Question
I fell about 4 months ago and im in horrible pain I got my MRI results I just don't understand them if you could put them in easiest terms to understand that would be great and any advice on what to do next. I have been in PT and seeing a chiropractor for the past 3 months and obviously it didnt help. Thanks.


Vertebral alignment and marrow signal are normal. There are small inferior
endplate Schmorl's nodes at L2 and L3. The conus terminates at L1-2.

The L1-2 and L2-3 discs show normal signal, height and contour.

At L3-4, there is mild disc degeneration marked by diminished T2 signal, mild
diffuse annular bulging and slight posterior annular fissuring. At L4-5,
there is slight diffuse annular bulging with preserved disc signal and height.
The L5-S1 disc is normal.

There is no spinal canal or foraminal narrowing within the lumbar spine.
Paraspinal soft tissues are unremarkable.


Answer
Thanks for your questions.

Regarding interpretation of the MRI:

- There are five vertebrae in the lower back (lumbar spine), which are referred to as L1 through L5. S1 is the top part of the sacrum (tailbone).

- A Schmorl's node is a vertical disc herniation through the bottom or top of the vertebrae. They may or may not be symptomatic, and their significance for back pain is controversial.

- Disc degeneration and annular bulging/fissuring are signs of degenerative disc disease indicating dehydration and excessive wear-and-tear of the discs (the shock absorbers of the spine). Degenerative disc disease may be indicative of early stage osteoarthritis.

- The bottom line: Your MRI indicates signs of mild spinal disc degeneration. This is a link to a website for lay people to help you further understand low back MRI terms and pictures:

http://www.doctorbuzz.com/Understanding%20Your%20MRI.htm

- Things a person with degenerative disc disease can do to reduce pain:

1. Consult a medical doctor for pain medication and anti-inflammatory medication, if appropriate.
2. Follow an anti-inflammatory diet:
http://www.deflame.com/
3. Stay mobile and perform appropriate self-help exercises daily. I recommend reading this book by the Australian physiotherapist Robin McKenzie:
http://www.amazon.com/Treat-Your-Back-Robin-McKenzie/dp/0959774661
4. Chiropractic manipulation and physical therapy are often helpful for people who have disc-related back pain, but if your symptoms are not improving with conservative care, your D.C. or P.T. may need to consider an alternative treatment approach, or you may need additional medical evaluation. All of the research to date shows clearly that patients who rely purely on a passive therapy like chiropractic or PT without performing appropriate rehabilitative exercises tend to have poorer outcomes than those who take a more proactive approach.

I hope that this helps to answer your question.