Medical Questions > Conditions and Diseases > Back Pain Forum

Herniated Bulging Disks MRI results

Should I make a career change because Housekeeping will prevent further healing and cause me to re-injur my back?
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I'm having trouble understanding what the MRI results read... Can someone write in lamens terns what this all means.

My symptoms are pain when bending, twisting, lifting, sitting or standing for long periods of time and pain in buttox. Can you also explain what might be causing this. I got hurt 6 months ago but didn't go off work till 2 months ago. My Physio Therapist says I'll never be the same. He also says since I was laying flat on my back during the MRI it could be the reason we can't see root compression since I have the pain when I'm bending

And it may help to know that I am only 25 years old. I've been a housekeeper at the hospital for 8 years, Monday - Friday 8 hour shifts. I mop at least 4 hours a day, empty close to 90 garbages and clean 14 toilets and shower stall.. DAILY. ..not to mention the medical equipment and mattress's I lift too.

I got hurt while cleaning a unit after the patient was discharged. The hospital was in gridlock (no beds available) and therefore instead of cleaning 2-4 beds like I usually do...I had 11 that day and everyday in gridlock. There was a demand for the beds fast..

I can't recall a specific incident when my back hurt, it was after cleaning one of the units. I continued with this work for another 4 months to which the pain became unbearable. I was taken off work for 2 months. Now I still have pain when bending, lifting, twisting, standing or sitting for long periods of time and I get pains in my right buttox.

Can you possibly explain whats happening to me? My PT says I'm at a plateau in therapy and this is as good as it gets. He recommends a career change. Could my job have made my injury worse like he said? Should I get a new job?


Heres the results:

L3-4
There is mild bulging of the disc which minimally flattens the anterior aspect of the thecal sac. There is however no significant spinal canal or neural foraminal narrowing that results. WHAT DOES THIS MEAN?

L4-5
There is bulging of the disc which minimally flattens the anterior aspect of the thecal sac. The AP thecal sac demensions are however maintained. There is mild bilateral neural foraminal narrowing with no contact of exiting nerve roots seen. WHAT DOES THIS MEAN?

L5-S1
There is a diffuse disc bulge at this level. There is focal indentation of the thecal sac. The AP thecal sac dimensions are however maintained. There is moderate left and right sided neural foraminal narrowing. No contact of exiting nerve roots is however noted. WHAT DOES THIS MEAN?

FINDINGS
The conus ends at L2. there is no visible abnormalities at the distal cord or conus. The cauda equina nerve roots appear to be normal. the epidural fat is preserved. The vertabral body sigal is normal with note made of degenerative end plate changes seen at level L5-S1 level. There is disc space dessication and loss of disc space height at this level. An annular tear is also noted.

And on Page 2 reads....

There are degenerative changes noted which is most prominent at the L5-S1 level. No spinal canal stenosis however results. there is however moderate left sided neural foraminal narrowing. no deffinate contact of exiting nerve roots is noted. WHAT DOES THIS MEAN?
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replied July 13th, 2008
Extremely eHealthy
Re: Herniated Bulging Disks, Annular Tear Indentation on Thecal
Hello vanilla dragonfly,

I'm by no means a doctor, so I will not attempt to totally interpret your MRI for you. I'm just another spiney like yourself, recovering from a spinal surgery.

But questions for you I do have.

Where is your spinal surgeon in all of this going on with you
Do you have a spinal surgeon?
If not, you sure need one ASAP
Why is a physical therapist interpreting your spinal issues for you and telling you that your MRI may not have shown everything because you where in one position and not another when it was done?
Why is your physical therapist taking the place of a spinal surgeon for you?

You need to have your MRI explained to you by a spinal surgeon, not the physical therapist.

The reading you have posted is the interpretation and reading by a radiologist that is trained in reading MRI scan pictures.
It also needs to be read by a well qualified spinal surgeon who may or may not agree with what the radiologist says.

4 months continued work, doing what you do for employment, most certainly continued to make your spinal situation worse.
I would agree, also, that continuing to work as you do and what you do will no doubt continue to create further problems for you and prevent you from healing from this problem as well.

Bad backs, disc problems and lifting heaving things never go together.

Most of us can't recall a specific incident that started the ball rolling and spine problems and symptoms began.

I can tell you some basics of your MRI reading though.
You have degenerative changes in your spine and some flattening of discs between your vertebrae. This is not always a problem to have though. Most people will have those changes. It only is a problem if they create symptoms, ie what you have now.

The key is to determine what and where the problem is coming from and to do something about that specific area that is a problem.

Your symptoms sound like they are coming from the low lumbar area of your spine, and the MRI report mentions an annular tear as well.

