Question
QUESTION: Hello Dr Keith, I am 48 years old, my weight is 74 kg and my height is 159 cm. I am a mother of 6 beautiful kids and recently I started having pain in my right thigh and these are results of my MRI done for lumbar spine and right hip. I wonder if you can kindly explain for me what is the problem with my back








=========== TEXT REPORT ===========
INDICATION:
Sever pain in the right hip joint radiate to the right thigh.
TECHNIQUE:
Multi planar, multi sequence images of the hips were performed.
Findings:
" No previous images available for comparison.
" Normal appearance of both hip joints with no evidence of effusion.
" The left iliac bone shows well defined focal fatty change , otherwise rest of the visualized bone marrow appears within normal.
" The visualized soft tissue is unremarkable.

Conclusion:
Normal study.



NB: Pelvic congestion is noted gynecological correlation is advised.


and the second report about lumbar:
MR LUMBAR SPINE
Patient Name: Hassan Emani Khadija
Date of Birth: 08/05/1964
Patient RIS ID: 69781
Patient Civil ID: 264050801999

=========== TEXT REPORT ===========
INDICATION:
Server pain in the right hip joint radiate to the right thigh.
SEQUENCES:
Non-enhanced multi-planar multi-sequences MR of the lumbar spines were obtained.
OBSERVATIONS:

" No earlier films available for comparison of lumbar spine.
" Exaggerated lumbar lordosis suggestive of back muscle spasm.
" Desiccation of L2-3 and L3-4 levels.
" L2-3 level shows mild disc bulge abutting the thecal sac with narrowing of the inferior
aspects both neural foramina.
" L3-4 level shows diffuse disc bulge abutting the thecal sac with narrowing of the inferior
aspects both neural foramina.
" L4-5 level shows diffuse disc bulge abutting the thecal sac with narrowing of both neural
foramina (LT>RT).
" Rest of the lumbar discs shows no significant disc bulge or protrusion.
" The facet joints are normal.
" RVF uterus is noted.
" High signal intensity focus ~ 1 cm is seen in the left iliac bone (T2 axial Im: 23)

IMPRESSION: -
Multi-level degenerative disc changes with neural foraminal stenosis.

I wonder if I can send you the MRI Pictures from the cd to take a closer look at it ??


I will be very thankful for your care and advice and I am sorry to take your time

ANSWER: Dear OM Ali,

There are a couple of things going on here.  First of all, you are having a lot of lower back disc problems.  At the L2-3, L3-4, and L4-5, the MRI states that there are multiple discs that are damaged and degenerating and bulging. These are causing pressure on the tissue surrounding the  spinal cord (thecal sac).  This clearly could be the cause of your lower back and leg pain.

Secondly, there is a question/issue regarding your uterus/pelvis.  It is impossible to know what it is on an MRI. You need to see your OBGYN doctor to have this evaluated.

Third, there is a "high signal intensity focus, 1 cm, in the left pelvic bone.  Your primary care physician should be made aware of this.  It is impossible, again, simply from MRI to know what this spot on the pelvis is.

MRIs are only pictures. They are not tissue samples.  The disc problems are probably causing your leg pain. The uterus issue could cause you some lower back pain. The small spot on the pelvic bone is probably not causing you any pain, but should be checked out to make sure that there is nothing to be worried about.

I hope that this helps you a little bit to understand the findings of the MRI.  There is no need for me to see the MRI pictures, as it would not change the outcome.  Please follow through with your local doctors regarding he uterus and the spot on the bone.

Thank you for your question.

Keith Biggs, DC
http://www.eastmesachiropractor.com

---------- FOLLOW-UP ----------

QUESTION: Hello Dr.Keith thanks alot for your help and sorry to disturb again . I wonder if you can tell what type of exercises to do because my appointment with the specialist is very far from now . Thank you for your care .

Answer
Dear Om Ali,

If you go to http://eastmesachiropractor.com/index.php?p=97781 on my website, you can find some exercises that you can try. It is impossible for me to tell you exactly what is going to help and what is going to hurt you.

Try the "Stabilization Exercises" and the "Standar Stretches" that you can find on this web page.  If you find that any one of the exercises is hurting you, then discontinue that exercise, and try doing the others.  Do not continue to exercise through increased pain. If the exercise is causing you more pain, it is not helping you.

Good luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com