Nerve-based disorders are becoming
more commonly diagnosed, thanks to advances in medical imaging
like MR neurography.
Commonly diagnosed disorders
The following is a collection of commonly
diagnosed disorders. You may have been diagnosed with one,
or you may suspect you suffer from one. In either event, please
consult your physician and contact the Neurography Institute
at 877-PAIN-MRI (877-724-6674) to
schedule an MR neurography at a location close to you.
Piriformis Syndrome
In the United States each year, 1.5 million people have lumbar
MRI scans to look for the cause of the buttock and leg pain
called "sciatica." More than 1.2 million of those scans fail
to find the cause in the spine. Three hundred thousand of the
scans are sufficiently positive that the patient has lumbar
spine surgery. Of the 300,000 surgeries, as many as 25% fail
to relieve the pain - in many cases this is because the diagnosis
of a spinal cause for the sciatica was incorrect.
Piriformis syndrome also causes sciatica. Its treatment is much
less invasive and severe than the treatment of herniated lumbar
disks. However, many doctors never consider piriformis syndrome
as a possible diagnosis. Many physicians who are aware of it
are uncertain how to properly diagnose and treat it.
The advent of MR Neurography and Open MR injection techniques
together with new large scale outcome studies are now leading
to the successful diagnosis and treatment of many more sciatica
sufferers.
Nerve Tumors
Actual tumors affecting the nerves are
rare, and the good news is that they are often benign and curable.
The problem is that they may be very hard to locate. The pain
and numbness from a nerve tumor may mimic a far more common
type of nerve pinch or syndrome. Often, failed surgeries are
done for other disorders when the actual problem is a nerve
tumor.
MR neurography is a highly effective method
for surveying significant regions of the body for nerve tumors.
It can see tumors as tiny as one or two millimeters, or as
large as lemon. In fact, in many cases, tumors of all sizes
have turned up by surprise in MR neurography studies ordered
by doctors who were looking for a nerve entrapment.
And, iIf a nerve
tumor has already been found, MR neurography is an excellent
way to help the surgeon determine exact details so the
most effective and successful treatment can be planned.
Thoracic Outlet Syndrome
Pain in the neck, shoulder, arm,
hands – even headache
may be due to a treatable disorder called Thoracic Outlet Syndrome
(TOS). This is a general medical term that refers to entrapments
and pinched nerves occurring in the neck and shoulder region,
but outside of the spine. The most common features of this
disorder are pain and numbness in the ring and little finger
and the experience of increased pain and numbness, even weakness
when working with your arms lifted or overhead.
Sure, neck, shoulder, arm and hand
pain can be due to the spine, but about half the time the
spine is normal and the real problem is in the nerves of
the “brachial plexus” that
travel through the thoracic outlet along with the arteries
and veins. In the past, there has been no good way to diagnose
TOS. Now, MR neurography has made the diagnosis of TOS reliable
and accurate. Don’t get a spine surgery you may not need
if your problem might be due to TOS. New treatments for TOS
are highly safe and effective so a neurography scan may be
your ticket to pain relief.
Brachial Plexus Disorders
Modern medical imaging has opened the details
of the human body for your
doctor to inspect when a problem develops, but until now,
there has been
one major exception: the brachial plexus. This critically
important complex
of nerves that controls the arms and hands has been essentially
invisible,
a "black box" for diagnosis. Even in 2006, many doctors resort
to surgical
exploration without even trying to image first.
With recent advances in MR neurography,
all that has changed. Now, your
doctor can have access to detailed images of the brachial plexus
that reveal
many different types of medical problems. Injuries to the nerves,
tumors,
nerve pinches, inflammatory disorders, pain syndromes, all
can now be seen
and diagnosed accurately and immediately with a Neurography
Institute MR neurography scanning session.
Reflex Sympathetic Dystrophy
Now there is hope for the many thousands
of sufferers affected by this painful condition. RSD causes
intense burning pain in the skin, odd temperature and color
changes in the limbs, even hair loss and bone fractures. Often,
the problem starts out with a relatively minor injury or entrapment
involving a nerve. The pain progresses and then transforms.
RSD can affect entire regions of the body and can even spread
to the whole body. Most pain medicines have no effect on the
pain of RSD.
Now, through MR neurography, it has been
shown that many RSD patients can be cured! This is a wonderful
surprise since many have been told by their doctors that they
have a cruel life sentence of pain. Spinal stimulators, ganglion
injections, complex drug regimens, hospitalizations, painful
physical therapy – all
have helped some sufferers reduce their pain. However, MR neurography
can often locate the precise cause of the RSD. If a doctor
can find and treat the source of the problem, the RSD often
disappears completely and permanently. If the root cause – often
a severely pinched nerve – is not fixed, then all the
other treatments never seem to produce a lasting improvement.
Lumbar Spine Disorders
Many lumbar spinal problems can be accurately
diagnosed and treated using conventional imaging tests such
as the MRI, the CT myelogram or X-rays. However, all too often
the results come up negative. You’ve got back pain – sometimes
with extra pain spreading down your leg, but the doctors say
they can’t find anything to fix.
MR neurography may provide
the answers you’re looking for. Here’s why.
Standard
imaging methods show the disk and bones. They also are excellent
for seeing neural tissue inside the spine. The problem is that
most imaging methods go “blind” as soon as the
spinal nerves start to leave the spine. Here’s where
the territory of MR neurography begins. Spinal nerves can be
pinched or chafed just outside the spine and problems of this
sort are completely invisible on standard images. For this
reason, many of the leading spine surgeons use MR neurography
to evaluate their most difficult cases. What if you already
had spine surgery but the results were not all that helpful – MR
neurography is one of the best methods for examining the area
of previous spine surgery to try to find what went wrong and
what needs to be fixed.
Pelvic Pain and Pudendal Neuralgia
There are many causes of pain in
the abdomen and pelvis – the
place to start in any investigation is with your internist, general
surgeon, urologist or gynecologist. However, sometimes, the cause
of pain and numbness in various areas of the pelvis remain a
mystery. MR Neurography has a proven track record for diagnosing
pelvic pain problems that are due to problems with the nerves.
The nerves involved form a complex alphabet soup of different
syndromes that many general doctors are just not familiar with.
In the front of the groin area – the problem may be with
ilioinguinal or genitofemoral nerves. In the inner thigh – it
may be the obturator nerve. Buttock pains can come from the superior
or inferior gluteal nerves, the cluneal nerves, or from the nerve
to the obturator internus. When pain or numbness affects the
area between the legs – the pudendal nerves may be involved.
The pudendal nerves travel a long
complex course – they
may be entrapped in the upper pelvis near the piriformis muscle,
in the mid-pelvis near the Ischial spine, or in the low pelvis
along the Alcock's canal that travels over the obturator internus
muscle.
An MR neurography study can be the first
step towards unraveling the knot and finding the source. Even
these small nerves can demonstrate a tell-tale signal of injury
or entrapment on an MR neurography study. Then, together with
a physical exam by a pelvic nerve specialist and targeted injections
and blocks you may finally be able to get a solid and treatable
diagnosis.
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