Degenerative Changes on MRI. What does it mean?

[CaptainUnderSkids]

I strongly suspect I have an autoimmune disorder, in particular an arthritic condition.

I’m 40 next year and I have recurring joint pains in my wrists, heel pain, Achilles tendonitis and flare ups of awful sacral area pain. I’ve been to the GP many times over the years and they tell me it’s generalised aches and pains, but when it flares up (every 6-8 weeks) it’s extremely debilitating.

I had an MRI recently for something unrelated and having received a copy of the report , it states there are “degenerative changes to L5-S1”.

I want to go back to the GP to ask for a referral to a rheumatologist but I need some strong evidence to do so.

Does anyone know what “degenerative changes” means in lay man’s terms? Would this fit with the possibility of an arthritic condition?

I thought that meant arthritis. It is what my scan reports say and I have arthritis- osteo in my joints, not auto immune.

Hi @CaptainUnderSkids degenerative changes can be due to just age (we all have degenerative changes on our joints and spine but mostly they are asymptomatic for people) but you are quite young for any significant ones. It just (usually) means that the disc height has reduced causing some nerve compression which causes the pain.
Could quite possibly refer to an arthritic condition, although possibly that would be more systemic (or more discs affected) L5/S1 is a very common one, sits at base of spine and compresses nerves which lead to sacral pain which you are experiencing.
You need an appointment with a consultant to go through the mri findings, they would know if just age related degeneration, which can be managed with exercise and physio if not too bad or indicative of something more sinister.
I have a bilateral L5/S1 disc bulge which has herniated twice, so I feel
your pain!

i would also say the fact that you get ‘flare ups’ is could be a red flag, although it may just be that you are doing activities which exacerbate your symptoms.
Can also be impacted by hormones etc.
Also worth looking into osteoporosis possibly.

@FVFrog TY for your response. The changes were listed as ‘’’mild to moderate” and also included L3/L4 to L5/S1 with minor disc protrusions (plural , so I think this means more than one? ) .

I also have recurring Achilles tendonitis in the same foot , along with morning foot stiffness and pain. I’m starting to go a bit mad with it really. I feel like I’m too young to be so stiff and decrepit!

@Chewbecca Sorry to hear you have arthritis. It can be very painful.

I have this too. My doctor told me it was degenerative disc disease. Mine is L4-S1 and is very painful during flare ups. I’m only 36 and currently 22 weeks pregnant so I’m expecting it to get worse as my posture changes due to bump. I feel your pain it’s debilitating.

Ok, so more widespread. I think
you should push for a consult to discuss mri results and next steps, which may just be physio. The issues in the foot and achillles can be related to the back back issue. Sacral issues can affect the whole ‘chain’ down the leg, stiffness in hamstring, calves and down into foot. Nerve compression will
irritate the sciatic nerve and can cause this kind of stiffness which is nerve related or ‘neural’. It still may be manageable with physio etc but you definitely need a consult.
I’m a Pilates teacher (the irony!!) and specialise in working with people on rehab issues, which is why I know something about the biomechanics involved.
Is your job fairly sedentary? Do you smoke or you significantly overweight (all risk factors)? Do you exercise at all?

@FVFrog What type of consultant should I ask to be referred to? Rheumatologist?

I am long term disabled so although I don’t exercise much , I’m not overly sedentary as I have young children . I do have a few (ahem) excess pounds which I’m trying to lose.

Will Pilates help? I could try some gentle online classes.

When you say you're long term disabled are you able to say what your disability is? Could it be relevant to all these joint/tendon problems. I have Ehlers Danlos Syndrome and since childhood have had tendonitis in my wrists, ankles and feet. I now have osteoarthritis in my neck, back and hips. The x-ray results for my neck say extensive degenerative changes through the cervical spine (as I remember). But all the problems I have I think come from the same condition . I had neck problems when I was a small child.

I would ask for rheumatology referral with the things you're describing I think

@CaptainUnderSkids No ! Absolutely no online classes!!!! You would need modified Pilates and a 1/1 with a well qualified instructor and ONLY after you have had medical and physio clearance 😋
Go and see the GP and discuss your concerns, they will know appropriate consultant.

I'm not a doctor but used to be a radiographer and have scanned many, many peoples spines.
Essentially "degenerative changes" is a catch all term for osteoarthritis of the spine.
See link below

www.mayoclinic.org/diseases-conditions/osteoarthritis/expert-answers/arthritis/faq-20058457

@LeuvenMan Is osteoarthritis autoimmune or just “one of those things”? I’ll look at the link , TY.

@Pifflewiffle It’s a complex disability of my nervous system . I don’t think it would be related to my current issues but I can’t say for sure. I will ask for a referral.

@FVFrog TY , I’m going to make an appointment next week.

As I understand it (remember I'm not medically qualified); Osteoarthritis (OA) is not an autoimmune disease ( Rheumatoid arthritis however is, I think an autoimmune condition but tends to affect other areas of the body).

Osteo is not auto immune but not always one of those things, sometimes the cause is identifiable. Mine is because of a connective tissue disorder meaning the cartilage is rubbish, hence the joints are damaged.

TY that explains it very well. The condition I suspect I have is called Ankylosing Spondylitis (I think it’s a form of arthritis). It’s not something I’ve heard of until a chiropractor mentioned it. I looked up the symptoms and they fit (widespread joint issues).

The MRI results are now making me more suspicious I may have this.

I have identical problems and nearly identical results ...!
We also have a family history of AS.. my Dad had it hence me being sent for an MRI and Xrays also.
However your MRI would have picked it up.. AS shows inflammatory changes (usually around sacroiliac area amongs others) and fusion, so unless the MRI picked up inflammation, it's very unlikely to be AS.
Mine showed disc degeneration and 'arthropy' and also fluid round my hip (can't rem what they said that was) which basically meant wear and tear arthritis..but not not auto immune.

Osteoarthritis is unfortunately 'one of those things' and of course pain in one area impacts on the function of other areas. It sucks!

Also.. did they do a blood test? They check for the HLA-B27 marker which 90% of those with Ankolosing Spondylitis have.

@StillMedusa No blood work done yet but I could ask for that test. No inflammatory changes were picked up but I was told that early stage AS doesn’t always show inflammation in the SI joints.

Were you diagnosed with anything?

As far as I’m aware, degenerative changes just mean osteoarthritis (wear and tear rather than autoimmune). I’d be asking for a physio referral and an orthotics referral to help with the back and Achilles issues, and focussing on losing weight. In my area there’s a specialist spinal physio service, where they seem to work wonders. Might be worth asking if there’s anything similar where you live.

@leavesontheground I am currently awaiting further physio but waiting lists are long (I’ve been waiting since November 2021 in spite of begging for an urgent referral due to the pain) .

ti could be the facet joints - i have this and have radio frequency treatment which basically destro ys the nerves. however they grow back but have managed this for a few years. whenever have an ex ray it always come back mild to moderate relating to back/hips/groin - referrals and treatments are so spaced out these days.; you phone gp - 2 weeks wait for a telephone call- he then says come down - another weeks wait- he will arrange a x ray - another wait - then the appointment for x ray - another wait for results - another wait or referral to consultant which takes months - some aliments can take 4 months before we start treatment or the wait for treatment - all spaced out in weeks backwards and forwards

lh