MRI results on back baffle me, can you help me understand please?

Hi all

I am relatively new to this site so apologise if I am posting in the wrong place.

I have had an MRI on my back and would appreciate if someone could help me understand the findings as my doctor has said all is ok.

Findings:

The conus lies at T12-L1

At L3-L4 level: There is minimal posterior disc bulge with mild degenerative change of the facet joints but no evidence of nerve root or cauda equina compression. The disc height and hydration are preserved.

At L4-L5 level: There is moderate posterior broad-based disc bulge as well as degenerative change and hypertrophy of the facet joints and ligamentum flavum. There is subsequent narrowing of the lateral recesses and likely impingement on the traversing L5 nerve roots particularly on the right. The disc and hydration are preserved.

At L5-S1 level: There is disc dehydration, mild broad-based posterior disc bulge as well as mild degenerative change of facet joints but no evidence of neurological compromise.

Conclusion: Mild multilevel degenerative change as described above but possible impingement on the traversing L5 nerve root at the L4-L5 level.

This scan was taken last September and since then my pain has gotten much worse. I can barely move as my right knee has decided to stop bending correctly or allowing me to put weight on it. This happen in December when I fell and landed on my back, one of four falls since.

I am not sure if this is relevant but I am deficient in VitD at 11 nmol, B12 is low at 243 ng/l and deficient in folate at 2.5 ug/l.

All help understanding these findings would be greatly appreciated. I apologise if I have posted in the wrong place.

Thank you for taking up time to read my post.

11 Replies

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  • See an Alexander Teacher. You need some training in muscle usage to reduce the danger of applying pressure on nerve roots. If you tighten muscles in the back in the wrong way you will apply pressure on structures that should not be receiving pressure.

    It is worth seeing a McTimony chiropractor to reduce any areas of micro cramps.

  • Thank you for your reply.

    What is an Alexander Teacher?

    Is there anything that I could do at home as I am too unwell from stomach/bowel problems to go out. I feel so frail with my falls and keep bruising my back on these falls. My leg seems to give out from under me and lately the knee feels like it is popping when I move. I can put weight on it but not bend and put weight on it, going upstairs is a nightmare and just moving it from one position to another really hurts.

    Is there a difference from a Mctimony chiropractor to a normal one?

    Thank you one again.

  • Mctimony chiropractor work with their hands and tend to have very sensitive hand skills. Their manipulations are very gentle and subtle in comparison to a standard chiropractor.

    In regard to Alexander Teacher see:

    alexandertechnique.co.uk/

    Teachers are needed. They can see what you do and modify what you do accordingly. You are in area where words are not helpful. This because words are understood in terms of previous life experience. New life experiences which a teacher will bring changes the meaning of words.

    Words cannot describe what someone with good hand sensitivity can do.

    Hope this helps.

  • Thank you for the description. I will check the link and read about both. Thank you so much.

  • Most of that report is just description of 'normal' rather than something that is wrong. When MRIs were first done on people that had back pain, they saw these things and figured they were causing the pain. They operated but the pain didn't go away. Then some bright spark decided to scan loads of people the same age that didn't have pain, and they realised that all people's backs look like that as they age, this is normal.

    The one bit that points to anything is the possible impingement of one of the nerves which might be part of the picture as to why you are having problems, but it might not be the whole story. Have you had an investigation as to why your knee stopped bending correctly? Have they eliminated anything going on in your knee?

    Being low in VitD and B12 could be part of the problem, as they have found that some people with low VitD are experiencing more pain, and low B12 can cause things like fatigue too.

    Bodies are complex and the more they understand about the interactions that go on within them, the more they realise they have to learn. Often it isn't one single thing causing trouble, but the interaction between different things.

    A good rule of thumb is that if your symptoms change or there are any developments it is time to see the GP again.

    And I agree with Johnsmith, either Alexander Technique, physio or a osteopath might also help.

  • Thank you for your reply.

    My back does not feel normal, it hurts all the time and I have limited movement especially round the rib area.

    I had a scan on my knee, the X-ray showed calcifications from thigh to knee and MRI showed a small cyst behind and fluid on the knee cap, or something similar to that.

    My health has been deteriorating as I have whole gut dysmotility so nothing wants to work, this started after surgery when my vagus nerve got severed. Not being able to get nutrients from food probably does not help and I can not absorb correctly.

    Sadly due to my stomach/bowel issues I barely leave the house and have no energy. As my stomach gets worse, my back and knee are getting worse.

    Thank you for your input and advice I will check out the technique. I was due to see GP today but as unwell, going Thursday, I am having too many falls of late. I am so fed up as I feel so unwell all the time and limited in movement which, I know needs movement but I am to lethargic and weak.

