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What Does My MRI Scan Test Report Indicate?
Question: Hello sir. History- in 1997 I had undergone spinal surgery for nerve root compression at L4-L5 & L5-S1. However I resumed normal activities afterwards. Now I'm 35 years male. Recent MRI showed still there is bilateral nerve root compression at L4-L5 & L5-S1. He advised omnicortil twice daily for 10 days along with dolonex DT 20mg. I took that and my pain subsided. Again within fortnight pain started and as per his advised took omnicortil twice daily for 5 days along with dolonex DT. Similarly pain got subsided. Now after fortnight- from yerstersay m having lower back pain and not able to make bodily movement. Very severe pain while getting up from bed. Also doctor had told me to take omnicortil along with dolonex dt once daily for 5 days. M now reluctant to take the medication due to side effects. But am having severe pain. What shall I do now.
Brief Answer:
Here follows:
Detailed Answer:
Hi,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
After going through your medical history,I suggest you to start antineuralgic medicines like Amitriptyline,duloxetine or pragabalin.Along with methylcobalamin,calcium and vitamin D supplementation should be taken.
At the same time continue steroids for 5 days as suggested and then stop.
A typical prescription would be like this-
1)Tab.Omnacortil 40 mg per day for 5 days.
2)Tab.Pregabalin-Methylcobalamin(75/1500) once a day--to continue.
3)Tab.Symbal(duloxetine) 40 mg once a day--to continue
4)Tab.shelcal 500(calcium plus vitamin D)-twice a day
5)Tab.Dolonex DT 20 mg to continue for 5 days
6)Regular strict physiotherapy(with proper technique)-except that physiotherapy is not recommended in acute stage.
PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE ONLY.
Further,please tell in the follow-up -
1)How long back was the recent MRI was done?
2)You said that you are not able to make bodily movements.What sort of bodily movements?Are you able to move your legs and arms?Are you able to sit up from the squatting position?
3)Are you having any difficulty in micturition?
4)Was this deficit in bodily movements acute in onset or gradual?
Waiting for your follow-up query.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Here follows:
Detailed Answer:
Hi,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
After going through your medical history,I suggest you to start antineuralgic medicines like Amitriptyline,duloxetine or pragabalin.Along with methylcobalamin,calcium and vitamin D supplementation should be taken.
At the same time continue steroids for 5 days as suggested and then stop.
A typical prescription would be like this-
1)Tab.Omnacortil 40 mg per day for 5 days.
2)Tab.Pregabalin-Methylcobalamin(75/1500) once a day--to continue.
3)Tab.Symbal(duloxetine) 40 mg once a day--to continue
4)Tab.shelcal 500(calcium plus vitamin D)-twice a day
5)Tab.Dolonex DT 20 mg to continue for 5 days
6)Regular strict physiotherapy(with proper technique)-except that physiotherapy is not recommended in acute stage.
PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE ONLY.
Further,please tell in the follow-up -
1)How long back was the recent MRI was done?
2)You said that you are not able to make bodily movements.What sort of bodily movements?Are you able to move your legs and arms?Are you able to sit up from the squatting position?
3)Are you having any difficulty in micturition?
4)Was this deficit in bodily movements acute in onset or gradual?
Waiting for your follow-up query.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
MRI was done on 21.05.2015(report enclosed in earlier mail). Actually I have been running for quiet sometime and on 1.5.15 I completed my half marathon. There was no problems. After usual post run recovery I have been practicing for my forthcoming XXXXXXX marathon that is scheduled for 30.8.15. But on 20.5.15 I had sudden muscle spasm having its niche shooting pain on my right buttock. Even pain shooted up on sneezing and MRI was done. on 21.5.15. My body posture was deformed. Even was difficult to move my waist on either side. Had problem on flexion and extension. But after taking a bout of medications for 10days as I mentioned in my earlier mail everything was set all right. No muscle spasm. However I continued usual running and spinal exercises but after a fortnight I again developed lower back pain as similar to what I mentioned earlier. Had medicines for 5 days and became OK. Now running has been stopped and only started spinal exercises. But on 2.7.15 I had travelled by a bus for 4 hrs and next morning developed back ache with severe pain and numbness to the left leg. No muscle spasm to right side buttock unlike the two earlier occasions. In retrospect, surgery was done to release nerve root compressions to my left leg pain. (All reports enclose in earlier mail for ready reference).
