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Low back pain, Negative MRI, and pain management
starlene27 posted:
My PCP referred me to pain management. My PM doctor sent me for a MRI. My MRI results were negative. The findings were:

"Lumbar vertebral alignment remeains anatomic and the heights of the vertebrae are maintained. Normal marrow signal. Mild age-appropriate disc desiccation and facet hypertrophy without resulting canal or foraminal stenosis.
No signal within the spinal cord which ends normally at L1-L2. No tethering, nodularity, or clumping of the cauda equina. The paraspinal soft tissues are unremarkable."

I am confused. I had a chiropractor tell me my L4 and L5 were in stage 2 deteroriation. I have sever back pain at times. How can my MRI show nothing if i have this back pain?
Also will they kick me out of PM if they cant find anything wrong on the MRI? Should i ask for more tests? I know something is not right or i would not hurt this bad. I am really upset they cannot find anything wrong. So this means no shot to numb whatever is causing me pain. What should my next steps be?
bren_bren responded:
I wouldn't rely on a chiropractor for an accurate assessment of any condition other than tight muscles and vertebral alignment. Chiropractors are not doctors. They do not complete medical school as do physicians. Everyone has disc degeneration (aka Degenerative Disc Disease), and it progresses with age; as it would in your situation.

Don't get too hung up on imaging not showing a "picture" of what pain you describe. Many people live with chronic pain with "clean" imaging and are under continued care of a pain mangement physician.

Calmly ask the pain physician if there are more tests that could be done for your situation. Don't panic over treatment that may or may not be what you expect.

It would be helpful to take notes about your pain levels and how they are afftected by: activity, rest, am vs pm., etc
This could be helpful to present to the doc on your next visit. Also prepare questions to ask your doc and try to get a clear understanding of what your treatment options are, if you feel that will make you feel more comfortable. Trust your physician to treat what he makes of your situation and if you don't like it look for another. Best of luck, B
annette030 responded:
I would not rely on a chiropractor to diagnose a problem. That is what MDs and DOs, are for. Also just because you have a negative MRI does not mean you can't have pain. There does not seem to be a correlation between MRI results and pain.

I would not worry so much about more tests as I would want a good clinical doctor who can take a history and do a good medical examination and decide what to do next. See what the PM doctor says, we can't guess what he will suggest next. If in doubt, get a second opinion.

Take care, Annette

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