Gateway Midwest Healthcare treats Town and Country patients for herniated discs, disc bulges and foraminal narrowing, about twenty minutes away. The first visit is spent on your existing imaging and an examination, to work out which findings actually explain your pain.
A great many Town and Country patients come to us for a second reading of imaging they have already had.
Why does my MRI report sound so bad?
A radiology report is written by one doctor for another, and it lists everything visible whether or not it is relevant. Handed to a patient, it reads as a catalog of damage. Handed to a surgeon, it can read as an indication.
The examination is what separates the findings that matter from the ones that are simply present. A moderate-sounding finding at a level that matches your symptoms is meaningful; a severe-sounding one at a level that does not is noise.
The roads around Town and Country, and what they send us
I-64 and Clayton Road bound Town and Country, and Mason Road carries the local traffic between them.
What that means in clinic is that we see fewer dramatic injuries from here and more of the kind that build. A commute measured in tens of minutes each way is a genuine daily dose of spinal loading, whatever else happened on the road.
The I-64 and I-270 interchange sits at the eastern edge, and Clayton Road carries the local traffic. Interchange collisions are the recurring source of road injury here.
What we treat most for Town and Country patients
Mild, moderate, severe
What the radiologist’s adjectives actually imply.
Disc bulge vs herniation
Two words that are not interchangeable.
Foraminal narrowing
Tightening of the exit tunnel a nerve uses.
Herniated disc
The condition behind most of those reports.
How do you know which finding on my MRI is causing my pain?
A radiology report is a complete inventory, not a diagnosis. It lists what is visible at every level whether or not any of it explains the symptoms, because that is what the radiologist is asked to do. Read by a patient, it reads as catastrophe.
The grading language makes it worse. Mild, moderate and severe have no agreed measurement thresholds for most spinal findings, and different radiologists grade the same images differently. A report reading ‘severe’ can belong to someone walking comfortably.
So the examination is what converts a report into a diagnosis. If your numbness is on the outer calf and the top of the foot and you cannot lift your toes, the L5 root is the suspect, and the scan is being used to confirm what the examination already suggested rather than to go looking blindly.
Planning the trip from Town and Country
For Town and Country patients the work most often centers on disc bulge vs herniation, foraminal narrowing and herniated disc. Each of those has its own page setting out how it is diagnosed here and what treatment actually involves, and reading the relevant one before the appointment tends to make the visit more productive.
With about twenty minutes by I-270 on the road, patients reasonably want to know what each visit achieves. We set that out at the first appointment rather than leaving it to unfold.
Useful to have: previous imaging, a current medication list including anything from another prescriber, and a record of what has been tried and what it did. Duration of relief matters more than whether it worked.
Twenty minutes each way is comfortable, and we usually spend the first visit almost entirely on the existing imaging and the examination rather than ordering anything new.
We also see patients from Chesterfield, Des Peres and Creve Coeur. The full list is on areas we serve.
To book, call or text us. Monday to Friday, 8:00 a.m. to 4:00 p.m. We are at 12174 Natural Bridge Rd, Suite 110, St. Louis, MO 63044 — about 20 minutes from Town and Country, St. Louis County. No referral is needed to book and no attorney is needed to be treated after an accident.
What does mild, moderate or severe mean on an MRI report?
Radiology reports grade findings as mild, moderate or severe, and patients understandably read those words as a measure of how much trouble they are in. They are not.
The grading describes the appearance of the anatomy, not the symptoms it is producing. Severe degenerative change is regularly found in people with no pain, and mild change is sometimes accompanied by considerable pain when a nerve root happens to be irritated.
The useful reading of a report is which structures are involved and at which levels, taken together with where your symptoms actually are. Where the two agree, the report is informative. Where they disagree, the examination decides.
Nearby: pain management in Frontenac, MO.
Questions we get from Town and Country
Should I get a second surgical opinion?
Often worth it. It is also worth establishing whether the pain is coming from the level being proposed for surgery, which is a different question.
Do you charge to review outside imaging?
It is part of the visit, not a separate service.
My report says severe. Should I be worried?
Not on the wording alone. Severity of appearance and severity of symptoms track poorly. What matters is whether the findings match your examination.
Should I get a second scan?
Rarely useful on its own. A second opinion on what the existing scan means is usually more valuable than a new image.
How serious is severe foraminal narrowing?
Foraminal narrowing is a tightening of the exit tunnel a nerve uses, and the word severe describes how that anatomy looks, not how much trouble you are in. Mild, moderate and severe have no agreed thresholds for most spinal findings, and radiologists grade the same images differently. What makes the narrowing matter is whether it sits at the level and side your symptoms and examination point to.
What is worse, a herniated or bulging disc?
The two words are not interchangeable, but neither one tells you on its own how much trouble you are in. How a finding looks on a scan tracks poorly with how much it hurts: a mild finding can cause real pain when it irritates a nerve root, and a severe one can belong to someone walking comfortably. What decides it is whether the finding matches your examination.
12174 Natural Bridge Rd, Suite 110
St. Louis, MO 63044
The map loads from Google, which sets its own cookies. We do not load it until you ask.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.