Usually those do seal over and heal with PT and time. When they don't, there is a surgical procedure to repair the disc tear that can be done.
and it does mention moderate neural foraminal narrowing as well.

Some of those 2 things that I mentioned could and probably are causing the pain for you and need to be addressed by Spinal Surgeon and need to be done ASAP to help you obtain relief from your pain.

Probably the reason your physical therapist is saying that "this is as good as it gets" is because there is nothing more that physical therapy can do to heal what is going on with your spine and you may or may not need surgical intervention and/ or a pain management doctor for help.

Please seek the advise and care of a spinal surgeon ASAP to fully understand what is going on with your spine, what your MRI means and what can be done to help you with your pain.
Then seek out further opinions from other spine surgeons, until you are comfortable with a spinal surgeon and then make your decisions on what to do.

And yes, you do need to find another line of work. You and your spine will no longer be able to tolerate the work you are doing. It will only continue to create havoc with your spine and create more and more situations that will further complicate an already problematic spine.

Fran
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replied July 14th, 2008
Thank You :)
Thanks for taking the time to read all that.

Right now I'm fighting with my employer. You see.. workers compensation is paying me when I'm off and my employer is Appealing that decision and bring me to court over it.. their reason is they say I didn't get hurt at work because i didn't go to the doctor right after the incident, bla bla bla...and so
Now I have to go see workman'c comp's orthopedic surgeon. I asked them if I should still see a specialist and they said no.. but i have another idea..
I'm going to my doctors this week and asking to see a specialist for my back. This will help with both the work issue and my cluelessness about my MRI results.
Thank you again for all your help and advice.

Ps: Do you know anything about dealing with Workmans Compensation? I live in Canada and it's called WSIB here.
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replied July 14th, 2008
Supporter
It sounds like what you're describing is soft tissue injures in your lower back region, which can become worse over time. Given the severity of your pain and the functional limitations it's now placing on you, it probably is time to consult with a reputable physician or medical acupuncturist who can help you determine your next step as intensive acupuncture can be helpful..
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replied July 14th, 2008
Extremely eHealthy
Zak_han wrote:
It sounds like what you're describing is soft tissue injures in your lower back region, which can become worse over time. Given the severity of your pain and the functional limitations it's now placing on you, it probably is time to consult with a reputable physician or medical acupuncturist who can help you determine your next step as intensive acupuncture can be helpful..



I'm sorry Zak_han, but your advise here is not good advise.

Vanilla dragon has presented his info with MRI findings that show spinal issues, not a simple soft tissue injury. A spinal surgeon is what is needed here to evaluate and determine exactly what is wrong and it needs to be done ASAP.

A medical acupuncturist and intensive acupuncture is the last thing that is needed here at this point in time.

Long before that route is sought out, a complete spinal evaluation and proper course of treatment is needed.

Acupuncture my be of some help, down the road, but evaluation and a proper medical diagnosis and course of treatment is needed long before alternative treatments are used.

I have seen several posts by you on the forums and they all say the same thing. Always soft tissue injury and always acupuncture treatment is DX by you.
Is there some reason that you continue to tell everyone that there spinal problems are soft tissue injuries and they should seek acupuncture?

I find that advise given to so many people, instead of advising proper diagnosis from spinal surgeons to be very poor advise.
Making assumptions by a lay person, based on symptoms described by a member is not, IMHO, a good thing to do.
Even if you have some medical knowledge, you have not examined the member nor are you sure how accurate the information provided is.

The best advise is not to attempt to diagnose someone, but rather, advise they seek the proper medical care by seeing a specialist, a spinal surgeon for proper diagnosis and treatment.

Fran
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replied July 14th, 2008
Extremely eHealthy
Re: Thank You :)
vanilla_dragonfly wrote:
Thanks for taking the time to read all that.

Right now I'm fighting with my employer. You see.. workers compensation is paying me when I'm off and my employer is Appealing that decision and bring me to court over it.. their reason is they say I didn't get hurt at work because i didn't go to the doctor right after the incident, bla bla bla...and so
Now I have to go see workman'c comp's orthopedic surgeon. I asked them if I should still see a specialist and they said no.. but i have another idea..
I'm going to my doctors this week and asking to see a specialist for my back. This will help with both the work issue and my cluelessness about my MRI results.
Thank you again for all your help and advice.

Ps: Do you know anything about dealing with Workmans Compensation? I live in Canada and it's called WSIB here.


You're quite welcome vanilla dragon.

I have no experience with WC and I am in the States, so I am not familiar with anything with the health care in Canada.

