My Doc Says I Shouldn't Have Pain Posted: 02-10-06 20:00pm
I'm 33 years old and i've been having
chronic back and neck pain for at least 9
months (+). I recently had an mri of my
lumbar spine and cervical spine. My
general practicioner says that the results
of the mri do not indicate that I should
have any pain. He wants me to see a
chronic pain clinic. I think that they're
might be something more going on. What do
you think?
Could I have degenerative disc disease?
Or could my pain be attributed to
ankylosing spondylitis?
I am most of all looking for a diagnosis.
L4-5: there is loss of disc space height
and signal of the intervertebral disc
consistent with disc dessication. There
is a diffuse disc bulge, slightly more
prominent on the right, however, this does
not appear to be contacting the exiting
nerve roots and may be barely contacting
the transversing nerve roots at this
level, right greater than left, however,
there is no evidence of significant
displacement or impingement of these
nerves from this disc bulge. No evidence
of spinal stenosis.
L5-s1: there is a tiny midline disc bulge.
No evidence of spinal stenosis or disc
herniation. Nerve roots exit normally.
Impression: degenerative changes of the
lumbar spine at l4-5 and l5-s1. Of note
is a prominent right of l4-5 disc bulge.
C4-5: mild bilateral uncovertebral
hypertrophy without canal stenosis or
neural formainal narrowing.
C5-6: bilateral uncovertebral hypertrophy
and facet hypertrophy. The left neural
foramen appears to have moderate
narrowing. A distinct disc protrussion is
not demonstrated.
Impression: spondylosis at c4-5 and c5-6
with suggestion of left neuroforaminal
narrowing at c5-6. As this appears
related primarily to the spondylitic
change, a ct of the cervical spine will be
confirmatory.
Owen
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Tamadrummer
Active User, Really EHEALTHy
Joined: 15 Oct 2004 Posts: 710 Location: Zephyrhills,Fl
Posted: 02-11-06 08:18am
You already have your necessary diagnosis.
I do not understand why your doc says you
should not have pain.
Because he is sending you to a pain
clinic, you are going to be treated by
folks that are truly qualified to handle
the situations you are having with pain.
They can also direct you to the best place
for repairs if that is necessary.
You have legit spinal problems, they may
not be surgical or if they are surgical
they will most likly be micro-surgical
like micro-discectomy/nucleoplasty/idet
procedures. The first thing they will do
is give you pain meds, schedule epidural
steroid injections and see if they can get
your pains under control.
This is not an exact science and you are
on a never ending road when it comes to
back pain, don't lose hope, there are new
answers being developed daily and
treatment gets better with each new
development.
P.S. Do not go out and buy magnets or
other placebo stuff to help, they do not
work and you will be wasting your money.
(if the mri didnt make your back feel
better then a magnet belt isn't going to
make it feel better either)
In the event of findings such as these,
physicians may tell patients that there is
no organic cause for the pain. The
reason is that degenerative finidings are
thought to be relatively normal and in
many people, if not most, do not cause any
symptoms. So, they are considered to be
false positives in most cases.
That doesn't mean that there isn't an
organic cause to symptoms. On the
contrary, false negatives are a huge
problem also. Many patients with pain
have completely negative imaging studies.
In general, in most cases, if a patient
reports low back pain, they have it. The
failure to find the cause does not
implicate them. We don't know the cause
in the vast majority of cases. This
isn't me speaking off the cuff. The most
respected researchers emphasize this.
One of the most prominent spine
researchers claims we can only find the
cause in about 15% of cases.
Only a small, small percentage of people
with lbp have truly psychogenic pain. In
these cases, there are relatively simple
screening tools to evalute this.
Good luck. Get to a qualified
professional who can help sort this out
for you.
