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What Does My MRI Scan Report Indicate?

Posted on Wed, 27 Jul 2016

Question: Over the last month and a half I have had progressive what I thought was lower back pain, which has turned into pain from the middle of my right but o over the last month and a half I have had progressive what I thought was lower back pain, which has turned into pain from the middle of my right buttock, that goes over my hip and all the way down my right leg to the back of my calf. The pain has become very severe. I had an MRI done about 3 1/2 weeks ago. Here is the impression: "Small L5 S1 Central and right paramedian disc bulge, which mildly narrows the right lateral recess, approaching and slightly displacing the descending right side nerve root". I am on my fourth day after an epidural steroid injection of which has not given me any relief yet. The injection was part numbing and nerve block and steroids. The nerve block made me feel instantly better for a day but the pain came back and has continued. Could you please review the above and give me your opinion? The diagnosis was sciatica. I am also in physical therapy. Should be steroid have started working by the fourth day?

Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)

Brief Answer:
Steroids can take some time in effect

Detailed Answer:
Hello,
I have studied your case. You are having nerve compression in spine so you have given steroids. Steroid may take some time to relieve this pain, and it make take seven days to show its effect. If it is not then you might need a repeat injection.
As far as definitive treatment is concerned it is physiotherapy.
You can follow these steps.
1.Avoid forward bending,jerking or any prolong sitting in same position. Travelling is also needs to be avoided.
2.Tablet Pregabain m one at night time should be taken.
3.Hot water fomentation is also useful.
4.Epidural steroids can be repeated 2 weeks.
I hope this answer will be useful for you.Let me know if their is any other followup questions.
thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (1 hour later)

My phsical therapist thanks it could be from piriformis and the doctor that gave the injection did not necessarily think the impression on the MRI Report would cause me to be in as soon they're paying as I am in. What do you think? Thank you for your help you are being great assistance.

Answered by Dr. Dr. Naveen Kumar Sharma (5 hours later)

Brief Answer:
Pyriformis is very rare

Detailed Answer:
Hello,
I do not think it is pyriformis as it is very uncommon diagnosis. Your MRI is suggesting PIVD. So follow these steps as advised.
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (13 hours later)

Day 5 after the epidural steriod injection. Also tajing Duexis and streching 3 times a day with no relief. My work requires sitting at a computer all day. The pain dioe not bother me while laying down. Cannot lift right up ro put on pants. The pain is too severe. Have been off work for 3 days & go back to eork tomorrow, which means sitting where it feels like the back of my right thigh is bring squezzed to a very painful degree. Also very difficult to stand up to get out of chair. Anything that i can do to alleviate oain whilesitting? I have a lumbar support and a seat wedge i have bern using. Really not much back pain. But very bad back of thigh, hip and calf pain. Thank you for your assistance.

Answered by Dr. Dr. Naveen Kumar Sharma (3 hours later)

Brief Answer:
You need to take Pregabalin and amytryptalin

Detailed Answer:
hello,
Duexis is not right choice for such pain. You will need some strong neural pain medicine. So I would give you few options. These drugs are sedative and should be taken at night time.
1.Tablet Pregabalin
2.Tablet Amytryptalin
So you can discuss with your doctor and take one of them. When you are sitting do not straighten up your legs as it make nerve more stretched. Small doses of oral steroid for short term can be taken. For example Medrol 8 mg thrice for three days.
thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (2 days later)

I went back to the orthapific doctor that gave me thr epidural steroid injection one werk ago eithout relief. He gave me one month of sampled of the prescription Horizant and had me svhedule an apot in a month with one of their durgeons. Told me to vontinue with the Duexis and ohysical therapy as eell. I dont want to have durgery but font want chronic scistica if that is truely what i have. Advise?

Answered by Dr. Dr. Naveen Kumar Sharma (3 hours later)

Brief Answer:
If medicines are effective then surgery can be avoided

Detailed Answer:
Hello,
Your doctor has given you medicines. If they are effective then you can avoid surgery. Surgery is done to relieve pain only. This is episodic disease and so if you can get away with this pain for1 to 2 month, then you might not need surgery.
But in case these pain killers are not effective and you are having severe pain that is affecting your lifestyle and daily work then you need to think of surgery. Give medicines trial at least 3 months.
Thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Priyanka G Raj