Symptoms worse than MRI findings

[jsewell]

Has anyone experienced this where there symptoms were pretty bad , yet the MRI did not show much wrong?
I definately have the symptoms of lumbar stenosis. I also have a compression fracture at L2 . I am fusing from C4 -L2 . My doc said that the fracture may be causing some of the symptoms , but not all. But he said the MRI shows some narrowing , but not a lot and he does not want to operate until he has the right spot. He is going to remove the screws at L2 and repair the fracture, but thinks i need some stenosis dealt with also. He is sending me to have an EMG of both legs first.
My symptoms are stiffness in my legs and low back, extremely tight hamstrings, a numb area on the left side of my leg, pain in buttocks , calf muscles, low back and some tingling in my feet when i am walking or hiking. I also have pain on the sides of both hips and quad weakness. Also if i am sitting on my bed with my legs extended they get numb.
I haven't picked up the actual report yet, just going on my doctor's eyeing the MRI. BAck in 2008 my hip MRI showed No arthritis , but when my hip surgeon went in to do a arthroscopic procedure, he found my hip destroyed by arthritis and the next step was a total hip replacement.

I will have to wait a few weeks to get the results of the EMG as my surgeon is getting married so i wanted to here what all of you had to say.
thanks
judy

Forgot to mention i get to have 2 hours a day free of my neck brace!!!!

[dshobbies]

Judy,

I guess the good news here is your 2 hour reprieve from the neck brace.

I've read many posts of minimal findings with maximal symptoms and the opposite too. 'I'm in so much pain and my doctor can't find anything wrong' happens too often. Though some doctors should not be practicing, others, while not dismissing your pain, simply don't know what's wrong while still others might pinpoint the problem. Some claim your injury couldn't possibly be the cause and others say that's your problem. This is why second and third opinions, especially for drastic or invasive surgeries is always recommended.

BTW, a similar symptom of almost all back patients is tight hamstrings. Your symptoms also sound nerve related, thus the EMG.

Medicine shouldn't be a hit or miss but often, that is the result. The variation of competence among health care professionals is amazing but I digress. So far your test results don't back up your pain which can mean several things. So, further investigation and second opinions are warranted.

Don't you wish you could trade your spine in on a new model?

Dale

[Maria]

Judy,
I heard my "subjective complaints were worse than my objective findings" re MRIs and myelograms yet surgeon did perform 2 discectomies on me and with findings I've had over the years and subjective complaints would have performed from 3 level global fusion to 2 level ADR/hybrid surgery had I kept complaining of same pain levels or worse.

I think sometimes the findings just looked at as one or several seperate entities may not look as bad as the effect they create in totality on the affected and/or neighboring structures.

We know we wouldn't be complaining and limiting ourselves for nada...

[jsewell]

Thank you for your replies.
Dale i did ask my spine doc for a new model a few years ago. they have model spine and spine parts all over the office and the room i was in had a full one. I twisted and messed with it until i thought it looked like mine.
so when my doc came in i told him i needed a new model as mine was messed up , he took the spine and twisted and turned it all over the place and handed it back and said now this is what your spine looks like.

I've had such extensive surgery now on my spine , i do like staying with my surgeon because i not only love and trust him, but he knows every little detail of my spine. Thus he knows what could be effecting what and has never jumped into surgery with me. Before anything was done with my thoracic spine we tried all other things for over a year and he just thanked me for being so patient with him. He also knows when to jump into surgery , like with my broken neck!!
He also knows of my other significant problems such as with steroids and my pulmonary issues so i know i am in good hands.
i do understand why he is going to the EMG and from what i read about them they can locate which nerve or nerves are causing the problems. I've had a total body one and my phrenic nerve/diagphram one so am pretty familiar with the electrocution!!!

judy

[mmglobal]

For 2 years, my spine surgeons told me, "your films look too good for you to be having the kind of pain you are reporting."

"I could pull 100 45 year old men who have no symptoms off the street and 1/2 of them would have MRI's that look way worse than yours." (good for them!)

Thought I was a malingerer. He put into my record, "I am wondering if the patient has a physical problem at all? I am ordering cervical, thoracic, lumbar MRI's to rule out HNP." (HNP = herniated nucleosus pulposis = herniated disc)

So, he was certain that I was faking. My lumbar MRI showed a 15mm protrusion at L4-5.

After my L5-4 discectomy relieved the new leg pain associated with a new disc protrusion, but left my unrelenting low back pain unchanged, was sent to pain management. After about 8 or 9 months in pain management, my PM doc called me and dumped me.

"You are way too mobile and your films don't look bad enough to be having the type of pain you are reporting", he said.

About a month later, my left foot went numb and started with very severe foot pain. Discography ruled in L5-S1 me ineligible for the Charite' clinical trial. (thankfully! At that time, I would have been happy to have been someone's first ADR...I did not know better!)

A couple of months later (after amazing trials and tribulations with new pain doctors having been dumped for not having bad enough films), a new MRI showed a 14mm protrusion at L5-S1.

Yes... being accused of being a drug seeker, malingerer, psych problem, etc... is VERY VERY common. I believe it's worse for women. It's worse for people with tattoos and piercings. It's worse for people who have depression or other psych issues in their past. If the doctors don't understand your pain syndrome, too many of them will blame it on the patient.

It's very unfortunate that so many of us must endure these indignities. Note that the small percentage of real drug seekers, malingerers, etc... all contribute to making it worse for us. In many cases, the doctors truly are doing the best they can and just have to accept the fact that they will make mistakes. Occasionally (or frequently) they will deny treatment for patients that should have it... and they will give treatment to some that shouldn't.

Spine sucks.

Mark

[jsewell]

Mark,
You sure had a tough time of it. My surgeon was going to remove the screws at L2 and cement the fracture as he though that was all my pain generators and that my pain was not that bad.
Over the last 2 months it has been really bad and some new leg symptoms are occuring, including weakness. Now he is looking for the area that has the stenosis in it to do surgery on the right level. I am almost all the way fussed and he is trying hard to avoid any more. He said with my long kyphosis correction he should have gone down to L4, but did not want to take away all my motion.
So i am sure he is the right guy, and i sure can't tell which levels are involved. He does believe that my pain is bad, just the MRI did not give him anything to go on. So i do consider my self extremely lucky to have found him . Hopefully the EMG will tell. I read that it can tell what levels are causing the problems. I'm hoping.

judy

Yes,
Spine Sucks and
Breathing Problems suck

judy