Next Steps After Lumbar Spine MRI: What to Consider
Age: 30, Height: 5'11", Weight: 190 lbs. Over the past three years, I have experienced a gradual decline in muscle strength. Initially, I would have discomfort after sitting for extended periods, but now I have progressed to experiencing loss of sensation in my feet and legs. Additionally, I struggle to activate my pelvic floor muscles and I feel instability in my tailbone. I recently underwent an MRI, and the findings are as follows: - **Lower Thoracic Spine**: The results indicate no significant narrowing of the spinal canal or neural foramina in the examined region. - **L1-2 Level**: No notable narrowing of the spinal canal or foramina observed. - **L2-3 Level**: No significant narrowing detected. - **L3-4 Level**: Similar results with no significant narrowing. - **L4-5 Level**: Mild reduction in the height of the intervertebral disc is noted, accompanied by a very mild bulge. There is minor narrowing of the spinal canal and bilateral foraminal spaces, though no nerve root compression is present. - **L5-S1 Level**: There is minimal bulging of the disc, with slight narrowing of the spinal canal. This MRI was conducted following an EMG of my legs, which revealed: A needle survey indicated chronic denervation changes alongside lower muscle recruitment, with higher amplitude and duration in muscle units. There were no signs of smaller units, premature recruitment, or polyphasic discharges. A few muscles displayed mild, transient fasciculations, but there was an absence of sustained insertional activity. Given the pelvic instability and my challenges with sitting, would it be advisable to pursue an MRI of the sacral spine? My neurologist plans to arrange a lumbar puncture and a brain MRI to eliminate the possibility of multiple sclerosis. However, considering the delays often associated with scan approvals, I would prefer to expedite this process if possible.
Answers (1)
9/12/2025, 5:40:46 PM
OpenHealth AI
It sounds like you're going through a challenging time with your symptoms and diagnostic journey. The MRI results indicate some mild disc changes at L4-5 and L5-S1, but there’s no significant nerve root compression noted, which is a positive sign. However, your experiences of muscle weakness, loss of sensation, pelvic instability, and discomfort are concerning and warrant thorough investigation.
Explanation
Your symptoms, including the loss of sensation and muscle strength changes, alongside the acute findings from your nerve conduction study (EMG), suggest that further evaluation is essential. While your current MRI doesn't show significant issues in the lower lumbar spine, the pelvic instability and your overall symptoms may justify a closer look at the sacral region. It is reasonable to raise this possibility with your healthcare provider.
Additionally, the planned lumbar puncture and brain MRI will help rule out conditions like multiple sclerosis, which is crucial given your symptomatology. Understanding all these aspects together will provide better insight into your situation.
Next Steps
-
Discuss Sacral MRI with Your Neurologist: Bring up your concerns about the potential need for an MRI of the sacral spine during your next appointment. Emphasize your symptoms of instability and discomfort, as these may impact your overall health and functioning.
-
Prepare for Upcoming Tests: Since a lumbar puncture and brain MRI have been planned, prepare for these tests by ensuring you are hydrated, following any specific instructions given by your healthcare provider for these procedures, and discussing results expectations.
-
Monitor Symptoms: Keep a daily log of your symptoms, noting any changes or additional difficulties you experience. This record can provide valuable information to your healthcare team.
-
Physical Support: Consider gentle physical therapy focusing on core strengthening and pelvic floor exercises if suggested by your healthcare provider. Avoid high-impact activities until your symptoms are assessed further.
-
Stay Informed and Engaged: Reach out to your healthcare team with any new symptoms or worsening conditions as soon as they arise, keeping the lines of communication open for timely responses.
Taking these actions may help you feel more in control of your health journey and ensure that you receive the attention needed for your concerns. Let me know if there are other specific areas where you require more information or support!
