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February 16, 2008

MRI, Back Pain, Herniated Disc, and Running

by robert hashemian @ 12:01 am
Filed under: health,running-hiking — Tags:

MRI, Lower Back Pain, Herniated Disc, and RunningIf you are an avid runner, you know that occasional pain is just a part of the activity. It comes in different intensities and it affects different parts of the body. Sometimes it's in the knee, other times it's in the foot, sometimes it's from a strained muscle, and other times it's in a joint.

Take a look at my recent MRI and it's not hard to tell where my pain was coming from. Even my kids had no trouble spotting it. Mind you, my doctor is yet to see this on my next visit, but odds are he'll zero in on this anomaly too.

The ordeal started about 4 months ago. At first it was a pulling and tightening sensation in my left hamstring. As time progressed it became painful, specially on long jogs and the hilly parts of my route. I would just attribute it to a strained muscle, yet strangely the hamstring was not tender to the touch. The discomfort would eventually subside, but kept returning with more intensity after each run. In my mind something was clearly wrong, but not bad enough to seek medical help.

Then 2 months later my body decided to send a stronger signal, in the form of a nasty lower back pain. I've had lower back pain before. They would normally hit me every couple of years, and eventually go away after about a week. I would just ignore them and continue with my daily activities, including running.

But this time the pain had no intention of leaving. In fact it kept worsening to a point that I could barely even walk. The hamstring pain was still there, but I was yet to connect the dots. My orthopedic doctor, however did make the connection when I finally decided to pay him a visit. An X-ray revealed no serious problems, so I was given some conditioning exercises, some anti-inflammatory medication and a follow up date.

Slowly the pain began to subside and I started to resume my normal life and running. But a couple of weeks later, just before leaving for a week-long business trip, the pain returned with a vengeance. This was the worse trip I had every been on. There I was in Miami Beach near the beach where I should have been running after work. Instead I was nursing a debilitating pain. I couldn't sit, I couldn't stand, I could barely walk, and I still had my job to do.

Things became even worse when I returned. Getting in and out of the car became a long exercise in pain. Turning in bed at night meant a certain wake-up with a piercing pain. Advil became a candy of choice in copious amounts. Finally I called my doctor again to see him before the follow up date. He discovered a distinct weakness in my left leg as compared to the right one. I believe this condition is known to some as Sciatica. He suspected a herniated disc and ordered an MRI scan, which took place yesterday.

The MRI (Magnetic Resonance Imaging) machine is truly a marvel of medical technology. It can virtually slice through the body and record images from multiple angles while the patient feels absolutely nothing, except his original pain that brought him there in the first place. Claustrophobics would certainly find the process disconcerting, as do people like me who can't hold still for even a minute. When I had to lie still in that loud coffin-like contraption for some 40 minutes, the desire to move became even more magnified. I don't know how I lasted that long, but somehow I managed to stay still the whole time. Moving around probably would have meant having to stay longer in there for re-scans, and my goal was to escape the mechanical beast as fast as possible.

At the end of the session, I was given a CD-ROM to hand over to my doctor on my next visit. I hadn't intended to browse the CD, but by the time I got home, curiosity (both technical and medical) got the better of me and I started to browse the images. Many of them made no sense to my untrained eyes. I could almost make out the position of the sliced images, but they all looked like a mass of chopped meat to me, until I got to the length-wise sliced images. As I looked closer, I finally spotted the damming evidence, which I have indicated above with a white arrow on the image. Yes, that's really my spine.

I'm no doctor (although I am a son of a darn good pediatrician), but this looks like an unmistakable culprit to me. It may be a herniated or bulging or protruded or slipped or ruptured disc, but it's easy to see how it's pinching the nerve between the L5 and S1 vertebrae. Ok, I googled their names.

Obviously my doctor will have the last word on this when I see him next week, but this evidence is hard to contradict. The good news is that I know the cause of the pain, and the bad news is that I know the cause of the pain. Could this mean the end of my running days? I don't know, at least I hope not. For now I have replaced jogging with the much gentler walking. As depressed as the thought of not running makes me, there's no need for me to dwell on it and become inactive. Life is filled with all kinds of obstacles and personal disappointments. Whatever the case here, mine can be no worse than others'.

*UPDATE: Herniated Disc - 4 Years on - Mar. 2012

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