Can MRI diagnose the cause of intractable lower-back muscle pain?

Peter Jason

I have had this for a long time.

Dr. Andrew B. C

"Peter Jason" <paul@colonel.com.au> wrote in message news:<bmipfb$1i6a$1@otis.netspace.net.au>...
> I have had this for a long time.

It can.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

M_un Over Seatt

On Wed, 15 Oct 2003 16:31:16 +1000, "Peter Jason"
<paul@colonel.com.au> wrote:

>I have had this for a long time.

Possibly, it will depend on the cause. For instance, LBP can be associated with kidney pathologies.
If the MRI does not image the kidneys, or the radiologists misreads the MRI looking at the spine
instead, well, you get the drift.

http://antwrp.gsfc.nasa.gov/apod/ap031011.html Lift well, Eat less, Walk fast, Live long.

Pf Riley

On Wed, 15 Oct 2003 12:38:29 -0400, M_un Over Seattle
<NoETOH@email.com> wrote:

>On Wed, 15 Oct 2003 16:31:16 +1000, "Peter Jason" <paul@colonel.com.au> wrote:
>
>>I have had this for a long time.
>
>Possibly, it will depend on the cause. For instance, LBP can be associated with kidney pathologies.
>If the MRI does not image the kidneys, or the radiologists misreads the MRI looking at the spine
>instead, well, you get the drift.

The answer is that the MRI will most likely either show nothing abnormal or it will show that his
back muscles hurt, which he knew already.

PF

Steve Harris Sb

pfriley@watt-not.com (PF Riley) wrote in message news:<3f8f73f3.2495254@news.nwlink.com>...
> On Wed, 15 Oct 2003 12:38:29 -0400, M_un Over Seattle <NoETOH@email.com> wrote:
>
> >On Wed, 15 Oct 2003 16:31:16 +1000, "Peter Jason" <paul@colonel.com.au> wrote:
> >
> >>I have had this for a long time.
> >
> >Possibly, it will depend on the cause. For instance, LBP can be associated with kidney
> >pathologies. If the MRI does not image the kidneys, or the radiologists misreads the MRI looking
> >at the spine instead, well, you get the drift.
>
> The answer is that the MRI will most likely either show nothing abnormal or it will show that his
> back muscles hurt, which he knew already.

COMMENT:

Or it shows some pathology like a possible compression from a possible old or new disk extrusion, or
possible narrowing of foramina due to this or that. All of which are common in middle aged people
with no pain, and none of which helps very much in deciding what to do with the average person with
moderate back pain.

If the symptoms from the back are so severe that the question is not WHETHER to cut, but WHERE, then
MRI can be helpful. That's cases where somebody is dragging a leg or foot, or in such severe pain
even on narcotics that after a few months they're still a basket case, and could not possibly wait
the 12 months it takes for the effectiveness of surgical treatment and drug treatment of back pain
to come out equal (as they do at one year).

But 95% or 99% of back pain that is MRI'd, doesn't qualify. For those people, the procedure is a
either a complete waste of money, or else it's worse than a waste, helping to promote a surgery
which wouldn't have been done on purely clinical grounds (ie, from signs or symptoms like weakness
or really severe pain).

If I we had all the money that has been wasted these last 15 years on MRIs for back pain or syncope,
etc, we'd have enough $ to bail out Iraq and California, built two new space shuttles, and still
have enough left over for a free box of Kleenex for all Cubs fans (hundreds of them!). A couple of
guys just won the Nobel prize for inventing MRI, but the machine is only as good as the users. In
this case, the whole technology reminds me a little of what Heller says in Catch 22 about the
military: it's a mechanism invented by geniuses, and run by morons.

SBH

M_un Over Seatt

On Fri, 17 Oct 2003 04:46:26 GMT, pfriley@watt-not.com (PF Riley)
wrote:

>The answer is that the MRI will most likely either show nothing abnormal or it will show that his
>back muscles hurt, which he knew already.

MRI's don't show pain.

http://antwrp.gsfc.nasa.gov/apod/ap031011.html Lift well, Eat less, Walk fast, Live long.

J

"Steve Harris sbharris@ROMAN9.netcom.com" wrote:

> If the symptoms from the back are so severe that the question is not WHETHER to cut, but WHERE,
> then MRI can be helpful. That's cases where somebody is dragging a leg or foot, or in such severe
> pain even on narcotics that after a few months they're still a basket case, and could not possibly
> wait the 12 months it takes for the effectiveness of surgical treatment and drug treatment of back
> pain to come out equal (as they do at one year).

Does such (dragging a leg - actually he intermittently has no feeling from the knee down) resolve in
a year w/o surgery? J

Peter Jason

I went to the doctor yesterday and suggested an MRI fo the lower-back muscle pain and he said that
pain that resolves itself is usually a lifestyle thing, and to piss off and stop wasting his time. I
do lift weighty things constantly at work, though it is only the LHS which gives any trouble and I
can't understand why it occurs sometimes and not others. I have already had a CT scan of my spine
which showed a few common-for-my-age osteophytes only.

