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MRI Accuracy? Nerve Impingement

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After having an MRI a back surgeon indicated that I have a bulged and semi-herniated disc (L5/S1) I was advised from WSIB that it wasn't pinching my nerve; therefore, I shouldn't have ever nor should I ever experience any pain from it. Consequently, WSIB disallowed my claim for any disabilities, as apparently I shouldn't have any restrictions as to what I'm able to do. I've been experiencing pain every day since May 12/08. I was in a forklift accident at work, which was documented and witnessed by several co-workers. It's been over a year now and I've been through two rounds of physio therapy. While I continue to perform the exercises, which were shown to me, it's only alleviated some of the pain. For the last week my back has deteriorated. I can't stand straight. When I'm in bed I can't get comfortable unless I drug myself. When I get up from bed in the morning I'm at about a 100 degrees for a while before I can straighten myself enough so that I can walk. I keep getting sciatic pain running down my legs. Throughout the day for the last few days I can't lift up the toilet seat with my hand. This morning was no different. I have to use my foot to lift it up enough so that I can grab it while supporting myself on the vanity with my other hand. My doctor said that it's not likely that I will ever be able to return to being a laborer on the floor. Currently, I'm attempting to obtain a lawyer, as I've appealed WSIB's decision.

My questions is: Is it possible for a disc, which is semi-herniated or bulged, to flare up and pinch the nerve and then go back down some time later, thereby taking pressure off of the nerve?

My second question is: The sciatic pain, which I receive rarely happens when I'm laying down. The pain happens frequently when I'm standing, bending, sitting, reaching, etc. The MRI didn't show any impingement; however, I was lying down on the table when the scan was completed. Is it possible for the MRI to not pick up nerve impingements due to the fact that I was in a position that typically offers me comfort? Could it have had different results if I was standing?

Please off me any kind of feedback. It is greatly appreciated.
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First Helper goldenyears

replied July 17th, 2009
Extremely eHealthy
First of all, if you where told that you can't get nerve pain from the L5/S1 disc bulge and partial herniation doesn't know what they are talking about.

Second, the interpretation of your MRI that there is no nerve compression (pinching of a nerve) is just that, someone's opinion and not necessarily correct.

Your description of yourself and your pain is classic nerve compression from a disc bulge that is compressing nerves and causing a stenosis in your vertebrae.

The location of your nerve compression could be the cause of being told there is no nerve compression.

If it is in the lateral recess area of the vertebrae, then that might explain the reason why you where told that there is no nerve compression.

There are still many doctors out there that do not believe in the lateral recess area of the spine causes nerve compression and do not see what is in front of their face.

There is, occasionally where an MRi doesn't show the nerve compression and a standing MRI would help or EMG, nerve conduction tests can pinpoint the nerve compression when an MRI doesn't.

But your symptoms are so classic that it is hard to believe that the MRI didn't show the nerve compression.

I'm assuming that WSIB is the Canadian agency that oversees work related injuries, disability stuff and healthcare from work related injuries. It sounds like it is the equivelent of Workman's comp in the US.

Assuming that is true, then you are dealing with the agency that is basically and insurance to protect the company and not the patient. They are going to do everything they can to protect the business and not care about the patient.
That would account for their saying that you have NO nerve compression nor can you have any from the location of your bulge.

I don't know how your system basically works but it sounds like you are going to be in for a fight for any treatment and proper diagnosis.

Are you able to get a copy of the MRI report that was originally done? If so then you need to get a copy of it right away. Can you talk with the radiologist that read your MRI? If you can, then do so.

It may be that what the radiologist has said and what you where actually told are 2 very different things.

You need to contact WSIB and tell them what is going on now. Explain that you are not only not any better,but rather far worse than you where a year later.

Demand to see a spine specialist ASAP and have another MRI done ASAP.

Can you talk with the physical therapist that you where seeing and tell him/her what is going on and get an opinion from the physical therapist.

Are you able to go on you own to see a spine specialist or are you totally under the control of your NHS?

Good luck

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replied July 18th, 2009

I do have a copy of my MRI. It merely indicates that despite there being a bulged and semi-herniated disc at the L5/S1 there is no nerve compression. You made a great suggestion. I will try and make contact with the person who interpruted these results.

