Commonly Diagnosed Nerve and Spine Disorders

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.

Read more: Disorders: Piriformis Syndrome

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 remains 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.

Read more: Disorders: Pelvic Pain and Pudendal Neuralgia

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.

Read more: Disorders: Thoracic Outlet Syndrome

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.

Read more: Disorders: Lumbar Spine 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 today, many doctors resort to surgical exploration without even trying to image the target area 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.

Read more: Disorders: Brachial Plexus Disorder

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, if 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.

Read more: Disorders: Nerve Tumors

Now there is hope for the many thousands of sufferers affected by the painful condition known as reflex sympathetic dystrophy, or RSD.

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, with the guidance of MR neurography, it has been shown that many RSD patients can be cured. This is a wonderful development, since many patients have been told by their doctors that they have a cruel life sentence of pain due to their RSD.

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.

Read more: Disorders: Reflex Sympathetic Dystrophy