Who can help me with this MRI scan and a painful sciatica?

Question

Please read my MRI scan result:

Findings- There is normal vertebral alignment. There is loss of intervertebral disc height and signal at L4/5 and L5/S1 where small posterior disc bulges and annural tears are noted. No focal bone lesions are seen and the conus is normal in appearance. Axial images were performed through the lower three lumbar levels. The canal is capacious throughout and no neural compression is seen.

How bad is this situation on a scale from 1-10? Is operation needed? What can I do now? I was told I have a sciatica which last now more than 3 months. What else can help me? thank you very much.

Answer 1

Hi Rose

It's Rob here again who answered your previous message on this. Sounds to me like the sciatica pain is most likely referred nature i.e. not coming directly from a nerve compression caused by the disc bulge. Instead there will be inflammation in the area of the disc irritating the ligaments and joints plus causing the muscles to go into spasm would be is causing the apparant sciatic pain. Referred pain is basically where the body gets is signals confused just like when someone has a heart attack but feels the pain in their arm rather than their chest as you might expect.

A spinal surgeon would be reluctant to operate on your spine if this is the case, especially in the abscence of any "signs" of nerves being compressed in your back shown by numbness, pins and needles or alterred reflexes in your legs.

For self help my suggestion would be to try an inversion table (to help traction our the disc bulge). Also try gettting a golf  ball or tennis ball and lean onto to against the wall or floor pressing it into any sore bits on your buttock, if you find any spots that reproduce or intensify the sciatica  that's good, hold the spot for between 1 and 3 minutes, after this time the sciatic pain should start to ease a little compared to the pain you felt when you first started pressing, if you get this reaction this means you've started to ease of the trigger points in your buttock muscles that could have been responsible for some of the referred pain.

A good chiropractor or osteopath may be able to help. Chiro's will be good with the joints but may not do justice to any tight muscles, a good osteopath should be able to use lots of deep tissue massage on the muscles as well, especially the buttock muscles where you likely to need it. An alternative would be to see someone trained in "intramuscular / trigger point dry needling (acupuncture)" (not necessarily the same as traditional chinese acupuncture) this can often work well - some osteopaths and chiros are trained in this in addition to the original training.

Whoever you see make sure they check your reflexes out properly and test you for any "neurological signs".

Good luck.

Answer 2

Normal vertebral alignment means no scoliosis. Loss of disc height means DDD degenerative disc disease which is not a disease but part of the normal aging process, your discs are dehydrating. Small bulges and annual tear are nothing to worry about, as they are not en-crouching on the spinal cord. On a score of 1-10 it would be a 2. I know the pain feels worse, but I have a prolapsed disc so the disc is sitting on the nerve roots to my legs, which is nice? What else can you do? Well if you could speed up the DDD, get the discs to dehydrate faster, they will shrink, so no pain. That usually happens with age anyway, but exercise will help the dehydration process. Pilate's or Aqua Jogging. Best of Luck

Answer 3

You shouldn't need an operation because the scan says that no nerves are being pressed on. The best advice I can give you is to see a chiropractor. Take the scan results with you. They ought to be able to make you feel a whole lot better. On the medical side, you could try taking amitriptyline, which is a not-very-good antidepressant but a brilliant treatment for nerve pain. You need a prescription for it. Anti-inflammatory drugs may also help, like diclofenac, or ibuprofen which you can buy at the chemist.

Answer 4

Pain Specialist will help with the sciatica. Other then that you get to deal with the pain. They won't do anything for a hernia that small. I have one in the same area and have been working my but off trying to strengthen my back up to get off the pain pills and it's working. Good luck and get well.