Mri scan unsure what it means

[Sjan123]

Please can some one tell me what my Mri results mean?

They are degenerative changes at L5/S1 where there is a right paracentral disc protrusion

Disc material indents the thecal sac and causes right lateral recess stenosis

This may affect the transiting right s1 nerve root

They is no evidence of exit foramen stenosis

Thank you in advance

[Sjan123]

Thank you for your advice much appreciated

[philnoir]

I'm glad that you are fit and young -- this helps a great deal.

I imagine you suspect cauda equina because of perineal numbness or what they call "saddle block" that can cause a loss of bladder and anal sphincter control. But, there are other conditions that can cause the same symptoms, so please don't jump to conclusions.

The MRI states that you have degenerative disc disease (DDD) at  L5/S1. Man (and woman) has been plagued with DDD ever since first walking on two legs. Many over 40 have this disease without a symptom. Perhaps you exacerbated the problem? It's difficult to tell exactly why you're experiencing this problem, which is essentially a disc protrusion at L5./S1.

With DDD and disc protrusions, this disc fails most often as it carries the weight of the entire spine. The protrusion into the intrathecal space -- the space that contains the spinal cord -- puts pressure on adjacent nerve roots, causing your symptoms.

At this level, the cord is not a solid nerve bundle. Instead, it's a collection of separate nerve roots called the cauda equina -- the term means "horse tail" as that's what it looks like.

The MRI report suggests that one or more of these nerve roots (S1) may be under compression from the protruding disc, mostly on the right side.

This sounds from the report like a disc compression syndrome and does not necessarily indicate cauda equina (CE), which has other causes.

Of course, only your doctor can make a correct diagnosis -- I'm just guessing from long experience talking with people like yourself.

I imagine your doc is trying the conservative route, which is smart -- you don't want surgery.

However, you should be asking many more questions, including:

Is this CE? Am I risking permanent nerve damage? What is the plan here? What are other treatment options along with risks and benefits? How will this effect my qualify of life?

I know the numbness is bothersome, but pain is more or less under control?

Incidentally, the amitriptyline dose is very low -- minimal. If you are experiencing bothersome side effects, you might ask your doctor to change you to another TCA -- nortriptyline. People sometimes have less drowsiness and dry mouth with nortrip instead of amitrip.

After a disc protrusion (not a herniation, which is worse), disc material can reabsorb on its own or move away from the site of nerve impingement, leaving you feeling much better. This can take up to 18 months.

Please continue to exercise to the best of your ability -- this increases circulation and promotes healing. But do not move into pain -- back off. Physical therapy with the right therapist can help accelerate healing and may be somewhat painful, but their knowledge allows them to understand what helps vs. what can be damaging.

I hope that I've answered your questions. I empathize with your pain and discomfort, but please understand that many people live with symptoms that are far worse. As of now, your case is fairly mild-to-moderate. Work with your doctor, continue reading about lumbar spine disease (try spineuniverse.com), and please, stop self-diagnosing -- it causes unnecessary anxiety that leads to depression.

There is hope in your case, but please ask your doctor for specific answers. They may put your mind at ease.

And remember that I am not a doctor and do not provide medical advice. See your physician for any medical concerns that you may have.

Best wishes.

[Sjan123]

I am concerned I may have
- cauda equina syndrom
Age - 43
Female
Height - 5ft 4
Weight - 9.10 stones
Hobbies- gym classes lessmills combat / pump and spin classes
Job - looking after children does not require lifting
General was a very active happy person, enjoying time with friends and holidays abroad , full time house wife also looking after my own 3 children doing all cooking and house hold duties.

Thank you for reading any replies most welcome  

[Sjan123]

Hi I injured my self 7 months ago doing  exercise at home repetitive movement off the leg, pain appeared 2 days later and got worse through out the months.
pain symptoms in right side leg are -
Feels swollen in my right butt cheek , lower back pain,
Pain radiating down the back of leg down to my knee,
Tingling feeling in my right foot,
I have a sort off numb sensation near my anal area that has been there for past 5 weeks, some times I do not make it in time to toilet and stool my self by the time I get to the toilet.
( No issues with urine so far )
Pain getting up from standing in/out car, I have began walking with a limp.

medication-
1 lansoprazole 30mg
1 x 2 a day codeine phosphate
15mg ( if require more can take but I just try stick to 2 max a day)
2 x 2 paracetamol 500mg ( if more can take but I take this amount only )
1 x 2 naproxen 500mg

1st Mri done for pelvic
results were -
minor fluid over the greater trochanter consistent with minor trochanteric bursitis

8 weeks ago went to a muscular- skeletal triage clinic
she said I have piriformis syndrome and was given additional medication

1 night  amitriptyline 10 mg

1 x 3 gabapentin 300 mg

This has controlled my pain but when I do not take medication I am back in tears with pain

Currently seeing a physiotherapist told to do exercise 3 times a day
Nero flossing 20 times each side ( this brings on more tingling in my right foot and can not lift foot up much )
Core exercise- bridge total 10 with a 5 seconds hold
Side-lying Clam Exercise - 20 each side
Piriformis stretch-
Lying on your back with both knees bent, gently place the ankle of the side to be stretched upon your opposite knee. Then place the hand of the same side to be stretched on your knee as shown and gently push your knee away from you.
Hold: 20 – 30 seconds

With all my medication I am getting depressed gp wants to increase my amitriptyline but I have decided against this so have gone back to the gym as I can not feel the pain as long as I take all my medication on time, I get a good feeling of being at gym and I am doing the yoga/palates classes to the best I can

2nd Mri results have said -
They are degenerative changes at L5/S1 where there is a right paracentral disc protrusion

Disc material indents the thecal sac and causes right lateral recess stenosis

This may affect the transiting right s1 nerve root

They is no evidence of exit foramen stenosis
---
I do not understand what this means 2nd Mri results so would like someone to explain in plain English terms

[philnoir]

Let me ask you some questions -- what are your symptoms? Do you have pain? Where? What does it feel like? Does it radiate? Is there any numbness or tingling in your legs or buttocks? Pain in the legs? Any difficulty with urination or defecation? Burning or cold feet?

What's you're approximate height, weight, age, and sex?

What is your job? Does it involve heavy lifting? Have you fallen recently or experienced another accident causing your to bend forward with force?

Do you have any other medical conditions?

MRIs alone are somewhat meaningless without clinical findings -- out of context --  that is, without a history and physical signs and symptoms acquired via a medical examination.