Mri for spine. Please help! I can't stand this pain.

I am experiencing very bad back pain so I had an MRI and see a spine specialist soon. I have had back pain since I was about 14 years old so for about 15 years now. It seems to be worse now. Things that have been tried are physical therapy, a steroid injection (this made the pain worse), tens unit, anti inflammatories, and a back brace. My pcp gave me vicodin 5-500 and said take 1 twice a day until I see the specialist. These don't seem to take the edge off at all. I have also been on ultram which doesn't do anything at all for it. I have a dip in about the middle of my back and this is where the pain seems to start but moves down to the top of my butt. The pain in the dip feels like someone stabbing a knife through my back and into my stomach then twisting it. I also have some numbness that comes and goes in the bottom of each foot. I am going to post my MRI results in hopes that someone can give me some idea of what it means and what might happen next in the treatment of this. Any information would be much appreciated as I'm in the dark on all of this and kind of freaked out since I'm only 29 and having all these issues. Thank you in advance.

MRI FINDINGS:
Alignment is anatomic. The paraspinous soft tissues are normal. Incidentally noted is chronic, mild ectasia of the distal thecal sac. The distal spinal cord and nerve roots of the cauda equina are normal in appearance. No bone marrow pathology is seen.

No significant abnormality is demonstrated at the T10-T11 through L3-L4 levels. There is no lumbar disc protrusion, spinal stenosis, or foraminal narrowing.

L4-L5: There is a posterior annular tear and a small, broad-based, left foraminal disc protrusion. There is mild left lateral recess narrowing. There is no nerve root displacement. There is no significant facet arthropathy. There is no spinal stenosis or foraminal narrowing.

L5-S1: There is disc degeneration and mild disc bulging. There is mild bilateral facet arthropathy. There is no spinal stenosis or significant foraminal narrowing.

The visualized upper sacrum is unremarkable.

Again thank you in advance to anyone who has any input for me.

As stated...no one here is a medical professional....So I hope that you have a Board Certified Neurosurgeon or BC Orthopedic surgeon who is going to go over these results with you...When do you see this "specialist"?

The good part is that we see the words "mild" and not severe...and they say there isn't any stenosis or foraminal narrowing...So these are good things! It seems to read that there is just a small disc protusion...

Again..a Dr. will explain all of this to you...As we age..pretty much starting at 25....changes in the spine/discs are very normal...

If you took 100 people off the street and did a MRI...you would find all sorts of things that are "wrong"...But some people have terrible MRIs and not a twinge of pain...and then others can have even the tiniest disc protusion and severe pain...

Another thing that Drs. have discovered is that smoking can actually cause disc dehydration and bone spurs...So if this is something that you do...there isn't a better time than now to quit...

So it's not just about the MRI but the physical exam and then other tests (if needed) like an EMG or Nerve Conduction Study to see if there is any nerve involvement.

The other good news is that 85% of those with spine/disc issues do NOT need surgery. Surgery should only be done when you have been on a comprehensive plan for a period of time.

Treating chronic back/neck pain is a multi-faceted approach...And usually it's not about trying something once and done...

Each modality is meant to take a tiny notch down of the pain level and get to a decent level like a 5 or so...

Usually the steroid injections are done in a series...and can be done a few times a year. Or take orally a Medrol dose pack which are also steroids.

There is also daily exercise, yoga/stretching, physical therapy, aqua therapy, TENS unit (on a regular basis), acupuncture, massage, ice, heat, lidocaine injections, counseling, eating healthy, etc.

Exercise each day (especially keeping the abdominal muscles strong) is crucial as is maintaining a healthy weight. The Neuro/Ortho should help you set up a good plan.

And most of us with spine issues are on a nerve pain medication as an opiate does not really do much for that type of pain. Those type of meds are Lyrica, Neurontin, or Cymbalta.

As well as there are actual muscle relaxers that will stop the muscles from having spasms...Again..an opiate does not work for this type of pain. I would be lost without my muscle relaxer!! LOL..

These are Flexeril or Amrix, Robaxin, Skelaxin, Baclofen, or Zanaflex.

So...hopefully you are going to see one of the Drs. I mentioned so that they can work with you on figuring out a great plan of attack to help with your pain levels and continue to strengthen your back to keep it healthy.

I've had 3 fusion surgeries and still have quite a few severe herniations along with severe stenosis and Spondy and all sorts of fun things! LOL..So believe me...I empathize...we all do on here as we know chronic pain..I have been working with my PM Dr. and Neurosurgeon for 6 years now since my last fusion and we are doing everything possible to avoid another surgery in the near future.

It's a great place to come where we all can understand what it's like for you...

