MRI Results… What next?

Good evening,

Newbie here.

I have been having symptoms since Oct 21.
Symptoms include:

Tingling and numbness in hands and feet
Dropping things
Loss of grip
Neck pain
Swallowing issues
Hoarseness
Smelling smoke all the time

Bloods showed lack of vitamin D and folate so been on those for 2 years now.
MRI in 2022 showed degenerative spinal disease in the cervical spine.

Have had a repeat MRI in Dec 2023 of the brain and spine. Called me back to do another one with contrast two weeks later.

I got my results today and unsure what it all means. I still have symptoms and the consultant mentioned a lumbar puncture and nerve conduction. My worry is these won’t happen now.
Can anyone advise if they think this will be the case and/or what this means?

Thank you in advance

Hello there, welcome aboard.
I read your explanation and the attached file, and will try to say and explain my point of view. Apologies for the massive wall of text.

Massive caveat of I-have-no-medical-expertise and my own treatment etc is all in Japanese being in Japan as I am, and so my system experiences in Britain and technical term experience in English is very limited.
So arm yourself with a caravan of salt deliveries before reading.

Hoarseness and smelling smoke seems to suggest a respiratory tract infection. Lacking key nutrition like indeed vitamin d makes you more vulnerable to infections among other things. Lacking folate can also causes tingling and numbness in the hands and such. Degenerative spinal disease can be caused by, other than just age, indeed infections. Overall, your explanation seems to mostly lead in the direction of [missing nutrition lead to infection which lead to other issues, and it was then treated with indeed the necessary nutrition for such issues.], after which you then had more MRIs just to make s.
The written note about that says that, well, since you still had symptoms they wanted to see if there was perhaps a reason like indeed MS behind it. And well there was no such thing it seems. What little white spots you have appear to be within normal, you have no syrinx, and your central canal is just big which is apparently not related to well neurological issues but which can also push further onto where you then already had issues in the spine due to the built up liquid. The contrast agent did not reveal active lesions or anything like that.

So err overall it seems you have no such disease like MS and your symptoms appear to basically be from the initial nutrition and degenerative spinal disease issue. Googling around a bit, it seems that basically won’t heal by itself. The proper nutrition and then stuff like massages and other physiotherapy, or just plain inflammation reducing steroids, is about all that’ll help, apparently.

It’s a bit like when you brush your teeth too forcefully after acidic food. Over time, the teeth get worn down losing their enamel and your gums pull pack revealing more of the teeth. This basically leads to pain, and it is a you lost something that cannot really be regrown kind of issue, meaning the treatment focuses on reducing the pain and the issues it’ll cause for you.
Degenerative spinal disease, it seems, is sort of similar in that you lose the soft cushions in the spine and leave the bones rubbing against each other sort of. You cannot regrow the cushion by yourself, so it’s various therapies and painkillers to reduce the impact on you like indeed the symptoms you mention.

Well, if they think so they might not think they need those extra checkups anymore as you indeed suspect.

While you do have similar issues to those with MS, the reason seems to be very different and much more physical/less immune system related.
That is again just my highly uninformed and hastily googled etc. tentative opinion. Now is the time to call in those camels carrying sacks of salt, apply liberally before you believe any of my nonsense.

Thank you very much for your detailed response.

I forgot to add in that my nutritional deficiencies are sorted now. I went on supplements last year, and my levels are now back in normal range.

Symptoms are still ongoing. The most worrying symptom is the swallowing and the hands.

It’s very nice that your levels are back to normal!
I really do hope things will work out well for you long term.
I’m sorry for my late reply, work was rather hectic this weekend and I didn’t get the usual email saying someone replied to me.

From what I could read at least, it seems degenerative spinal disease in the cervical spine, once you get it for whatever reason, does not really heal. I found it listed as a chronic degenerative process. I suppose this would mean once you have it, you’ll just be slowly getting worse even if you fix what caused it initially, like indeed MS actually (but please don’t take it as gospel).
It does seem to have things like tingling and numbness in hands mentioned as an eventual symptom, as well as trouble with the legs and feet, but I am reading rather technical stuff and research papers where I must admit I would need more specific information about your results and symptoms to make sure I am not just tossing you a blanket diagnosis and scaring you unnecessarily (and err well there’s a limit to my random-person-trying-to-understand-actual-research effectiveness as well I figure).
Neck pain at least is very much mentioned as a symptom of degenerative spinal disease in the cervical spine (which I believe is indeed in the neck). That’s also where your swallowing muscles and such work so damage and degeneration there would make it harder I think. But I am not sure if by issues you mean like, pain, or say being unable to do it well due to lack of sensation for example, as they are a little different. I for example have issues walking down stairs due to numbness in my right leg, but I do then as a result not have any pain there. I am sorry for making a stupid example, I just want to make sure I can be understood.

There does seem to be treatment that will help you, though I can mostly find phrases like “treat the symptoms” rather than indeed fix the problem (rather like MS again actually) , so that seems a bit unfortunate, but I am sure your doctor knows well better than I about indeed what they have studied and work with. It does seem like putting a break on the degeneration process would be a good idea in order to not get worse at least. Maybe you’re being set up for something already? It sounded like you were cleared of neurological worries, which is great, but I sure hope it doesn’t mean you were then just dropped as a done deal.