Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following Cervical MRI Report Indicate?
Question: Am female 72, had cervical MRI done because of constant neck pain and migraines. Found arthritis, stenosis, bulging degenerated discs etc. All reasons for the pain. What concerns me most is note stating mild marrow heterogeneity w no destructive lesion.Some of the heterogeneity could be from anemia. No focal lesion is discernible.
I saw my Neurologist who ordered a CBC. Results all normal except b12 is high at 1190. Red and white ell counts in normal range. I tried to tell family Dr.my concerns and he said...you will be fine handing me a script for Cymbalta. (Said it is for pain ). Can't fill script...too expensive on medicare.
I am so tired can barely get through grocery store..wake more tired than when went to bed.
He asked if I'm depressed, no but getting there from worry and constant pain. Where do I go from here?
I saw my Neurologist who ordered a CBC. Results all normal except b12 is high at 1190. Red and white ell counts in normal range. I tried to tell family Dr.my concerns and he said...you will be fine handing me a script for Cymbalta. (Said it is for pain ). Can't fill script...too expensive on medicare.
I am so tired can barely get through grocery store..wake more tired than when went to bed.
He asked if I'm depressed, no but getting there from worry and constant pain. Where do I go from here?
Brief Answer:
Hello I would give following recommendations.
Detailed Answer:
Hello mam,
I did review your concern.
I can understand that you are in deep pain. Let me discuss some issues.
1) First of all since your CBC is normal (elevated vitamin b12 is not much of an issue) you do not need to worry hematologically as of now. Your MRI findings show mild marrow heterogeneity but no destructive bone lesions ruling out any thing significant. So nothing to worry about that as of now.
2) Cymbalta is a serotonin reuptake inhibitor drug and used in patients with chronic back pain or widespread body pain along with its effect as an antidepressant. I would recommend you continue this medication and review with your doctor after taking it continuously for 1 month. The effect of this medication will take atleast 21 days. You can also ask your doctor to add Pregabilin with this as few doctor do recommend it.
3) If the pain is acute you can take Ibuprofen plus omeprazole for 3-4 days to relieve of acute pain.
4) About feeling tired, If you feel more tired when you wake up, I would consider a possibility of obstructive sleep apnea. Has anyone noticed you snoring while you asleep? This can be discussed with your doctor and there are various nonsurgical and surgical treatments available and many patients benefit after treatment.
5)For the degenerative spine disease, apart from the medications, I would recommend regular moderate exercise after consulting a physiotherapist and also yoga or tai chi classes(you can learn through youtube also, but a local teacher if available is better). These mind body interventions can go a long way in helping yourself feeling better as well as reducing chronic pain. More and more doctors are prescribing it and more and more patients I have seen who have benefitted from these exercises/mind-body interventions.
SO all in all, I would recommend you to continue the medications if possible and follow suggestions as I have asked above and I am sure You will feel much better. It is very difficult for you to deal with chronic pain due degenerative problems but I am sure with some activity and medications you will do much much better.
I hope this helps
Please provide me feedback of your health.
Let me know if you have any more questions or concerns.
I will be more than happy to help you best I can.
Wish you all the best mam
sincerely,
Dr Parth Desai
Hello I would give following recommendations.
Detailed Answer:
Hello mam,
I did review your concern.
I can understand that you are in deep pain. Let me discuss some issues.
1) First of all since your CBC is normal (elevated vitamin b12 is not much of an issue) you do not need to worry hematologically as of now. Your MRI findings show mild marrow heterogeneity but no destructive bone lesions ruling out any thing significant. So nothing to worry about that as of now.
2) Cymbalta is a serotonin reuptake inhibitor drug and used in patients with chronic back pain or widespread body pain along with its effect as an antidepressant. I would recommend you continue this medication and review with your doctor after taking it continuously for 1 month. The effect of this medication will take atleast 21 days. You can also ask your doctor to add Pregabilin with this as few doctor do recommend it.
3) If the pain is acute you can take Ibuprofen plus omeprazole for 3-4 days to relieve of acute pain.
4) About feeling tired, If you feel more tired when you wake up, I would consider a possibility of obstructive sleep apnea. Has anyone noticed you snoring while you asleep? This can be discussed with your doctor and there are various nonsurgical and surgical treatments available and many patients benefit after treatment.
5)For the degenerative spine disease, apart from the medications, I would recommend regular moderate exercise after consulting a physiotherapist and also yoga or tai chi classes(you can learn through youtube also, but a local teacher if available is better). These mind body interventions can go a long way in helping yourself feeling better as well as reducing chronic pain. More and more doctors are prescribing it and more and more patients I have seen who have benefitted from these exercises/mind-body interventions.
SO all in all, I would recommend you to continue the medications if possible and follow suggestions as I have asked above and I am sure You will feel much better. It is very difficult for you to deal with chronic pain due degenerative problems but I am sure with some activity and medications you will do much much better.
I hope this helps
Please provide me feedback of your health.
Let me know if you have any more questions or concerns.
I will be more than happy to help you best I can.
Wish you all the best mam
sincerely,
Dr Parth Desai
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
