I've been a bit at my wit's end trying to figure out what to do about my severe and chronic lower back pain. I conjunction with my shoulders and right knee (which are less severe in terms of the pain), it's almost unbearable at times and while I appreciate the thoroughness of doctors, time drags on for me. Anyway, let me share with you the results of my most recent MRI, and a little history of that location.
First, I had a discectomy in March '08 in my L5-S1 joint. It was a large (roughly 1 inch) rupture, which resulted in spinal stenosis and I began to develop cauda equina syndrome. After the surgery, my right heel and entire outside of my right foot are numb. The pain subsided to mild levels after my recovery, and remained that way for about 6 months.
Now, at the 1 year+ point, the pain is back around the moderate-severe level, and making me quite miserable when it's bad. I've also had 2 surgeries on my left shoulder in the last 4 months to remove inflammatory tissue and part of the bone in my AC joint, which was causing pinching and a lot of pain. My right shoulder is headed that way, but for the moment it's tolerable.
During my first shoulder surgery, a crystalline fluid was found, but pathology did not test the material to determine WHAT KIND of crystals they were. No idea why. Calcium levels, rheumatoid factor, cell counts, sed rate, have all come back normal. I am positive however for the HLA-B27 antigen.
Now, my most recent MRI. This was a pelvic MRI, though it also included the L5-S1 region. It was ordered by my rheumatologist under suspicion that I may have ankylosing spondylitis. That was not the case, however. Here is the information on the report. Perhaps someone can help me make sense of what I should be expecting, or what all this might mean for me:
STIR coronal images do show moderate spondolytic changes of the L5-S1 disc space where there is some discogenic degenerative changes and edema in the adjacent endplates at L5-S1. There appears to be a Schmorl node involving the inferior endplate of L5 with some surrounding bone marrow edema on the STIR coronal images.
The sacrum itself otherwise has normal bone marrow signal and the SI joints are not fused and have normal signal characteristics as do the visualized segment of the iliac bones. Axial images show that the sacral canal has normal caliber. There is a central disc protrusion at the L5-S1 disc space level which may represent a small focal confined central disc herniation as well. The presacral fat has normal signal with no evidence of fluid or soft tissue mass surrounding the sacrum.
1. Moderate spondolytic changes of the L5-S1 disc space level. There may be a central confined disc herniation at L5-S1 with no spinal stenosis. There is some mild narrowing of both neural foramina at L5-S1 due to degenerative changes.
2. Schmorl node deformity involving the inferior endplate of L5 with some surrounding bone marrow edema.
3. Normal MRI Exam of the sacrum and both SI joints.
My general physical info:
Male - Caucasian
30 years old
Any insight would be greatly be appreciated. I heard mention about seeing a "pain clinic", but also not sure if I will need to go back to my neurosurgeon...