Answers to your questions
1)MRI done on 21.5.15
2)difficulty in flexion and extension. Waist becomes stiff and becomes difficult in moving both sides. Yes I can sit up from squatting position but with difficulty.
3)no difficulty in micturition.
4) onset.
Is it mandatory to take steroids containing drugs as I have already taken them for 15 days in two occasions.
Medicines as you suggested are to continue for how long?
I want to get these pain subsided for now and I have got an appointment at NIMHANS on 18.7.15. As per your perusal and examinations what would be the prognosis? Which Doctor shall I consult at NIMHANS.
IF YOU HAVE NOT RECEIVED ATTACHED MRI REPORT AND OTHER DOCUMENTS PLZ. INTIMATE. YOUR REPLY IS HIGHLY AWAITED. THANK YOU
Answers to your questions
1)MRI done on 21.5.15
2)difficulty in flexion and extension. Waist becomes stiff and becomes difficult in moving both sides. Yes I can sit up from squatting position but with difficulty.
3)no difficulty in micturition.
4) onset.
Is it mandatory to take steroids containing drugs as I have already taken them for 15 days in two occasions.
Medicines as you suggested are to continue for how long?
I want to get these pain subsided for now and I have got an appointment at NIMHANS on 18.7.15. As per your perusal and examinations what would be the prognosis? Which Doctor shall I consult at NIMHANS.
IF YOU HAVE NOT RECEIVED ATTACHED MRI REPORT AND OTHER DOCUMENTS PLZ. INTIMATE. YOUR REPLY IS HIGHLY AWAITED. THANK YOU
Brief Answer:
Non steroidal anti-inflammatory medicines may be taken.
Detailed Answer:
Hi,
Thanks for being in follow-up.
Short term use of steroids(as for 5 days) will not cause any harm.You are already taking DOLONEX-DT(piroxicam) which is a Non-steroidal anti-inflammatory drug(NSAID).It should be effective.Steroids are used if patient's inflammation does not improve with NSAIDS.But,as you may be having severe inflammation here,I suggest you to continue steroids for 5 days.
Other medicines I suggested(pregabalin/methylcobalamin,duloxetine and calcium/vitamin D) are to be continued for now.They may have to be taken for 2-3 months.
Prognosis depends on how you respond to medicines and physiotherapy.Time ahead will tell about the prognosis.
NIMHANS has several good neurologists.Dr.P.Satishchandra,Dr.A XXXXXXX or Dr.A.B.Tally can be referred to.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Non steroidal anti-inflammatory medicines may be taken.
Detailed Answer:
Hi,
Thanks for being in follow-up.
Short term use of steroids(as for 5 days) will not cause any harm.You are already taking DOLONEX-DT(piroxicam) which is a Non-steroidal anti-inflammatory drug(NSAID).It should be effective.Steroids are used if patient's inflammation does not improve with NSAIDS.But,as you may be having severe inflammation here,I suggest you to continue steroids for 5 days.
Other medicines I suggested(pregabalin/methylcobalamin,duloxetine and calcium/vitamin D) are to be continued for now.They may have to be taken for 2-3 months.
Prognosis depends on how you respond to medicines and physiotherapy.Time ahead will tell about the prognosis.
NIMHANS has several good neurologists.Dr.P.Satishchandra,Dr.A XXXXXXX or Dr.A.B.Tally can be referred to.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good morning Doctor,
Thank you so much.
From yesterday onwards I have started all the drugs as suggested by you. But I felt bit drowsy in the morning. Is it due to tab symbal? Is that drug to be taken during bed time? How long should I take this drug? Other drugs will be continued for 2-3 months - sure I will do that.