"Steve Harris sbharris@ROMAN9.netcom.com" <sbharris@ix.netcom.com> wrote in message
news:79cf0a8.0310171053.68156332@posting.google.com...
> pfriley@watt-not.com (PF Riley) wrote in message
news:<3f8f73f3.2495254@news.nwlink.com>...
> > On Wed, 15 Oct 2003 12:38:29 -0400, M_un Over Seattle <NoETOH@email.com> wrote:
> >
> > >On Wed, 15 Oct 2003 16:31:16 +1000, "Peter Jason" <paul@colonel.com.au> wrote:
> > >
> > >>I have had this for a long time.
> > >
> > >Possibly, it will depend on the cause. For instance, LBP can be associated with kidney
> > >pathologies. If the MRI does not image the kidneys, or the radiologists misreads the MRI
> > >looking at the spine instead, well, you get the drift.
> >
> > The answer is that the MRI will most likely either show nothing abnormal or it will show that
> > his back muscles hurt, which he knew already.
>
>
> COMMENT:
>
> Or it shows some pathology like a possible compression from a possible old or new disk extrusion,
> or possible narrowing of foramina due to this or that. All of which are common in middle aged
> people with no pain, and none of which helps very much in deciding what to do with the average
> person with moderate back pain.
>
> If the symptoms from the back are so severe that the question is not WHETHER to cut, but WHERE,
> then MRI can be helpful. That's cases where somebody is dragging a leg or foot, or in such severe
> pain even on narcotics that after a few months they're still a basket case, and could not possibly
> wait the 12 months it takes for the effectiveness of surgical treatment and drug treatment of back
> pain to come out equal (as they do at one year).
>
> But 95% or 99% of back pain that is MRI'd, doesn't qualify. For those people, the procedure is a
> either a complete waste of money, or else it's worse than a waste, helping to promote a surgery
> which wouldn't have been done on purely clinical grounds (ie, from signs or symptoms like weakness
> or really severe pain).
>
> If I we had all the money that has been wasted these last 15 years on MRIs for back pain or
> syncope, etc, we'd have enough $ to bail out Iraq and California, built two new space shuttles,
> and still have enough left over for a free box of Kleenex for all Cubs fans (hundreds of them!). A
> couple of guys just won the Nobel prize for inventing MRI, but the machine is only as good as the
> users. In this case, the whole technology reminds me a little of what Heller says in Catch 22
> about the military: it's a mechanism invented by geniuses, and run by morons.
>
> SBH

M_un Over Seatt

On 17 Oct 2003 11:53:02 -0700, sbharris@ix.netcom.com (Steve Harris
sbharris@ROMAN9.netcom.com) wrote:

>But 95% or 99% of back pain that is MRI'd, doesn't qualify.

Correct.

http://antwrp.gsfc.nasa.gov/apod/ap031011.html Lift well, Eat less, Walk fast, Live long.

Pf Riley

On Sat, 18 Oct 2003 08:49:06 -0400, M_un Over Seattle
<NoETOH@email.com> wrote:

>On Fri, 17 Oct 2003 04:46:26 GMT, pfriley@watt-not.com (PF Riley) wrote:
>
>>The answer is that the MRI will most likely either show nothing abnormal or it will show that his
>>back muscles hurt, which he knew already.
>
>MRI's don't show pain.

They can show abnormal signal from the muscle, which shows that his muscles are inflamed, and
therefore hurt, as opposted to bone or ligament.

PF

Steve Harris Sb

J <PhilOMatH@example.net> wrote in message news:<3F904201.EFBE672A@execulink.com>...
> "Steve Harris sbharris@ROMAN9.netcom.com" wrote:
>
> > If the symptoms from the back are so severe that the question is not WHETHER to cut, but WHERE,
> > then MRI can be helpful. That's cases where somebody is dragging a leg or foot, or in such
> > severe pain even on narcotics that after a few months they're still a basket case, and could not
> > possibly wait the 12 months it takes for the effectiveness of surgical treatment and drug
> > treatment of back pain to come out equal (as they do at one year).
>
> Does such (dragging a leg - actually he intermittently has no feeling from the knee down) resolve
> in a year w/o surgery? J

COMMENT:

Maybe, but generally nobody dares find out. It's pain-only that the results mentioned
above apply to.

SBH

Steve Harris Sb

"Peter Jason" <paul@colonel.com.au> wrote in message news:<bmprfa$4tk$1@otis.netspace.net.au>...
> I went to the doctor yesterday and suggested an MRI fo the lower-back muscle pain and he said that
> pain that resolves itself is usually a lifestyle thing, and to piss off and stop wasting his time.

Good for him.

I do lift weighty things
> constantly at work, though it is only the LHS which gives any trouble and I can't understand why
> it occurs sometimes and not others. I have already had a CT scan of my spine which showed a few
> common-for-my-age osteophytes only.

Probably a wasted CT scan, too.

SBH

M_un Over Seatt

On Sat, 18 Oct 2003 18:43:06 GMT, pfriley@watt-not.com (PF Riley)
wrote:

>>MRI's don't show pain.
>
>They can show abnormal signal from the muscle, which shows that his muscles are inflamed, and
>therefore hurt,

Inflamed muscles are not always hurt or hurting.

> as opposted to bone or ligament.

MRI's don't show pain.

http://antwrp.gsfc.nasa.gov/apod/ap031011.html Lift well, Eat less, Walk fast, Live long.