My doctor knows that my situation has spiked. A couple of days ago I asked her if I could get a referal to see a neurologist. She told me that there would be no point of getting the referal. Furthermore, she advised me that if she did my insurance wouldn't pay for it as I've made an appeal against WSIB. You are correct. WSIB is sometimes referred to as Worker's Comp. I do have good days and bad days. Lately, it has been more bad than good. When I had my MRI I was having several good days. WSIB advised me that it doesn't matter of how I was feeling when the MRI was conducted, as it would pick up nerve compression regardless of how I was feeling.

You have offered me further incouragement with my fight against WSIB and my employer, Pilkington Glass Mfg. Perhaps you've heard of them. They make windshields for automobiles. Just like most automotive related companies they suffered a large decline in orders for production. They are attempting to relate my claim with the fact that I'm laid off. As such they believe that my claim should be dissalowed in full. They seem to forget that my accident happened over a year ago. I was on modified duties at the factory for a period of 11 months, as I have restrictions from my forklift accident on May 12/08. It's a much larger story than what I've presented.

I realize that I am in a dirty battle. I've was suspended from work unjustly. I received constant harassment and discrimination post May 12/08. I used to be referred to as a company man by my co-workers. After the accident the same co-workers asked me what I did because it was clear that management was treating me differently. I've babbled on long enough. Thank you for listening.

As I mentioned I will attempt to contact the person who interpretted my MRI. I know that this may be difficult but it's definately worth a shot. My lawyer and I will have to discuss what avenue will be best to take in my legal action against WSIB and Pilkington.

If you have any addional wonderful suggestions please let me know. Thank you to all who have taken their time in reading this post.

With many thanks,

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replied February 16th, 2012
I was injuried in 2008 my MRI came back stating as your did. But my surgeon stated that I was not a surgial candidate. Therefore my symptoms ( sciatic )are mainly due to the soft tissue injury from the multiple falls at work my cliam was approve by WSIB. But it's been hell with my case manager....
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replied April 20th, 2010
OMG ,finally I have found another person with same systoms.I thought I might have gone crazy in my golden years.I was injuryed in Jan at work. WSIB has made it hell for me.Not only is the abuse from wsib awful, my Back pain is unbearable.
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replied March 2nd, 2011 symptons nearly exactly...except that i have been to 3 different physio's who all told me that i have l4/l5/si problems as well as sacroilliac pain....i have pain running down my right buttock all the way to my toes, i also have pain in the lower part of my back. Each of these pains is bought on by different actions, lower back is bought on by sitting, sacroilliac bought on by walking, 2 spinal physicians and one other specialist later(paid for by insurance form) and they tell me I am fine.
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replied May 24th, 2011
When it comes to back pain the NHS are pretty hopeless.

I have suffered for over 15 years from back problems including trapped nerves and sciatica and was always examined by the doctor by being poked a couple of times in the back or them asking me to bend over. Not a very accurate method of diagnosis!
Usually I was given ibuprophen, which was a short term help.

I had terrible back problems after the prolonged use of crutches following ankle reconstruction and my friend recommended an osteopath and after a number of manipulations I was pain free and everything moved in the right way. I could bend right down without coming to a sudden nerve-pinching pain half way.

The NHS don't do osteopaths, their back clinics are physio as it is statistically more cost effective.

An osteopath isn't cheap, but worth every penny in my opinion, if a painful back restricts your life so much.

I'd advise going to one that is recommended by someone you trust.

If you live in South East England, I'd recommend John Taberman-Pichler (google him) he's worth traveling a few miles to see, amazing results.
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replied October 3rd, 2011
wondering how it worked with WSIB. I am in the same situation and the nerve conduction tests (2) proved the damage. I have lost the feeling in about 1/2-2/3 of my right foot and am appealing the WSIB desicion right now.
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replied October 30th, 2011
Currently, I'm waiting for WISIAT to call me in, as WSIB has denied me in full. I've been told that it may take another year for this to happen. Apparently, the entire process can take from three to five years. It's such a great system.

Although my situation has improved, I still receive sciatic pain on a daily basis. I've been getting more pain running down my right side the last few weeks. I've also been doing a lot more driving the last few weeks. What can one do? Just like the average person, I too have to keep working. Good luck to any victim out there!

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