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MRI results show bulging discs: what are my options?

Spine Health | Last Active: May 1, 2023 | Replies (21)

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I was referred to the Neuro Spine clinic. I ended up seeing a physiatrist. He was only one who accepted to see me. (the clinic has all necessary Drs., orthopedic surgeons, neuro surgeons, etc. ) He ordered the MRI. He recommended physical therapy, injections and possibly a chiropractor. I am going to call a chiro. today. I cannot see how a physical therapist can move my vertebrae that is out of place, let alone help with all bulging discs. I do know my entire spine is BAD, especially my neck but I am only allowed to address ONE area at a time. I have so many pinched nerves and bulging discs. I personally do not want to rush into surgery though. Hoping I can get help before it gets worse. Decades a go, a chiro. did help me when I only had 2 bulging discs. But once I got fibromyalgia, a chiro makes EVERYTHING much worse. But willing to try it again.

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@saleha59 I would advise you to call your insurance and insist on seeing a spine neurosurgeon. They want to send you to a chiropractor to put off having to fix the spine issues you have to avoid spending money on your care. A chiropractic manipulation is very risky in your present condition according to many spine professionals and can cause permanent damage such as paralysis. One of the tactics to put off spine surgery is the spinal injections. You already have some instability and that will likely continue, and you have narrowing of the spinal canal in addition to all the nerve root compression at multiple levels. Anything that touches or compresses the spinal cord can cause issues which can be pain, spontaneous muscle contractions, numbness, and paralysis of body parts and even problems and disability with walking. It all depends where the damaged level is. With arthritis already there in the foramen, that will continue pressing on the nerve roots. The time comes when the only real fix is a spine surgeon who can clean out and enlarge the arthritic areas around the nerve roots, and remove discs that are too far damaged, and then replace that disc with a bone graft or an artificial disc. Injections only buy time by reducing inflammation with steroids or nerve blocks, and put off surgery, but there comes a point when spine surgery is the best choice. I have heard cases of patients who wait too long and live with permanent nerve damage and pain as a result. When discs collapse, the spine will try to stabilize itself by growing bone spurs near the disc, and the bone spurs can fuse the spine around a collapsed disc. That may be an out of alignment position that becomes permanent or causes spinal cord compression, and it may not be able to be operated on later; a surgeon would have to answer after reviewing your case. You can end up in a wheel chair with some degree of paralysis.

There are surgeons who will look at your MRI without charge to see if they would take the case. Mayo does that too. Spine surgery is very expensive, and Medicaid is not going to pay as much toward it, so many surgeons in private practice don't want to take the case. You really should insist on a spine surgeon to evaluate your imaging, then get their basic opinion on if you should seek an official surgical evaluation. It is your choice, and surgery is a big step, but it can give you your life back. That was my experience, and I knew if I let my spinal cord compression continue, that I would have become disabled. I didn't want that. The earlier you can fix a spine problem, the better your chance of a good recovery. You have to do it before nerve or spinal cord damage becomes permanent. I wasn't a patient who looked forward to surgery, quite the opposite, I feared it, but it was the best choice I could have made. I have done a lot of physical therapy which has helped my spine and my recovery, so don't overlook that. PT's can have a lot of knowledge about surgical procedures and relay their experience because they rehab surgical patients and they know the degree of success and the details of the patient's recovery.

The choice is yours. No one else can advocate for you. It is hard and you have to be informed so you can make your point. They can easily dismiss you if you can't counter their argument. I know my comments are pretty direct, and I learned my way through all of this by being denied help by 5 spine surgeons. It wasn't about insurance. It was because I had a case with an unusual presentation of symptoms and they were afraid to take it for fear of a poor outcome that could damage their ratings of successful surgeries. I was given different wrong opinions, and I figured out what was wrong after I found medical literature with cases similar to mine. I sent that to a surgeon at Mayo and he helped me. That is what advocating can do. I found what 5 surgeons missed, and then I had to move on because no one would help me address this with surgeon #5 and I didn't think he would listen to me since he had already disregarded the symptoms and clues that lead to the discovery. It would be pointing out a mistake to a highly respected surgeon, but that's OK, because my surgeon at Mayo was the best. I wish I had come to Mayo first and not wasted 2 years chasing surgeons who would not help me and playing along with every test they wanted to do instead of surgery. Again, more direct comments, but it is important to be truthful and it is not meant as criticism. I did not know medicine would be like this, and I didn't know how medicine could and should be until I came to Mayo. This is why I help patients on Connect and I want you to know that I do this out of respect for other patients to help them make their own choices.