levels .. Any way through your network you can identify an expert doctor in these hospitals who can soecifically help me ..
Brief Answer:
consult in Apollo or NIMHANS
Detailed Answer:
Hello XXXX,
You can consult in Apollo as they have many neurologist and neurosurgeon opinion may also be sought under same roof.
Decision of Mri depends upon clinical condition.
Consult with all your previous records, Mri films.
In government set up NIMHANS is another option dedicated to neurology and of world standard.
You can take a second opinion there also.
Hope you recover early.
Wishing you good health
Regards
Dr Neeraj Kumar
Neurologist
consult in Apollo or NIMHANS
Detailed Answer:
Hello XXXX,
You can consult in Apollo as they have many neurologist and neurosurgeon opinion may also be sought under same roof.
Decision of Mri depends upon clinical condition.
Consult with all your previous records, Mri films.
In government set up NIMHANS is another option dedicated to neurology and of world standard.
You can take a second opinion there also.
Hope you recover early.
Wishing you good health
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doctor,
I had visited a neurosurgeon in Forits. It was a pretty bad experience to say the least. He was hellbent on telling only one thing - "Surgery, complication, blah blah". He didnt do anything but create more fear. His examination was just checking whether i could lift the toes and foot.
Anways, I have decided to go for a repeat MRI for effective treatment. I have one basic doubt.
Does doing exercise and backbends just before MRI ( say tonight, and then MRI tomorrow morning ) affect and influence the MRI results ?? Does any kind of physio exercises done before MRI ( previous day ) positively/negatively affect the MRI results ?? Should i stop the exercises just for today until MRI is done ??
I had visited a neurosurgeon in Forits. It was a pretty bad experience to say the least. He was hellbent on telling only one thing - "Surgery, complication, blah blah". He didnt do anything but create more fear. His examination was just checking whether i could lift the toes and foot.
Anways, I have decided to go for a repeat MRI for effective treatment. I have one basic doubt.
Does doing exercise and backbends just before MRI ( say tonight, and then MRI tomorrow morning ) affect and influence the MRI results ?? Does any kind of physio exercises done before MRI ( previous day ) positively/negatively affect the MRI results ?? Should i stop the exercises just for today until MRI is done ??
Brief Answer:
exercise can be continued, surgery not required in all cases
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
See surgical decision is based on
1) motor weakness (as checked by neurosurgeon in fortis by foot and toe power examination),
2) sensory loss in the distribution of nerve
3) reflex loss (checked by hammer used by doctor)
4) bladder bowel involvement
5) excessive unresponsive pain to medication.
Repeating Mri may or may not show any progression.
Exercise don't lead to major changes in such a short time and should be continued if improvement is visible.
Hope all your concerns are addressed adequately.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
exercise can be continued, surgery not required in all cases
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
See surgical decision is based on
1) motor weakness (as checked by neurosurgeon in fortis by foot and toe power examination),
2) sensory loss in the distribution of nerve
3) reflex loss (checked by hammer used by doctor)
4) bladder bowel involvement
5) excessive unresponsive pain to medication.
Repeating Mri may or may not show any progression.
Exercise don't lead to major changes in such a short time and should be continued if improvement is visible.
Hope all your concerns are addressed adequately.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi doc ..
Attaching the MRI report .. And some fought cam taken film pics
Hi Doctor, attaching the previous and current MRI report again.. Please let me known how it has progressed from last one ?? - better, worse, same, same but redistributed ??
Is this serious and not something conservative physiotherapy can treat ?? What are the important posture tips ( sitting, sleeping, standing, walking ) that you have for me in this condition ???
Attaching the MRI report .. And some fought cam taken film pics
Hi Doctor, attaching the previous and current MRI report again.. Please let me known how it has progressed from last one ?? - better, worse, same, same but redistributed ??
Is this serious and not something conservative physiotherapy can treat ?? What are the important posture tips ( sitting, sleeping, standing, walking ) that you have for me in this condition ???
Brief Answer:
Only little change from previous report, drugs sufficient
Detailed Answer:
Hello XXXX, I have gone through your report.
Your MRI report is showing disc prolapse at L5 and S1 nerve root levels with bilateral foraminal narrowing.
Previously only right sided S1 root was involved.