Related Questions
Seeking Insights: My Journey with Undiagnosed Neurological Symptoms
Hello everyone, I'm a 34-year-old female grappling with neurological symptoms that first appeared in October, and I’m eager to hear from anyone who might have faced similar challenges. My journey began with unexpected migraines, blurred vision, and an ongoing sensation of being off-balance or intoxicated. Gradually, I began experiencing mainly sensory-related symptoms, such as tingling and burning sensations, feelings of extreme heat and cold, sharp pains radiating in my arms and back, as well as discomfort in my hands and toes, alongside intermittent numbness. I also endure varying degrees of weakness and heaviness in my right side, specifically my arm and leg, although I haven’t suffered complete functional loss. The nature of my symptoms is erratic; they fluctuate rather than consistently deteriorate. An MRI revealed mild, scattered lesions in the white matter, which were deemed nonspecific. Further tests from a lumbar puncture returned normal results, showing no markers of inflammation, and the oligoclonal bands were not present. A thorough range of lab tests yielded no significant findings. After evaluating my case, the neurology team suggested a possible diagnosis of MS and administered a three-day course of intravenous steroids. While I noticed a slight improvement in some sensory pain, my symptoms persist and continue to vary day by day. I still experience headaches and pressure in my head along with episodes of blurred vision, but there have been no new deficits since treatment. I am reaching out to connect with others who have had similar experiences. I would like to learn about the insights or diagnoses you encountered and what treatments proved beneficial (such as those related to migraine disorders, dysautonomia, or sensory neuropathy, for example). If you have navigated a similar path, I would greatly appreciate your sharing your story. Thank you!
Unusual Heart Sensation
I’m an 18-year-old, weighing 50 kilograms and standing at 170 centimeters (and yes, I’m aware that I’m quite slender). For the past couple of years, I’ve developed a habit of smoking about half a pack of cigarettes each day. So, the other day I was lying on my left side, relaxing, when I stumbled upon an unusual sensation. It felt as though my heart was pulsating so intensely that it was almost outside my body. Out of curiosity, I pressed a bit on the area and was instantly hit with a rush; my head started to tingle, my vision momentarily blurred, and it felt as though my heart dropped. It was as if my entire system had malfunctioned. Just for context, I’ve experienced something similar before after a ketamine overdose, and it persisted for about a month afterward, occurring occasionally while trying to sleep or during random moments in bed. This current episode has me quite anxious, especially since it hasn’t happened in a while, but this time felt particularly alarming.
Mass on the Glottis
Patient Details: 63-year-old male, height 165 cm, weight 66 kg, Asian descent. Lifestyle Factors: No history of smoking or alcohol consumption. Medical History: Diagnosed with asthma and angina. Current Medications: Uses a Symbicort inhaler and takes Concor tablets. Main Concern: A mass was detected during a gastroendoscopy carried out a year ago. There is no report of pain, but the patient experiences mild hoarseness. What might be the diagnosis?
Experiencing Heart Palpitations Following Chest Impact
I'm a 17-year-old female who has struggled with tachycardia for several years, having been diagnosed with postural tachycardia syndrome (POTS) about five years ago, although I haven't pursued further testing because I haven't completely lost consciousness. Recently, over the past month or two, I've started to experience sensations of my heart skipping beats, accompanied by difficulty in breathing during these episodes. These occurrences have become significantly more frequent, even when I'm at rest. Five years ago, I underwent a Holter monitor test, which indicated primarily tachycardia with occasional premature ventricular contractions (PVCs), but nothing alarming was found. In early December, I was struck hard in the chest by an elbow while in a mosh pit, which resulted in some pain when taking deep breaths for a few days. My sternum became bruised and slightly swollen, and it remained tender to touch for about two weeks, but this discomfort was manageable. I still feel some soreness when stretching, although it’s not severe. Additionally, I have diagnoses of Crohn’s disease and hypermobile Ehlers-Danlos syndrome (HEDS), and I am currently on immunosuppressants. Given these circumstances, would it be advisable for me to seek medical evaluation, or could these symptoms be considered typical?
Post-Gallbladder Surgery Concerns: Potential Infection Three Weeks Later?
Subject's Age: 35 Gender: Female Height: 5 feet 4 inches Weight: 160 pounds Ethnicity: Asian Duration of Symptoms: Last Three Weeks Geographic Location: United States Relevant Medical History: Almost three weeks ago, I underwent gallbladder removal surgery. In the last few days, I have observed a small amount of cloudy discharge emerging from my incision site. Recently, I noticed what appears to be pus leaking from the area. While there is no significant pain, I do feel a mild soreness when I touch or move the site. I have not experienced any fever or chills, and there’s no unpleasant odor coming from the wound. Should I continue to clean the area with soap and water, or is it advisable to seek medical attention at the emergency room for further evaluation?