OpenHealth Q&A

How Should I Proceed?

I want to share my situation to seek advice (38-year-old female): Since a fall at the beginning of December, I've been experiencing worsening pain along my left side, numbness, and difficulties with sexual function and bladder sensitivity. This alarming situation finally pushed my doctors to order MRIs. Prior to this, I was diagnosed with Functional Neurological Disorder (FND) in 2023, but my requests for spinal MRIs were consistently dismissed. The pain management specialists chalked it up to “just fibromyalgia” and chronic pain syndrome, opting for physical therapy instead of further investigation. Having endured pain since I was around nine, I am currently being tested for Mixed Connective Tissue Disease (MCTD) alongside a diagnosis of hypermobile Ehlers-Danlos Syndrome (hEDS). I can no longer accept that my pain is merely psychological or just my “body keeping the score” as I’ve been told in earlier consultations, especially considering my past trauma from sexual assault. Where do I turn from here? Neurology has been notably dismissive over the years, and I now find myself anxious about visiting any healthcare provider. Should I take immediate action based on this report’s findings? The pain remains persistent, alongside issues with proprioception and the previously mentioned numbness, including a feeling of heaviness in my legs that complicates my ability to walk upstairs. ### MRI Findings: - The thoracic curvature (kyphosis) appears largely intact with no major signs of anterior-posterior septation. The heights of the vertebral bodies are preserved. - The bone marrow signal has minor variations, with some scattered endplate alterations observed. At the T10 level, there’s an 8.5 mm rounded area signaling benign intraosseous hemangioma. No indication of acute bone injury is detected. - Degenerative changes manifest with slight disc desiccation in the mid-thoracic spine, especially at the T6-7 and T7-8 levels where there's minimal narrowing of the disc space and a few slight ventral osteophyte formations. A partial effacement of the ventral thecal sac is noted at T7-8, without significant spinal canal stenosis. The openings for the nerves (neural foramina) remain mostly clear. Bilateral degenerative changes in the facet joints at T10-11 have caused some indentation in the dorsal thecal sac, yet significant canal stenosis isn't present. - The spinal canal is naturally slender, with shorter bilateral pedicles and an increase of epidural fat. The thoracic spinal cord appears normal in its structure and size, without abnormal signals detected. Additionally, no fluid collections or masses are noted in the spinal canal or surrounding soft tissues. ### Lumbar Findings: - The lumbar curvature (lordosis) shows no significant anterior-posterior misalignment, and vertebral body heights are intact. An approximate 17-degree lateral curvature (levoscoliosis) is evident, centered at L1-2. - The marrow signal shows minimal variations with trace changes at the L5-S1 level without significant abnormalities. There are no indications of acute injury in the lumbar area. - Degenerative changes include disc desiccation and marginal space narrowing at L5-S1, but the other disc heights and signals are relatively stable. Minor ventral osteophytes are present. - The spinal canal is naturally slender, with shorter bilateral pedicles and accentuated epidural fat. The distal spinal cord and conus medullaris appear normal with no atypical signals. The conus ends at L1-2, and no fluid collections or masses are observed in the spinal canal or surrounding tissues. - At L1-2 level, no significant disc bulging is detected, only mild to moderate degenerative changes in the facet joints bilaterally. No substantial narrowing of the central canal or neural foramina is noted. - At L2-3 and L3-4 levels, slight bulging of the disc is visible along with mild degenerative changes in the facet joints, but no significant narrowing exists. - At L4-5, some prominent disc bulging measuring 4.5 mm affects the left foraminal area with notable degenerative changes present. - At L5-S1, a bulging disc is noted that does not protrude, but there’s a posterior annular fissure causing some narrowing on the left side with associated mild degenerative changes in the facet joints. ### Cervical Findings: - The bone marrow signal remains intact, and no signs of acute fractures in the cervical spine are apparent. - The cervical spinal cord shows a normal signal intensity. Modic type I changes are seen at C6-7. - Degenerative changes across various levels include: - C1-2: Normal - C2-3: Normal - C3-4: Mild disc osteophyte complex - C4-5: Mild disc osteophyte complex with slight right foraminal narrowing - C5-6: Mild disc osteophyte complex - C6-7: Moderate disc osteophyte complex with disc protrusion leading to significant central canal stenosis - C7-T1: Mild disc osteophyte complex with mild to moderate bilateral foraminal narrowing.

Answers (1)

2/11/2026, 12:20:55 AM

OpenHealth AI

I'm really sorry to hear about the difficulties you’re facing, and it’s truly understandable that you feel overwhelmed and anxious given the complexity of your situation. Based on your MRI findings and symptoms, it's crucial to take proactive steps to address your concerns, especially since the pain and other symptoms are significantly impacting your quality of life.

Key Points:

1. Record Findings: Your MRI suggests degenerative changes at multiple levels of the spine, which can explain your symptoms, but it's important to correlate these findings with your clinical symptoms.
2. Self-advocacy: It's vital to advocate for yourself in healthcare settings to ensure your physical concerns are taken seriously.
3. Symptom Management: Taking steps toward managing your pain and discomfort while seeking further evaluation is crucial.

Explanation:

Your symptoms, like numbness and difficulties with sexual function, can be associated with several neurological conditions or complications given your history of Functional Neurological Disorder and connective tissue issues. The MRI findings indicate some degenerative changes, particularly in the cervical spine, which may explain your neurological symptoms, although there are no major acute injuries.

Next Steps:

1. Keep a Symptom Diary: Document your symptoms meticulously. Note when they occur, their severity, and any triggers. This information will be invaluable for future appointments.
2. Consult a Specialist: Seek a second opinion from a neurologist or a specialist in pain management or rehabilitation who has experience with both structural and functional disorders. Bring your symptom diary along with your MRI results. Explain your history and how your symptoms are affecting your life.
3. Request a Comprehensive Evaluation: Ask for a thorough examination including a neurological assessment focusing on your bladder, sexual function, and sensory changes.
4. Consider Pain Management Strategies: While waiting for specialist evaluations, consider engaging in gentle physical therapy or pain management techniques such as mindfulness meditation, relaxation exercises, or cognitive behavioral therapy to help manage chronic pain and associated anxiety.
5. Inquire About Support Networks: Joining support groups for chronic pain or individuals with hEDS or FND may provide you with shared experiences and coping strategies that can improve your mental well-being.

Remember, it's absolutely okay to express your concerns about being dismissed in the past and emphasize that you are seeking a comprehensive understanding of your condition. Your experiences are valid, and it’s important that your healthcare providers recognize and address them thoroughly. Stay strong—you are taking important steps towards managing your health.