My MRI scan results - can anybody help please?

[Tillytop]

Hello and I wonder if anyone can advise me please.

I had an MRI scan of my thoracic spine a few weeks ago - the idea being to see if my ongoing "chest wall pain" might actually be nerve pain originating from my spine.

Apparently the scan report shows that I have "disc protrusions at C3/4, C4/5, C5/6 and multi level degenerative disc disease". Although I have osteoporosis, apparently there were no collapsed vertebrae which is good news.

I'm guessing that the "degenerative disc disease" is "posh speak" for osteoarthritis, although I could be wrong, but what I don't know is whether the disc protrusions are something which should/could be treated in some way and I am still none the wiser about whether any of the above might explain the pain. I have no follow up appointments regarding this and only got the results because I asked the rheum nurse when I rang about another appointment, So, although we are none of us medics, I just wondered if anyone else has been told they have disc protrusions and, if so, whether any physio or other treatment was suggested. I am hoping that this might give me an idea of how to get the appropriate help and advice and from whom.

Any thoughts would be most welcome.

Many thanks.

Tillyx

[watson3]

Disk protrusion can cause nerve pain. Sometimes they cause no pain at all. Nerve blocker can alleviate pain he troublesome. Also local pain relief injections can give patients relief... physio can be very helpful to help realign the spine so,the sponge disk can slip back the advice of your specialist is important.Good luck. Chase up a follow up appt. Carole

[helixhelix]

Presumably you know that the C3/4/5 vertebrae are the ones in your neck? And as the song goes "the back bone is connected to the neck bone, now shake dem skeleton bones..." So stuff up there can affect you in all sorts of ways.

I have degenerative disc disease lower down, and was basically told that it's not a specific disease but just that I'm wearing out rather than specifically osteo or anything else - but the difference between them seems rather vague. And since it's just as painful whichever it is I'm not sure I care what's causing it. So my discs are flattening and bulging in various places. As well as the pain killing drugs, I was offered injections (which I refused as the idea of needles anywhere near my spine scares me). Unless you actually get to the point where the discs really tear I don't think other treatments are recommended/available but others may know different. And I guess it all depends on how it affects you. Basically the only thing that helps me is exercise to keep the muscles around the spine as strong as I can...if I sit around even just for a day I find that it just gets more and more painful and I rapidly get very immobile and lose what little flexibility I have left in my back. I did see one totally useless physio, and then one that was remarkably helpful so that also seems to vary.

Hope that helps, and hope not too painful. Pollyx

[phil-s in reply to helixhelix]

i had a protruding disk c4 /5 i had it removed and a bone graft off my hip put in with a plate screwed across the vertebrae the opperation was through my throat , this opp was ok but the plate came loose and i had to have the plate removed the graft had taken so they left the plate out unfortunately i suffered nerve damage the second time and have been in constant pain since i wasnt given much choice because the disk was pressing on my spinal cord ,physio,s nearly paralised me .

good luck whatever you decide phil

[Hidden]

I think I'm in the same boat as Polly although I have never had scans or x-rays so this is based on guess work and my physio who felt a dip in my spine and said "L5 degeneration" as if she was commenting on the weather.

My rheumy said to keep active and his side kick said to get more weight off - I try hard at both and like Polly, if I keep on the move then I'm okay broadly speaking but if I'm still for any length of time then I'm hardly able to put one foot in front of the other. The pain and extreme stiffness are at the top of my thighs on both sides and into my groin. But its the spinal degeneration that causes my mobility problems i'm told, even though I only have infrequent spells of backache.

The worst part for me is when I'm with people and rise to move and find I just can't and everyone looks startled because I don't look old enough to be arthritic in their book!? X

[Tillytop]

Thankyou so much for your replies.

Sorry, should have said "T" not "C" ie my protruding discs are thoracic not cervical spine. I'm lucky in that generally I don't have too much problem with my back overall, but the potential nerve pain over the past year or so has been excrutiating at times - but thankfully it has hugely improved with recent prescription of amitriptilyene.

I feel so frustrated that the NHS pays for these MRIs (which I think are probably quite expensive to do) then nobody bothers with the results. In my case, the scan was requested by the gastroenterologist as a "last ditch attempt" to try to find the cause of at least some of my ongoing severe abdominal pain. He put the request to rheumatology who organised the scan. But the gastro doc won't be interested in the results cos its "bones not stomach" and the rheum isn't interested because it's not inflammatory. Yet again I just feel so very alone with this in terms of any support from the medics - but then that just seems to be par for the course. Hey ho.

Thanks so much for taking time to reply.

Tillyx

[Hidden in reply to Tillytop]

Tilly you poor thing. I put my comment using the iphone and thought I was responding to a different post - I'm sorry.

Do you have a GP you like and trust whom you can go and see about what these results mean for you? I hate the word degeneration - and when people sometimes think that OA is a much lesser problem than RA I do wonder about this because, as you say, we are offered so little support or advice for degeneration/ OA. It should be a GP's job to take this to them and have a proper chat about the implications for you in the context of your RA. They are the ones who are supposed to join up the dots between the various specialist consultants. I hope you can do this and will feel less alone. It's a horrible feeling I know - shouldn't be part of the course at all. I think you're being very brave and sorry again for the mentioning of keeping weight off and exercise as this seems somewhat stupid of me in the context of everything you're going through. I do wonder if it's the thing that's been affecting you with your stomach and surely if you were referred by the gastroenterologist then he would be interested and may be able to advise as to whether this might have been causing referred pain in your stomach perhaps?