What little I do know about WC is that they are there to protect the employer and will do what they can to not pay you, etc. they are not there for your benefit and you have to fight them all the way.

I don't know if it will help you to see your own doc or not, or have the doc send you to a spinal doc either.

I dont' know if it will hurt you or help you with WC. but I do know that you do have to go to their doc right now as well.

Good luck with everything and keep us posted on what happens.

And I do not believe that you are suffering from soft tissue injury or that acupuncture will help you at this time.

It may at some future point, I have used it myself, but only after proper diagnosis and treatment first and under the care and advise of my orthopedic surgeons.

Fran
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replied July 15th, 2008
Supporter
To answer your original question...yes, you might want to consider another vocation that DOES NOT put strain on your spine. And I DO think that there's room for alternative medicine modalities as complements to Allopathic therapy.

What were the results of your appointment?
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replied July 18th, 2008
Thanks
Thanks everyone for the responses, it's good to know that others agree that I need a new profession. And thanks with the help understanding the MRI results. I see an orthopedic surgeon on July 30th.. I'll see what he has to say then.
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replied July 18th, 2008
Extremely eHealthy
You're welcome
Glad you have any appt with an orthopedic surgeon. Just be sure that he/she is an orthopedic sugeon that specializes in spines not just a general orthopedic surgeon. I would also suggest that you consider getting a second opinion if this surgeon suggests surgery for you.

Fran
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replied July 18th, 2008
Extremely eHealthy
Re: You're welcome
littleonefb wrote:
Glad you have any appt with an orthopedic surgeon. Just be sure that he/she is an orthopedic sugeon that specializes in spines not just a general orthopedic surgeon. I would also suggest that you consider getting a second opinion if this surgeon suggests surgery for you.

Fran


From one spiney to another, I agree with you Fran 100%. Where is Rich T??????

Carrie
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replied July 18th, 2008
vanilla dragonfly
Sorry to hear about your back, and the pain that we all know to well that comes along with it. I do know a thing or two about work comp, in august of 07 i sustained injury, march of 08 is the first time i received treatment...i am in the US and know that the laws must be very different.....always ask for a copy of your test results...x-rays, mri, bonescan, anything. My occupational doc. ordered an mri for me, and when the tests results came in, he said they showed nothing, no cause for pain and no evidence of any injury,..i knew there had to be something, some reason for my pain..i asked for a copy of the mri results, and it very clearly stated that i had a bulge at the T2....as Fran said, ask for a second opinion...your spine needs to be in the best hands, and work comp dosent always provide you with that...do your best to see a neurosuergon....ask as many questions as you can, and demand answers untill you feel comfortable...
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replied July 19th, 2008
Extremely eHealthy
Carrie, thanks for agreeing with me. Seems like many people don't realize that an orthopedic surgeon can be a general one, which there aren't that many of now, or one that specializes in various areas of the body that deal with bones and joints.

I'm old enough to remember when orthopedic docs where just that. Orthopedic docs and they dealth with everything to do with bones. The end results for patients where not that good. IE, my 3 crooked fingers, broken when I was a kid and not properly set. Eventually in my 30's, I'd had enough of them a difficulty using my left hand and saw an orthodpedic surgeon who specialized in hands, wrists and fingers.
Yup, surgically all 3 where rebroken, reset and when healed, they where straight and no further problems using my hand.

My personal preference for a spine surgeon is a sports medicine orthopedic surgeon. I like the way they relate to patients, are far more up to date on new but conventional spine surgeries, expain everything is mass detail but simple to understand, and the idea of cutting into muscle is not one that they take lightly. They always start with the smallest incision possible to do the surgery, usually a 1 inch incision and if that is found to not be large enough, they increase the incision but 1/2 inch at a time, till the have the incision size they need.

They are fully aware of the difficulty recovering from cut muscles and their goal is to do as little cutting as possible, and do the surgery safely.

On the other hand, I've had second, third, 4th and fifth, (yup, the idea of spinal surgery the first time was not something I wanted and tried to avoid at all costs) and I saw neurosurgeons, orthopedic surgeons and another sports medicine orthopedic surgeon, all who specialize in spines. And all where at leading hospitals in the Boston area.

What I found was the most eager to cut and with the largest incision where the neurosurgeons, both wanted to do my decompression surgery on the L4/L5/S1 using a 3 1/2 to 5 inch incision. Mind you my original spine surgeon who is a sports medicine orthopedic surgeon who specializse in spines had told me he couldn't imagine needing an incision any larger than 1 inch.
The regular orthopedic surgeon that specializes in spines wanted 3 inch incision,
but the other sports medicine doc, agreed with the 1 inch incision.

