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HomeAnswersRadiologyback painWould you be able to evaluate the attached MRI of the lumbar spine?

Why is my back pain not resolved after four months of chiropractor visits?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At August 18, 2022
Reviewed AtJune 9, 2023

Patient's Query

Hi doctor,

I have attached an MRI file of my lumbar region. I have no history of medical conditions and am currently not on any medication. My chiropractor advised me to get an MRI after four months of unsuccessful visits.

Would you be able to evaluate the left side?

Hi,

Welcome to icliniq.com.

I understand your concern.

I perceive that you have been suffering from low back pain for quite some time and finally got the MRI ( magnetic resonance imaging) done. I have reviewed the MRI images (attachment removed to protect the patient's identity) in detail and identified some points. However, since you did not mention your specific problems, it would be difficult for me to correlate the MRI findings with your pain or other issues.

On the MRI, level-by-level analysis (please pardon the jargon) :

  • [L2/L3 & L3/L4] - Flattening of posterior disc margin with indentation upon thecal sac and narrowing of lateral recesses on both sides, compressing traversing nerve root on the right side.
  • [L4/L5] - Circumferential disc bulge, producing spinal canal stenosis with a narrowing of lateral recesses and neural foramina on both sides, compressing traversing nerve roots on both sides.
  • [L5/S1] - Circumferential disc bulge, producing narrowing of lateral recesses and neural foramina on both sides, compressing traversing and exiting nerve roots on both sides.

In simple terms, the above description means that the discs in your spine have slipped from their normal positions and are compressing the nerves that run down the spine. The findings are most significant at L4/L5 level and may produce low back pain that shoots down your thighs. The nerve root compressions at L4/L5 and L5/S1 levels may also produce some numbness around the buttock and, in severe cases, may weaken one's control over defecation & urination. A probable diagnosis would be PLID (prolapsed lumbar intervertebral disc) and would suggest a follow-up with a spine surgeon. In the present situation, the doctor treating you may advise you on some exercise or therapy and may counsel you for surgery later.

I hope the above explanation can clarify most of your queries.

I wish you all the best for your early recovery.

Probable diagnosis

PLID

Regarding follow up

Spine surgeon

Patient's Query

Hello doctor,

Could you send a picture that points out precisely where the damage is located?

Thank you.

Hello,

Welcome back to icliniq.com.

I understand that you are very concerned about the MRI (magnetic resonance imaging) findings, and it would be very helpful for you to have annotated images. So, for your assurance, the locations of the problems are as described in my previous message, albeit the wording may be too technical. In that case, I would suggest you talk with the orthopedics to clarify visually where the problems are located. Till then, best wishes for your early recovery.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Shoyab
Dr. Muhammad Shoyab

Radiodiagnosis

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