    Once again, thank you for your response.

  • Your vitamin D level reads like it's very deficient - and as there are known associations of bone and muscle pain with very low vitamin D levels then you might be well advised to improve those levels through supplementation, diet, and safe sun exposure. Have you had a chat with your GP or someone similar about that level?

    Likewise, tho' it's difficult to interpret without the reference ranges, it looks like you might benefit from a chat about the folate or B12 levels you report.

    Even tho' you must be deconditioned from being unable to leave your home on a regular basis, it's concerning to read about the frequency of the falls etc. and it's something that your GP should address. Many areas have Falls Clinics where they can not only advise on practical items but they teach Better Balance classes and can either prescribe or point people towards advice on supplementation for various nutrients.

  • There are posts here about L4 L5 level changes - and a fair number of them report leg pain/sciatica etc. (NB, your report mentions "likely impingement on the traversing L5 nerve roots particularly on the right"): healthunlocked.com/search/l...

    It sounds like it is well worth a chat with your GP about the results of your blood tests and a referral to a Pain Clinic, a Falls Clinic and, when it's appropriate, say a referral for inclusion in any helpful classes in local sports centres such as supervised aqua therapy (perhaps) or classes such as Tai Chi (if you've been able to go through Better Balance classes with a Falls Prevention team or such).

  • Thank you your reply.

    I am at a loss. My bloods have been out for 11 years and my doctors say I have malabsorption from my stomach issues, the answer? Pills that I can not absorb!

    In the last year I have been told I will lose the function of my enteric nervous system. Basically my stomach does not hold onto food after surgery, so I have dumping syndrome.

    My duodenum is not working correctly as I have brunners gland hyperplasia.

    My colon is very delayed and I get failed evacuations/obstructions.

    My pancreas is calcifying and is insuffiecient in producing enzymes so I need to take croeon with my meals, but food is painful and makes me sick for hours and I still can not absorb it.

    My pulse is 110 bpm upon rest, episodes of tachycardia, sinus aryithmia, a long QT and t-wave inversions due to reactions from food, I suffer hypers and hypos despite not being diabetic and I am in chronic pain from my failing gastrointestinal tract. I come under the complex Illness range though so am left to get on with it.

    I have added my latest bloods with ranges:

    B12 is the highest ever at 483 ng/L (197-771 ng/L) (NOW 243 ng/l) no treatment given.

    Folate low at 2.5 ug/L ( 309-20.0 ug/L)

    VitD low at 11 nmol/L (50-150 nmol/L)

    Ferritin high at 200 ug/L (13-150 ug/L)

    C-Reactive Protein high at 12.4 mg/L (0.0-5.0 mg/L)

    Red Cell Count low at 3.73 x10^12/L (3.95-5.15)

    MCV high at 102.9 fL (80-99 fL)

    MCH in higher range at 33.2 pg. (26.0-33.5 pg)

    RDW is 14.3% (11.5-15.0 %)

    I feel at a loss, my gp knows how unwell I feel and that I have been deficient in vitamins since 2006 when I started suffering from cyclonic vomiting syndrome and dehydration. As my condition got worse after 3 operations and sepsis, everything is now put down to gastro problems. Dizzyness is part of the illness so therefore falls are expected. I am only 42 so I am feeling very down. I have no income, I lost my job through ill health and I have been told my condition will get worse but there is nothing that can be done. I gave gastro issues, why can they not help with the back and knee issues?

    Sorry for moaning, I am having a particularly bad time of late my normal pain is already so bad, the knee is taking me to a different level and I can not handle it.

  • That is a wretched collection of conditions and I think most of us would find it overwhelming to manage so you're hardly moaning.

    Even tho' it's not surprising that you fall, I still wonder if your GP would be well-advised to refer you to a Falls Clinic for some of the practical techniques that are available from them and to reduce your risk of additional injuries. And a very specialist Pain Clinic/consultant that could advise on appropriate pain management, taking your complex gastric motility etc. issues into account?

    Are you under the care of a specialist dietitian or is your GP managing your nutrition status?

  • I am under a dietitian and biofeedback nurse. I have been told they can not really help as my condition is functional.

    I think you are right, a pain clinic or fall clinic (never knew a fall clinic existed) would be great. I had facet joint blocks in 2007 but since then it has not been mentioned in regards to pain clinic.

    I am sure my gi issues aggravate my bone health, I know my bloods are out of sync and aggrevate both my gi and bone. It's hard as each of my specialists leave for the next. I am sorry, I suppose we all end up here for the same kind of reasons and all have our crosses to bare. I hope you are doing well.

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