• FAQ
  • Forms & Insurance
Office (941) 955-5858 Fax (941) 955-0044
HealthFlex
×
  • Home
  • Our Practice
    • About Sarasota Neurology
    • Our Staff
  • Services
  • My Blog
  • Info
    • Patient’s & Visitor’s Guide
    • Appointment Booking
    • Forms & Insurance
    • FAQ
  • Contact
  • Medical Missions

MRI Scans & Lower Back Pain

April 8, 2011admindanBack PainPainUncategorized

Lower back pain is a common complaint seen by almost every primary care doctor in the United States. So common in fact that 80% of the population will experience at least one episode of significant low back pain in their life. Many will experience recurrent episodes of lower back pains. Of those patients, one third will have some degree of leg pain in one or both legs. Back pain and most cases of associated leg pain do not originate from lumbar (lower back) spinal disc problems. There are many pain fiber bearing structures in the lower back including muscle, tendons, ligaments, vertebral joints and bone itself. The good news is that over 97% of all low back pain problems can be treated without surgery. Low back surgery is the most commonly overly performed surgical procedure in the United States and all too frequently the results are poor and even worse, makes the patient’s condition (back pain) more severe.

In the vast majority of patients, a careful history and detailed physical exam is the basis for developing a comprehensive, conservative treatment plan. Most patients show significant back muscle spasm with tenderness. Some will have exquisite tenderness in the sacroiliac joint where the tail bone meets the hip bone – a condition known as sacroiliitis. Piriformis Syndrome can cause low back pain and leg pain, but there is no spine involvement in this condition. The patient’s neurological exam is usually normal – it is uncommon to find clinical evidence of lumbar spinal nerve root compression (“pinched nerve”). In any clinical setting however, non-surgical treatment is indicated. Even in individuals who have evidence of a disc herniated, on exam, need conservative therapy – physical therapy, massage and anti-inflammatory medication. The natural history of disc herniation is to heal without the need for surgery or other invasive procedures such as epidural spine injections. A specifically designed course of hands on physical therapy combined with neuromuscular therapy in combination with self administered back stretching exercises will result in favorable outcomes the majority of the time While not clinically needed, many patients undergo CT or MRI scanning to look for the cause of their low back pain. This is where the road splits on the proper decision to use appropriate conservative therapy or improper decision to go to with an invasive route such as spinal injections or worse, surgery. Studies have shown that epidural steroid injections are no better than placebo. Other studies have shown that the outcome of back pain patients treated surgically is no better than those treated with best medical therapy. Narcotics should be avoided as they are habit-forming and do nothing to clear up the pain.

For patients that do get MRI studies, it is not uncommon to find spine MRI abnormalities. The important fact is that these abnormal MRI findings do not necessarily explain the pain that that individual is experiencing. To account for an individual’s back pain or sciatica (leg pain), the MRI findings must correlate exactly with the patient’s symptoms and neurological exam to have clinical significance. MRI studies of normal individuals without back pain or sciatica have been done. The results have shown that approximately 55% had bulging discs at one or more levels, 28% had disc herniation on the MRI scans. More than 70% of the MRI scans showed abnormalities and yet the patients had no symptoms! These MRI scans were done on patients who never had any back or leg pain – 70% of the MRIs were “abnormal.” The conclusion that just because the MRI scan shows “something”, does not mean that the findings are the cause of any given patient’s back or leg pain.

With conservative treatment and patient cooperation to do the back exercises, most patients have significant relief with clearing of their pain within 4-6 weeks. It is then important that patients continue to do their back exercises on a regular basis, as part of their daily exercise routine. Physical body reconditioning and core strengthening will also help a great deal. Back surgery (or neck surgery) can almost always be avoided. If you have back or neck pain that is troubling you, contact Dr. Kassicieh now for treatment.

Search

Recent Posts

  • Nurtec – Novel New Migraine Treatment
  • Aimovig
  • Professional and Olympic Athletes Using Platelet Rich Plasma for Joint Pain and Muscle Injuries
  • Platelet Rich Plasma PRP Therapy in Sarasota Florida for Joint and Foot Pain
  • Does Insurance Cover Botox Injections for Migraine Headaches?

Recent Comments

    Archives

    • July 2020
    • June 2018
    • January 2016
    • May 2015
    • March 2015
    • December 2014
    • November 2014
    • October 2014
    • September 2014
    • August 2014
    • November 2013
    • March 2013
    • May 2012
    • November 2011
    • April 2011
    • March 2011
    • February 2011
    • December 2010
    • October 2010
    • March 2010
    • January 2010
    • October 2009
    • September 2009
    • July 2009
    • October 2008
    • September 2008
    • August 2008
    • July 2008
    • June 2008
    • May 2008
    • April 2008
    • December 2007
    • November 2007
    • October 2007
    • September 2007
    • August 2007
    • April 2007
    • January 2007
    • November 2006
    • October 2006
    • September 2006

    Categories

    • Back Pain
    • Botox
    • Brain Stimulation
    • Computers
    • General Medicine
    • High Cholesterol
    • Memory Loss / Alzheimer's Disease / Dementia
    • Migraines / Headache
    • Movement Disorders
    • Nerve Diseases
    • Nerve Pain
    • Neuropathy
    • Pain
    • Parkinson's disease
    • Platelet Rich Plasma
    • Podcast
    • Seizures
    • Stroke
    • Uncategorized
    • Vertigo / Dizziness
    • Welcome

    Meta

    • Log in
    • Entries feed
    • Comments feed
    • WordPress.org

    logo

    Phone (941) 955-5858 Fax: (941) 955-0044

    info@sarasotaneurology.com

    3501 Cattlemen Rd, Sarasota, FL 34232

    Facebook

    Latest News

    • Nurtec - Novel New Migraine Treatment Jul 2

    • Aimovig Jun 20

    • Professional and Olympic Athletes Using Platelet Rich Plasma for Joint Pain and Muscle Injuries Jan 12

    • Platelet Rich Plasma PRP Therapy in Sarasota Florida for Joint and Foot Pain May 28

    • Does Insurance Cover Botox Injections for Migraine Headaches? Mar 3

    Copyright ©2018 all rights reserved
    Designed by YoHoHosting