A lot of people prefer neurosurgeons because they believe they are better with dealing with nerve issues.

The truth is that all spinal surgeons, neurosurgeons as well as orthopedic ones have had years and years of extra training in nerve issues, spinal nerve issues and it is the same extra training that a neurosurgeon would be getting to be a spine surgeon.
The neurosurgeon gets additional training to be able to operate on the brain, something and orthopedic spine surgeon would never get.

As for where Rich T is. I think he was having computer problems as was going to be off line for about a week.

Fran
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replied July 19th, 2008
Extremely eHealthy
Vanilla dragon
After reading Jada3's post, I realized that there are a few things that I do know about WC and it wouldn't be any different from country to country.

WC is insurance that protects the employer and it's purpose is to save the business/company as much money as possible. They are not there for you or for your best interests.
You will no doubt have to fight them to get the care that you should get, that's the usual way, and they will only relent when,
1. they have no choice because the situation just smacked them in the face and they can't get around not doing something
2. you keep after them, don't give up and don't go away. That's what they really want you to do, be good, do as they say and follow and believe everything they say and tell you.

Remember it is your body, your life, your health.

Without question, get copies of everything and don't let them tell you that you can't have them.

In the states, most WC patients have a WC attorney that they've hired and work for them only to protect them from WC.
I don't know if you have that ability in Canada. If you do, I would suggest you get a good one right away.

You will no doubt have to follow the procedures that are set up for WC, but don't settle for thing like.
there is nothing wrong with you.
you didnt' get hurt on the job. that's what they always say.
you can't see another doctor etc.

Good luck and let us know how you are doing and what the doc says.

Fran
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replied July 19th, 2008
Extremely eHealthy
Hi Gang.
Yes I was very lucky to have one of the best neuro surgeions. But, I had to go to Tampa to have my surgery. Well worth it,. I had kipherplasty and was on the OR table for 1 1/2 hours. I came out without my 55% break at t-12 into L-1. Had no more pain untill I fell coming in the front door about two weeks ago. Now I am having some pain in my toracic area besides my two buldging disc's at at L-3&4. So doc is puting me back on Morphine ER and again I am having an XRray first and if that show andything I will then have another MRI of T-spine. Doc is afraid I may have franctured another verabre. The pain is just a little above the sergical sit. And we really don't know how much trama the cement insertion is able to take at this point. The fall could have very well chipped of a piece. If so, back to the OR I go. Spinies are a never ending battle. I am now and have been for allmost a year, taking Vicodin for my buldging disc's. I also have a wonderful neurologist. Very caring and compassionate man. I think the world of him. He himself calls his patients back.
I will keep you up to date.

Hugs,
Carrie
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replied July 19th, 2008
Thanks Again
Thanks again everyone. I think I will go see my family doctor and ask her to refer me to a neurosurgeon because the orthopedic surgeon I'm seeing works for workers comp. I think I may need a second opinion if this guy turns out to be a jerk. I found a local support group for injured workers. We spoke through email and will be setting up a date to meet someday soon. They are all volunteers that have been through the system and know what I'm going through and what lays ahead.
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replied July 19th, 2008
Extremely eHealthy
The group you found sounds like a wonderful support network for you and will provide you with tons of info on dealing with the dreaded WC.

I don't know how it works in Canada, but here in the states, once you have injured yourself at work, you are required to use WC. No private insurance that you have, either through your employer or personally obtained will allow you to use the ins for any kind of coverage.

Be sure you don't have a similar type of situation as well. you wouldn't want to be stuck with huge medical bills because you saw a doc that was not part of WC

