
History Of Lower Spine Pain. Having Neck Shoulder Area. Done With MRI And PCP. Taking Adderall. Surgery Required?

Thank you for posting your query.
I have gone through the detailed clinical notes, you have written. It is unfortunate that you suffer from so much pain and discomfort, despite so much treatment, including drug and non-drug treatments.
MRI needs to be looked at more closely, as that could explain the reason for the pain starting in the neck and traveling down. Sometimes, there may be disc bulges pressing on the nerves, at other times, there would be foraminal stenosis, which could cause nerve compression. A neuro radiologist would help in giving the detailed MRI reports.
You could benefit from medications, such as pregabalin or gabapentin which you can get by your treating doctor's prescription. These medications are specific for nerve pain (pain of nerve origin).
In some cases, epidural injections are also useful.
I think you should XXXXXXX up with a neurologist who can guide you for future treatments.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist


Thank you for getting back.
Generally, a radiologist would be able to pick up most of the major findings on MRI, however, minor or subtle findings may get missed. A neuro radiologist, on the other hand, is an expert, and would pick up all abnormalities, including minor ones. Other option is to discuss the clinical findings and what to look for in the MRI with the radiologist. This information can be provided to the radiologist by the neurologist.
Abnormalites in the lower (lumbar) spine would lead to symptoms in lower back and legs, and abnormalities in upper back (cervical region) would lead to symptoms in neck and arms.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)


MR Cervical Spine (0000)
Indication: Neck, left head and shoulder pain.
Comparison: cervical spine radiographs 6-17-13.
Technique: Standard, variable echo protocol in axial, coronal and sagittal planes. Findings: Normal vertebral body height and alignment. The spinal cord is seen well from the cervicomedullary junction in to the upper thoracic spine and the cord demonstrates normal morphology and signal tendency. At c5-c6 level, mold posterior degenerative disk space narrowing with osteophyte-disk complex. Minimal asymmetric uncovertebral spurring on the left. The thecal sac remains widely patent. The other cervical levels, and the visualized upper thoracic levels are negative.
Impression:
1. Near normal study.
2. At C-5 and C-6 minimal posterior degenerative disk space narrowing and diffuse osteophyte-disk complex, with slight asymmetric prominence of mild uncovertebral spurring on the left. The thecal sac is widely patent.
3. Otherwise, negative study, with multiple specific pertinent negatives above.
Can you tell me what this means in ENGLISH? Does the scan see any problems and if so are they concerning and relate to what is happening now with my symptoms?
Do you still think I should seek another opinion and if so how do I go about this? Do you have anyone in Maine you would suggest? You have been very informative and I do not want to waste your time, but suggestions would be very much appreciated.
Thank you, XXXX
Thank you for getting back and providing the detailed MRI reports.
Putting simply, there are no significant abnormalities in the report to be concerned about.
There are minor disc bulges at two levels, which may pinch the nerve intermittently. However, as per the report, there is no significant pinching of the nerve.
The report is quite detailed, and there is no need to go for another opinion on this MRI.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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