Yesterday, unlike other time, this time I had muscle spasm on my left buttock resulting deformation of posture. Why is my muscle going into spasm time and again? This is my third episode in two months.
Sir, did u perused my MRI report?
I respond to drugs very well- in last two occasions, after taking steroid my pain subsided completely. But recurred after a fortnight in both occasions. So what can be the prognosis as per this experience and MRI report. Other than surgery what are other alternative treatment for this problems?
As I told you I am an avid Runner. Will this frequent back pain will stop me to run forever. Will running aggravates back pain? Should I continue running after my full recovery.
I am giving u the impression shown at MRI
1.loss of lumbar lordosis
2.effaced L5-S1 disc space, with L5,S1 vertebral end plate and subchondral marrow degenerative changes.
3.PIVD seen causing narrowing of bilateral neural foramin at L2-L3 level. Significant narrowing of bilateral neural foramina at L3-L4 level. Bilateral nerve root compression at L4-L5 and L5-S1 levels.
Doctor can I plz know in which hospital/place u r located.
Thank u
Thank you so much.
From yesterday onwards I have started all the drugs as suggested by you. But I felt bit drowsy in the morning. Is it due to tab symbal? Is that drug to be taken during bed time? How long should I take this drug? Other drugs will be continued for 2-3 months - sure I will do that.
Yesterday, unlike other time, this time I had muscle spasm on my left buttock resulting deformation of posture. Why is my muscle going into spasm time and again? This is my third episode in two months.
Sir, did u perused my MRI report?
I respond to drugs very well- in last two occasions, after taking steroid my pain subsided completely. But recurred after a fortnight in both occasions. So what can be the prognosis as per this experience and MRI report. Other than surgery what are other alternative treatment for this problems?
As I told you I am an avid Runner. Will this frequent back pain will stop me to run forever. Will running aggravates back pain? Should I continue running after my full recovery.
I am giving u the impression shown at MRI
1.loss of lumbar lordosis
2.effaced L5-S1 disc space, with L5,S1 vertebral end plate and subchondral marrow degenerative changes.
3.PIVD seen causing narrowing of bilateral neural foramin at L2-L3 level. Significant narrowing of bilateral neural foramina at L3-L4 level. Bilateral nerve root compression at L4-L5 and L5-S1 levels.
Doctor can I plz know in which hospital/place u r located.
Thank u
Brief Answer:
Here follows:
Detailed Answer:
Hi,
Thanks for being in follow-up.
Here are answers to your queries pointwise:
1)Symbal may cause drowsiness in the intial few days.
2)It can be shifted from morning to night.No specific recommendation for timing.Depends person to person.Those having troublesome drowsiness in the daytime may take it at the night time.
3)At this time,I can't tell the exact duration to continue the drug.It will depend on the response.It is not to be taken long term.
4)You are having nerve radicles compression(radiculopathy) which can cause such muscle spasms
5)I have gone through your MRI report and mentioned the above treatment regime based on that.
6)Recurring problems tilts the prognosis downside.If not managed with medicines and physiotherapy,surgery is the option.Epidural steroid injections can also be given as an alternative therapy.
7)Such heavy running may aggravate your problems.For precaution,you should not take such heavy running,even after recovery.
You can check my details on my Profile page.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Here follows:
Detailed Answer:
Hi,
Thanks for being in follow-up.
Here are answers to your queries pointwise:
1)Symbal may cause drowsiness in the intial few days.
2)It can be shifted from morning to night.No specific recommendation for timing.Depends person to person.Those having troublesome drowsiness in the daytime may take it at the night time.
3)At this time,I can't tell the exact duration to continue the drug.It will depend on the response.It is not to be taken long term.
4)You are having nerve radicles compression(radiculopathy) which can cause such muscle spasms
5)I have gone through your MRI report and mentioned the above treatment regime based on that.
6)Recurring problems tilts the prognosis downside.If not managed with medicines and physiotherapy,surgery is the option.Epidural steroid injections can also be given as an alternative therapy.
7)Such heavy running may aggravate your problems.For precaution,you should not take such heavy running,even after recovery.
You can check my details on my Profile page.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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