Good luck and keep us posted on your upcoming appt.!

Thank you all for your responses. You all replied more quickly than I thought would happen. I actually go to the doctor tomorrow. It's sad that I am so excited just to go see a doctor but we all know what it's like to deal with pain. Pain makes us a little crazy at times. The doctor I am seeing is here in Indiana where I am from. The clip from his website says "John W. Arbuckle, M.D., is a minimally invasive spine specialist with Indiana Spine Group focusing on spinal diagnostics and therapeutics. He is board certified in anesthesiology and pain management. Dr. Arbuckle’s areas of medical interest include interventional pain management and degenerative spine disease." So I am hoping he will be able to help me. I see him in the morning so I will let you all know what he tells me. Thanks again for the replies.:)

That makes me feel a little better. I have seen this doctor before and he's the one who did the injection and tens unit. I liked that he asked me if I wanted something to make me more comfortable during the injection. Hopefully i get some sort of information about what is going on and what needs to be done. I will let you all know something after I find out.

That's a bummer...

That is what is hard about MRIs as they only tell one part of the story so they are trying to conservatively treat things as it doesn't look surgical right now..

So, I know it's frustrating but at least you can celebrate that they didn't find something so severe that needed immediate surgery.

I know that this doesn't help your pain levels though:( Did you tell him you had tried the Voltaren gel recently?

It sounds like he is trying to see if inflammation is the cause for the majority of the pain. Many Drs. do not feel comfortable putting someone on an opiate with the first appt....So I guess you will have to decide if you want to move forward with them and try steroid injections (or it could be lidocaine ) and see where they want to take the treatment from there...He may move towards other medications when he sees that other things aren't working for you.

That's the hard part about starting with a new place/new Dr....they want to go through their "process" when treating someone new and try things in order.

Other meds that you can speak with him about are the ones I mentioned like nerve pain meds or muscle relaxers...

But only you can decide if you want to see how it goes with them after a few appts...or just go ahead and try another place.

Sorry that you didn't get more definitive answers....spine/disc issues are tricky in that so many people have some sort of degeneration going on...

We empathize with you...you want answers and pain relief!!

Sending you some hugs (( ))

Just so you know...some of the muscle relaxers are less sedating than others. A few of them only have that side effect for a few weeks.

I was on Flexeril many years ago and it did that to me but this time around I have no fatigue at all.

Robaxin and Skelaxin do not make me tired in the least. So...there are so many to choose from and see which one may be a good fit.

The main thing with a muscle relaxer is to take at the end of the day when the spasms are the worst.

Anyway...just some thoughts as I know you have kids...but it's important that you take care of yourself first to keep the pain levels down..

And as I mentioned...most people with spine issues are on a nerve pain medication as these do a great job with helping that type of pain.

I hope that you can either work with this Dr. and find other things to help, or find another one who has a better plan for you...

The thing with spine/disc issues are that they are put into either of two categories...Surgical or non-surgical...

So, I think he looked at your MRI and concluded that there isn't anything serious enough for surgery and that lumps you (most of us as well) into the category of having DDD which just means that there are degenerative changes in the spine.

As I mentioned, this happens to most of the population starting at about mid to late 20's...

Now..that doesn't mean you don't have pain...that is obvious that you do and that is what they will try to treat.

Once they determine it's not surgical...it's really about managing any pain there is with things like injections, physical therapy, traction, stretching, massage, acupuncture, ice and heat. Helping someone maintain a healthy weight as well as helping you have a strong core and surrounding muscles as well as good posture to keep the back strong.

And then the use of medications like the nerve pain and/or muscle relaxers..

Putting all of these modalities together is what usually helps instead of just trying one thing and then done.

I know it's frustrating...but that is the unfortunate nature of spine issues..It can take some months of consistent treatments and medication to get things back to a manageable level.

There just aren't any quick fixes...Even with surgery.

So, I think you are going to find similar answers even if you seek out another Dr. and your best bet is to just jump in and try as many things as you can to see if they will help your pain levels.

Again...I empatize...we all do. It's tough when things are not black and white like a broken bone...set it, cast it, and then heal....With spines...it's a "process"...

Sending you some hugs (( ))

I hope, I'm sorry that you at your age is experiencing so much back, but at least now with the MRI, you have a better perspective on whats going on. I too, have the DIP that you have, so I really understand the stabbing pain that you speak about and the twisting. It appears that in a long run you will probably need a fusion, (I had two separate fusions), I cannot say that it will help, but you will need that tear repaired to keep the liquid in the disk from escaping.

Just try to hang in there, and explain to your doctor that the current meds are not helping with your level of pain.