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MRI Says No Nerve Impingement?

From: rcshelley - on 11/28/2010 12:14am

I've ruptured L5-S1 4 times over 25 years, but went 10 years in between treatments, as I gave up hope that any thing could help me without surgery. 2 years ago I went for an MRI after rupturing the disc. The MRI showed a small herniation with "no nerve impingement", but my left leg has been numb from the knee to foot ever since. How can the apparent nerve impingement not show on the MRI? The doctor I saw said it would heal, it hasn't.

I've lived with chronic back pain for 25 years, but recently it has gotten really bad, as it always does before the disc re-herniates. So I picked out a top notch neurosurgeon and took my 2 year old MRI to him. After looking over the MRI he says, "I can't do anything with this." , and sends me for another MRI. He said the tingling in my leg could be from something else & ordered an EMG, but I know it's from the disc herniation, as it started with the injury. I'm to the point now that I want back surgery, yesterday! I can't take it anymore and I'm not going to become a pain pill addict. I'm wondering what to say to the doctor if he says the new MRI doesn't show nerve impingement. Or that surgery will not help me. I personally know that the disc is shot and needs to be removed or replaced. Any suggestions on how to handle the doctor during my upcoming visit would be greatly appreciated.

I'm going to ask the doctor to do surgery! Even if it is exploratory. I can find no other options to getting my life back.

Running out of hope.

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on 11/29/2010 7:41pm

I have basically the same symptoms as you and had a fusion in August. Here is what I have learned about myself in case it is in any way helpful to you. I share your frustration!:
- Surgeons don't really care about numbness - they're more concerned about functional issues like foot drop. I was told my numbness (which felt like I was wearing a thin sock on my outer lower left foot) was "subtle nerve damage".
- By the time something shows up on your EMG there is pretty serious damage. I don't think it's as sensitive as it could be.
- When I had surgery, they found a double nerve root on the left side L5-S1 - instead of one root like most people I had 2, and one was tucked under the other. SO - MRI does not show everything. The surgeon said my 2nd nerve root was really compressed.

Lastly, have you tried drugs that calm nerves like Neurontin? Worth asking about. It did help me but unfortunately made me really depressed so I did not stay on it long.

Good luck! If your doc has no answers for you, go get a 2nd and a 3rd opinion.

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on 12/06/2010 7:10pm

Doctors, surgeons are relying on technology much because from their narrow point of view only nerve root compression, dislocated / degenerated discus are causing nerve irritation. There's not just one nerve / nerve root responsible for numbness and pain you feel , but whole group of roots coming out between vertebras L3-L4, L4-L5 as well as L5-S1 is impacting intensity of pain you feel. Roots and nerves are laying pretty deep into buttocks segment , where a number of pelvis muscles and cysts are laying very close to the schiatica nerve. In many cases I witnessed unexplainable irritation of shiatica, resulting in same pain you feel, where deep and strong massage of buttocks,lower back plus spinal traction, vertebra reposition resulted with quick and constant improvement. If you witness your muscles are always tight and hard, with usual back muscle pain in the morning, my advise would be to give a try with hot jacuzzi tub then strong & deep lower back/buttock/leg massage! Every chiropractic action (spine traction, torsional extension)would speed up your recovery and nerve rehabilitation. First week 3xjacuzzi + massage, 1x chiropractor or leg&back stretching.Second 2x and 1x chiro...
Pain will not vanish but you will notice after second week, pain that started going up the leg /to your knee/hip/ to the point of irritation. This should be done for one month constantly.
Muscle relaxation with hot water treatment, easing blood circulation will impact on joints/ vertebra being properly "greased". Lower back/ buttocks muscle spasm blocks blood and lymph circulation, so lymph cysts, adipose cysts( near CRISTA ILIACA ) are collecting material, growing bigger at the end directly irritate their neighbor -sciatica nerve/ nerve roots, which I believe is problem made you suffer for years. Conservative medicine have its rigid approach - that's why people medicine cannot help always.
This advice is relying on my 10 year sports-physio, chiropractic practitioner experience and army of satisfied clients.

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on 12/06/2010 8:14pm

there s a condition called discogenic nerve pain. when there is an internal disruption of the disc even if there is no herniation the nerves in the disc itself can become irritated. you dont need exploratory surgery to find the problem. a test called a discogram will determine if the disc is the problem. it is a painful procedure but it is a very good test to see if the disc is causing the pain....pete

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on 12/10/2010 2:55am

I'm so sorry to hear about your pain. Please...go get a MRI standing up or sitting. Think about it...laying flat might not put pressure on your nerve root if you have a compression problem. Look at your MRI's...are the discs completely black with no white center? If this is the case...then you have degenerative disc disease. Once you stand up the discs flatten out and your veterbrae compress on one another. duh??? I've been to hell and back with Dr's saying that there's no problem...except it was killing me.

Please be careful about a fusion...expecially an anterior/posterior surgery. It takes about 2 years to heal. Mine's been 7 years of pure hell. good luck... Try using ice packs, deep sleep, magnesium,
bengay patches, vit b's and drink lots of water/distilled.

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on 12/20/2010 1:41pm

Take a copy of the film or disc to the NEUROSURGEON. The MRI is read by a RADIOLOGIST who reports his objective findings. The radiologist has not examined you and has little clinical information to coorelate as he is not intending to be your treating physician. His job is to report obvious findings from a "picture" regarding a real person whom he has never seen. Often the abnormality may be subtle or merely suggested- but when coorelated with your clinical findings, may be of great significance to a neurosurgeon. Think of the initial radiologist's report as a guide... not the final word.

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on 12/21/2010 1:12pm

initial problem may have pressured nerve to the point where damage became permanent. then after disc got better you still have pain. surgeon may be right that no surgical help will fix it. there may not be pressure on nerve now....pete

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on 06/17/2011 12:27pm

What ever you do don't let the doctors give you a CT Myelgram, as it has ruined my life. I am 54, 6 foot 3 and a year and a half thought I was in good condition. I lifted a piece of wood and pulled my back so I worked for a month like it in heavy industry not long after 4 weeks I was put in hospital and then transferred to another one where they did a emergency Diskectomy. I had pain back after 2 days, but that's what you get on public system. A neuro surgeon was working for the hospital one day a week for free. He rescued me and I went into the private system.
Since then I have had 3 Disketomys, 1 laminectomy, 1 fusion, torn dura causing chemical meningitis, countless MRIs, CT's X Rays. I have had 3 epidural steroid injections and also into my facet plates.
Now mainly because the CT Myelgram I have a condition called Arackhoiditus with no cure only pain medication and every time I have a spinal opp it will increase the pain which is full on. There is a lot of reading about the danger of CT Myelgrams . My Neuro is trying to get Workcover to okay a spinal cord stimulator, as its my only hope the injections increase the pain. I will never able to work again. I struggle to lift say 5 kilos it hurts like hell plus I don't sleep much as the pain comes out of now where. My wife's doctor asked if was in hospital with a morphine pump !!! as that the second opportune which I really don't want to go down.
So sorry to bore you all.

Wazza
And at the start of this wild journey I had a bulging disk on L4,L5 S1

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