OpenHealth Q&A

Seeking Clarity on My Lumbar MRI Results - 29F

I have been enduring chronic pain since September of last year, and I’m struggling to make sense of my condition while I await my neurosurgery consultation. My painful experiences have transformed my life significantly. Previously, I maintained an active exercise routine, working out five to six times weekly. Although I occasionally dealt with sciatic discomfort that would last four to five days, this sustained pain is unlike what I had faced before. I now feel imprisoned by my own body. In an effort to alleviate my symptoms, I have been carrying out physical therapy exercises at home, but I had to stop attending sessions due to work commitments. Interestingly, my pain levels are more manageable on my days off, suggesting that long hours spent at the computer exacerbate my condition. Wearing anything other than sneakers dramatically heightens my discomfort. My baseline pain is around a level three, but it escalates to an eight by bedtime during most weekdays. Ice therapy provides some relief, and I have taken to sleeping with pillows under my legs, as it is the only way I can find comfort at night. I’m hopeful that someone with qualifications could take a look at my MRI findings. Despite consulting ChatGPT and doing some research, I tend to approach what I find on the internet with skepticism. Ultimately, I long to regain control over my life. I’m not looking for an overly complicated evaluation, especially since I have an appointment coming up. Thank you for your help! **MRI Summary**: **Purpose**: Evaluation of intervertebral disc disorders with radiculopathy in the lumbar area. **Previous Imaging**: Comparison with existing lumbar spine X-rays. **Imaging Method**: Conducted using multiparametric 1.5 Tesla MRI scans of the lumbar spine. **Results**: - The L5-S1 disc exhibits dehydration and a reduction in height, showing L5-S1 Modic type 1 subchondral marrow signals, notably on the left side. - A fragment of the L5 anterior inferior vertebra surface indicates a chronic apophyseal injury, alongside the presence of degenerative spurs at L5-S1. - The conus medullaris, terminating at the L1-2 level, appears normal, as does the portion of the distal spinal cord that was scanned. No abnormalities were noted in the filum terminale. - Levels T11-12 through L3-4 did not reveal any suspicious findings. **Additional Findings**: - At L4-5: A disc bulge is observed along with a small central/right central protrusion that mildly compresses the thecal sac, with the anteroposterior sac diameter at the lower limit of normal. No concerning findings in the recess or foramina. - At L5-S1: Features include intersegmental lordosis with slight retrolisthesis, a broad downward-directed disc protrusion that compresses the epidural fat, and bilateral foraminal encroachment with mild stenosis on the left side. The caliber of the S1 nerve root sleeves is notably prominent.

Answers (1)

7/21/2025, 1:31:00 AM

OpenHealth AI

Thank you for sharing your situation and MRI findings. It sounds like you're experiencing significant discomfort, and I understand how frustrating it must be to manage chronic pain. Let's break down your MRI results, identify key concerns, and provide some actionable steps to help improve your situation while you await your consultation.

Key Points from Your MRI:

1. L5-S1 Disc Issues: Your MRI shows dehydration and height reduction of the L5-S1 disc, along with degenerative changes (like spurs) and some compression of nearby structures.
2. L4-5 Concerns: There is a mild bulge at L4-5 and slight protrusion compressing the thecal sac, though it doesn't appear highly concerning.
3. Normal findings elsewhere: Important structures like the spinal cord and nerve roots do not show critical issues based on your MRI.

Understanding Your Current Condition:

Chronic pain, especially with a mechanical component like disc issues, can lead to nerve-related discomfort (such as sciatica). The fact that you feel better on days off suggests a clear link between prolonged sitting/work and increased pain levels.

Actionable Steps:

1. Ergonomic Adjustments:

   • Adjust your workspace to make it more comfortable. Try using a chair with good lumbar support. Consider a standing desk or alternating between sitting and standing to reduce the strain on your back.

2. Continued Physical Therapy:

   • Even if you can't attend sessions in person, continue the physical therapy exercises you know help. Focus on core strengthening and flexibility exercises that can help relieve pressure on your spine.
   • Only do what feels comfortable and avoids exacerbating your pain.

3. Pain Management Techniques:

   • Continue using ice therapy to reduce inflammation when needed. Consider using heat as well, which can help relax tense muscles.
   • Over-the-counter pain relief (like ibuprofen) can help manage flare-ups but consult with a healthcare provider about what’s safe for you.

4. Restorative Sleep Positions:

   • Keep using the pillows under your legs and explore keeping your knees slightly elevated to relieve strain on your lower back—this has been beneficial for you.

5. Mindful Movements:

   • During daily activities, be mindful of your posture. Changing positions frequently can prevent stiffness.

6. Documentation:

   • Keep a pain diary to track what activities or positions increase or decrease your pain. This will provide helpful information during your upcoming consultation.

Support and Next Steps:

Stay hopeful; many patients with similar MRI results find relief through appropriate treatment and lifestyle adjustments. Your upcoming neurosurgery consultation is a great opportunity to discuss the MRI results in detail, and you can inquire about specific treatments, including potential injections or surgical options if necessary.

Don't hesitate to reach out for support or further clarification as you navigate this challenge. Remember, you're taking proactive steps toward regaining control over your situation.