Tilda xxxx

[earthwitch]

Discs can bulge in several different directions. The doctors only seem to be worried about them when they are really big bulges in the direction of the spinal cord, and actually compress the spinal cord. If it just presses into the thecal sac (the bit around the spinal cord) they don't seem to see it as significant.

I totally agree about how often very expensive tests are ordered, then noone is really that interested in the results. The xray I had that finally gave enough evidence for Ankylosing spondylitis sat in my file for over a year, and it was only when I took it to a private radiologist that it actually got noticed and acted on.

There was a wonderful odd bit of research done once where radiologists were given the same xray films to report with a query on a specific disorder. What they hadn't been told was that someone had altered the films to include a wee image of a gorilla. 83% of these expert radiologists failed to notice the gorilla. Shows how hard they look at anything other than what they expect to see. Here is the link to the research, which also explains why they wouldn't have noticed other things npr.org/blogs/health/2013/0... . I spotted the gorilla straight off - but then I'm not a radiologist.

[Tillytop]

Thanks so much Tilda and Earthwitch for your replies.

Thanks for the suggestion of the GP Tilda. I have really lost all faith in the GPs Tilda after the experiences of the past few years but I have made an appointment with the "better of the two" for next week. And, if I feel I can face going to the appointment (rather than cancelling as I usually do) I will be interested to see what he says. I agree totally about the weight thing as well Tilda. Having been pretty much housebound - and often sofa-bound for the past few years, I could seriously do with losing some weight. That said, thanks to my stomach and my teeth, eating has been so limited and so difficult, I should, really be like a stick insect by now! No such luck though.

Thanks for your comments Earthwitch - what you say about bulging discs makes complete sense to me. And I thought the "gorilla" thing was very telling! I will go and have a look at the link in a minute.

Since posting, I have had a letter from the rheumatologist which basically outlines the results which the rheum nurse told me and ends by saying "whilst this doesn't mean that your pain could not be coming from your back, there is nothing serious and nothing that needs further action". Although that is good news, it just left me feeling that as far as they are concerned it really doesn't matter that, RA aside, I have spent much of the past 18 months in pain - and sometimes severe pain - and nobody is interested in trying to find out what might be causing it. Thank goodness for the Amitriptilyne - else I would have been ready to call it a day I think. Sorry for the negativity, I'm just feeling very low and not coping well.

Thanks again both.

Tillyx

[Hidden in reply to Tillytop]

Oh Tilly I'm so sorry you are feeling so low. I see you wrote this 2 days ago and it never came through on my email box so I've only just spotted it. How I hate the idea of you being in constant pain. I also hate the dismissive tone which so many of us are experiencing just now. I think this is a byline of the financial climate and all the emphasis being on just keeping us alive rather than on alive and feeling well and pain free. I hope the better of the GPs has something more constructive and supportive to offer you - please go and see them and if necessary bawl your heart out just to make them realise that you are human and have to live with all this awful pain day in day out and you need help. Please let me know how you get on on here or by PM. Tilda xxx

[hawker955]

Degenerative disc disease is different to a disc protrusion but the latter can lead to the former. Disc degeneration affects all humans as we get older as the spongy discs become less spongy and more crystalline and brittle. osteoarthritis is a wear and tear disease so is associated with age as a result.

I am currently well controlled re. my RA but following my fractured skull in 2012 and four months lounging around in hospital beds I also have developed osteoporosis [apparently My ra and my genetics have made me susceptible to it, and then developed four compression fractures in vertebrae. What we thought was a slipped disc in November turns out to be fractures [See! I TOLD YOU MY BACK WAS HURTING!! That's what I said to people who told me that it's just back-ache!] ]

I go in tomorrow for vertebroplasty which has a very good prognosis, and I should walk out the day after the procedure.The nurses and specialist are extremely confident it will take away the severe on-going back pain. Let's hope they are right.

Re. physio for disc protrusion? No, No, No. Get the protrusion treated medically before you go down the physical route. If I had had physiotherapy before knowing about the fractures, the results could have been catastrophic. Injection of steroid at the site of the disc is the best treatment nowadays; physical activity can sometimes return to normal in just a few weeks.

HTH.

[hawker955]

I arrived back Tuesday afternoon and things seem to have gone okay. The procedure involved a general anaesthetic, and has left me feeling battered and bruised in my lower back; normal after these multiple injections for this procedure I am told. Unfortunately I have been strongly advised not to ride my bicycle for 6-8 weeks in order to let the bones knit together properly as I don't want to have the procedure repeated if they don't; so it is no lifting, nothing more than walking and taking it easy for now. That was disappointing advice but I have to follow their instructions after all this. The consultant was very happy on the Tuesday morning, morning when I told him the severe pain going through my hip had stopped in what was less than twenty four hours after the procedure. He thinks it must have lifted the bone away from pressing on the nerve. All in all, it is an early stage but htat means things are very promising.

The time in hospital wasn't as depressing as I feared, not least because all the nurses and even the tea-lady remembered me due to my severe injuries eighteen months previously and were pleased to hear about the good parts of my progress after the initial injury. in August 2012. I was even in the same bed in the same ward Although it is disappointing to be laid low for another few weeks, the physio said I can start using my indoor bicycle trainer in about four weeks if I feel okay. That's good, because exercise is my lifeline despite the RA and in time, time as in many, many months, I could just maybe get back to racing? I just hate sitting around doing nothing, probably aggravating the osteoporosis triggered by my four months of lazing around in hospital beds. Here's me crossing my fingers for further good progress.