Fran
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replied March 7th, 2009
i am also dealing wit wsib as of 2007 to present with same
i've been dealing with wsib for the past year and some. I was injured at work, fired because of the injury, work was fined for breach of employment obligations, i was origanly diag. with back strain. Took almost a year to get mri, i have a 3-4 disc herniation and a bulged disc and a protruding disc also. wsib said i am able to return to my regular duties, when my doctor, physiotherapist, ciropractor said i cannot return to my regular duties. They have sent me for my NEL for i have a permanent injury, but yet i've been cut off of LOE and i am not to receive LMR. The company was asked to give wsib a list of physical demands and neglected to disclose all of physical demands, and wsib has taken the word of the employer and has determined i am able to return to regular duties, but as mentioned above i was terminated from my job, they did not want me back so they were in breach of employment obligations. But yet wsib says i can return to my previous job,even with my restrictions and my impairement. WSIB has not followed policy and they are not reading all the medical and not reading file properly. I have had to get the Member of Parliment involved (wich has infuriated them) and still i have gotten no where. I've called the fair practice commision they don't understand what wsib is doing, the wsib return to work person dosen't understand what my adjudicator is doing, my doctor has suggested i hire a lawyer. I have been without any means of financial support now for over a month, with only 8 weeks left on sickness benifits that i can claim from ei, wich i am still awaiting there decision, i am in constant pain and discompfort and i've been sent up the river withou a padle. I am about to be avicted from my appartment for i cannot pay, my loan is going into collections, i cannot pay my credit card bills, i will have to give my dog away for i can't afford to feed her. WSIB says they are not on anyones side but they seem to work for the employer, for if i falscified documents, i'd be in jail right now, but the employer can do it and nothing is done. I will keep fighting, for i've already lost everything, it's all i'v got now is a fight left in me.....
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replied April 26th, 2009
reply to Markpon
Markpon, (and whomever else it may concern), I understand that you are in Canada dealing with a road block with the W.S.I.B.
I live in California, U.S. and if faced with this road block with Workers Comp (worst State in the nation to be on W.C.) I would have applied for disability benefits from the State. Also, I would have started the application for Social Security Disability benefits. These are all benefits that we as workers in the U.S. have available to us if situations like these arise. It does vary from State to State, for each has its own laws. But Federaly, there are similarities. When a Workers Comp. doctor says that there is nothing further for you to do, or, that you have reached maximal medical improvement (or permanent and stationary) and that you can go back to work with or without any restrictions, then you have to make a choice, (in the U.S.), either you go back to work, of course risking further injury because you were not seen by the best doctor or specialist out there because W.C. and Canada's W.S.I.B. are there for the company that you work for and not for you, if you let yourself. Or, get a lawyer that has been recomended to you by someone that has had expirience with him/her in the past. Its like going to an auto mechanic, you need to know who you are dealing with. In California, you would have the opportunity to request a QME (Qualified Medical Evaluator) which can be chosen by you from a list of doctors given to you by the State you live in, but, you have a certain amount of limited time to do your selection, otherwise, you lose the right to choose, and the employer or W.C will choose one for you (and we all know who they will pick). In the long run, depending how you agree or disagree with the QME findings, you can request a different doctor/specialist up to a third time, and if nothing results from all this, then a Jugde in W.C. law will take everything into consideration and make a final decision. All this takes a long time which I'm not sure of how long because it all depends on the specific case. Be aware that none of the disability benefits you get will ever make up for your money loss because of being hurt. And, you will only have one back. That's the choice, really. Here in the U.S. it is against the law to retaliate or fire an employee for seeking Workers Comp. A lawyer can secure this for you. Remember, you know your body more than anyone, if you truly can't return to work then you just can't. Here in California, if you are permanently hurt at work, you are entitled to disability benefits from W.C. even if you can go back to work. Its the law. You can work less hours or shifts. Remenber, nobody can force you to lift something heavy. Ask for help with your tasks, and keep in mind that you get paid by the hour (if you are not salary). If they want to send an injured person back to work, then they will get an injured workers productivity, right? If you can't stand the pain once more, then you can get in touch with your employer and tell them that its hurting again. By law they need to give medical attention again. By law. If they refuse, then they are liable. They won't refuse. The W.C system is set up so that the employer does not get away from their responsibility. W.C. is a no one at fault system, unless the employer refuses to give an employee medical attention or the employee is faking it. Both are punishable by law. They will try to say that your injury was not caused by work, and if this happens then you must get a lawyer.
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replied July 17th, 2009
Response to Marcpon - Your story matches mine 90+%
In response to Marcpon, I am having pretty much a carbon copy to your situation. I had an adjudicator up until earlier this year, who advised me that I would be in receipt of LOE and LMR. Later I was swithced to another adjudicator who advised me that I was being denied. I discovered that my new adjudicator was only assigned to me temporarily. I'm back with my old one with no coverage of any kind. My employer is happy while I'm struggling to walk, stand, and sit. Was that adjudicator from Toronto, Ontario? If so, was his name Tony Hanna?
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replied September 12th, 2012
RE: WSIB & who really decides how you feel? The adjudicators
Oh my God! I just decided to google Mr.Tony Hannahs name to see if he has ruined or severely scarred any families by stoping their WSIB benefits with ones weeks notice? I'm just writing on my phone but I have to sign up to this sight because you're all people who understand what I've been going through & that even with a spinal fusion done I was cut off from my benefits by this man months ago. His general rudeness on top of that & talking down to you while you're in agonizing pain! Like I said its hard to read everything here on my phone but I will register on my laptop & would love to join the conversation. All the best to everyone, keep on fighting!
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