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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31329
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I had an MRI last week of my spine and my dr's

Customer Question

Hi I had an MRI last week of my spine and my dr's interpretation of it was different than the radiologist's. My dr referred me to a spine dr but I can't get in to see her until next week. There are a couple of images that I have questions about
JA: OK. The Doctor will need to help you with this. Is there anything else the Doctor should be aware of?
Customer: No can I upload a picture?
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 5 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 months ago.


I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

Please up load the pictures?

What are your symptoms?

Customer: replied 5 months ago.
Hi just added two pictures. Can you tell me what the dark spots are from on the vertebrae at the top of the picture? Just below the top two discs. My dr said it is just bone marrow
Customer: replied 5 months ago.
My father had severe arthritis and it looks off to me. I'm seeing the spine dr in a week
Customer: replied 5 months ago.
I went in for pain in my hip, left leg and numbness in my leg
Expert:  Dr. Arun Phophalia replied 5 months ago.

Thanks for the picture.

The black spots you mentioned are termed change in the signal intensity. The part of the bone density / bone marrow may change the magnetic signals of MRI due to age or change in the bone density. Nothing serious or significant here.

You would be benefited by physical therapy, deep electrotherapy, steroids (prednisone) and reducing weight (if over weight).

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 5 months ago.
Expert:  Dr. Arun Phophalia replied 5 months ago.

You are very welcome.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 5 months ago.

Following measures would be helpful;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

8) If obese or over weight, reduce weight for long term benefit.

9) Epidural steroid shots

10) Surgery is usually last resort, when the above conservative measures fail. You can start the following exercises;

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

This is a slide show for the exercises (you can pick up your own set, which suits you);

You can consult following specialists (apart from your GP);

a) Orthopedist

b) Neurologist

c) MD in Physical medicine and rehabilitation.

Best wishes,
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Expert:  Dr. Arun Phophalia replied 5 months ago.

This is also termed as Schmorl nodes.

Please see this reference resource;

Schmorl nodes, also referred as intravertebral disc herniations, refer to protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra. The protrusions may contact the marrow of the vertebra, leading to inflammation.

Expert:  Dr. Arun Phophalia replied 5 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.

Expert:  Dr. Arun Phophalia replied 5 months ago.

Please let me know if you have any further questions. I would be glad to answer them.