The actual comparison may only be made if images of both MRI are available.
Still it seems that at this stage you may get benefit from physiotherapy and posture Care. You have to avoid forward bending, stooping, lifting heavy objects, squatting position and carrying heavy objects overhead. Also avoid vehicle especially motor cycle on uneven surface.
Surgical management may not be required if you get improvement on drug and physiotherapy.
Hope you recover early.
Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Only little change from previous report, drugs sufficient
Detailed Answer:
Hello XXXX, I have gone through your report.
Your MRI report is showing disc prolapse at L5 and S1 nerve root levels with bilateral foraminal narrowing.
Previously only right sided S1 root was involved.
The actual comparison may only be made if images of both MRI are available.
Still it seems that at this stage you may get benefit from physiotherapy and posture Care. You have to avoid forward bending, stooping, lifting heavy objects, squatting position and carrying heavy objects overhead. Also avoid vehicle especially motor cycle on uneven surface.
Surgical management may not be required if you get improvement on drug and physiotherapy.
Hope you recover early.
Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Considering the symptoms from then to now. The sitting and standing toleraonce is more now. shooting pain is gone now. heaviness and numbness defi nowhere near as before and much less now .. Only problem at this stage being mild to moderate tingling and slight weakness in legs .. discomfort in long sitting when the seats are not at proper height... Are the symptoms severe by normal standards or are they mild ?? The reason i ask all these , is that positive true feedback by a doc helps a great deal mentally to me ...
What is the exact role of drugs in my case ?? What drugs can i use ?? Can you prescribe some ?? Or should i have myself examined from a local neurologist/orthopaedic..
On the physio front, I will continue to work on it as per the physio's revised plan based on this MRI.
I am planning to fly to US for Masters this august end. DO you think , its wise to say here / continue for MS with the state I am in ?? Am i in too serious condition to be deciding towards dropping masters ??? I was hoping that this MRI is an indicator towards my decision making.
Let me know if the cam pics helped . I can take the old and new cam pics on l5-s1 level and send it to you again for your analysis.
What is the exact role of drugs in my case ?? What drugs can i use ?? Can you prescribe some ?? Or should i have myself examined from a local neurologist/orthopaedic..
On the physio front, I will continue to work on it as per the physio's revised plan based on this MRI.
I am planning to fly to US for Masters this august end. DO you think , its wise to say here / continue for MS with the state I am in ?? Am i in too serious condition to be deciding towards dropping masters ??? I was hoping that this MRI is an indicator towards my decision making.
Let me know if the cam pics helped . I can take the old and new cam pics on l5-s1 level and send it to you again for your analysis.
Brief Answer:
No surgery required , continue drugs and physiotherapy
Detailed Answer:
Hello XXXX,
I have gone through your MRI images also. You are having central disc at L5-S1 level causing your symptoms. But as you are improving with physiotherapy and drugs you must continue them. The involvement is mild and doesn't require surgical intervention at present.
You should avoid sitting for prolonged period . Sit with back well supported backwards.
Drugs like pain reliever and muscle relaxants can be tried as your normal lumbar curvature is lost may be due to pain induced spasm. Other drugs like pregabalin, gabapentin and amitrptyline may also be used in neurologist guidance.
You can move to US as planned as hopefully you will recover with proper physiotherapy and treatment by neurologist.
You can also send old images if you wish . I always here to help you on health acre magic forum.
May you recover early
regards
Dr Neeraj Kumar
Neurologist
No surgery required , continue drugs and physiotherapy
Detailed Answer:
Hello XXXX,
I have gone through your MRI images also. You are having central disc at L5-S1 level causing your symptoms. But as you are improving with physiotherapy and drugs you must continue them. The involvement is mild and doesn't require surgical intervention at present.
You should avoid sitting for prolonged period . Sit with back well supported backwards.
Drugs like pain reliever and muscle relaxants can be tried as your normal lumbar curvature is lost may be due to pain induced spasm. Other drugs like pregabalin, gabapentin and amitrptyline may also be used in neurologist guidance.
You can move to US as planned as hopefully you will recover with proper physiotherapy and treatment by neurologist.
You can also send old images if you wish . I always here to help you on health acre magic forum.
May you recover early
regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Raju A.T
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