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Forum Name: Spinal problems and back pain

Question: MRI shows nothing on my back pain


 xEnOn - Sat Apr 25, 2009 6:42 am

I have been experiencing back pain for around 10months. The pain often occurs around the lower back and when it gets very bad I may feel pain at the middle part of my back too. It will always happen when I stand, stood, bend slightly forward for too long, running, jumping and carrying heavy loads or exerting strength. I will feel the pain when I do any of these and the pain will cause my back to feel VERY VERY weak that I will want to immediately sit down to rest my back. Sitting down only help a bit. I need to totally lean my back against a wall or something to allow it totally rested. And the pain often continues and causes me to not able to sleep well during night.

I have seen a specialist regarding this issue and did a MRI scan on my lumbar spine. The MRI report was:
-----
Sagittal T2, T1 Flair images of the lumbosacral spine with axial T1, T2 weighted from L4 to S1 were accquired. Reference made from C2 with superficial marker placed at the level of T11/12.

Conus medullaris terminates at the lower border of L1. No focal abnormalities are seen in cauda equina. There is preservation of lumbar lordosis, intervertebal disc height and morphology of the vertebral body.

There is mild loss of posterior concavity of the disc at L4/5 and L5/S1 though there is no disc protrusion demonstrated. The lateral recess and exit foramina are not compromised.

MRI shows no evidence of degenerative disc disease in the lumbosacral spine.
-----

Apparently, the doctor told me that the MRI shows no problem and has no idea about the pain that I am having. I have been going through physiotherapy for the past few months but the improvements are mediocre. As I am a sailor, my job requires me to use a lot of strength which often hurt my back very much.

Now that I go back to the specialist doctor, he would often just tell me the MRI scan on my lumbar spine is fine and there is nothing to worry. But I am still feeling the terrible ache.

What other possibilities could my symptoms tell? And what could be the next thing I could request the doctor to do for me apart from telling me everything is fine and taking pain killer all the time.
 Tom Plamondon PA-C - Tue May 05, 2009 11:17 am

User avatar Hello,
The MRI looks good however the back is not improving with physiotherapy to the degree expected.

The diagnosis at this point is chronic low back pain probable mechanical in nature.
Treatment is conservative: physical therapy, NSAIDS, and activity as tolerated.

In order to work, you may need a lumbar brace in addition to the physical therapy treatment. Another options is Tens unit - to use at night to help with sleep - your job may not allow the use of a Tens unit while on ship???

Sometime an injection in the lumbar facet joint(s) helps. This can be arranged through your family physician.

Take care and let us know how it goes.

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