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Chronic Back Pain - L-4,5 L-5,S-1 - MRI, X-Ray, Bone Scan results included


I am a new member and wanted to introduce myself.

I am a 36 year old male with chronic back pain. I have had ongoing pain for 3+ years but it has just recently (9 months ago) come to a level of debilitation. I have seen 3 different Dr's, a chiropractor and have an appointment with a spine specialist. I have had a 2 X-Rays, a MRI and a bone scan, all of which have come back with a result of "mild" this or that. My regular Dr suggested the specialist will recommend a spinal injection. I'm getting frustrated with the level of pain compared to the results of the scans.

I have come to the site to research conditions listed on the test results. Any help would be appreciated.

I've tried Tylenol, Advil, Aleve and Tramadol for pain to no relief. Dr. refused to prescribe narcotic meds because of his diagnosis of chronic back pain and the possibility of addiction to narcotic meds. His latest recommendation was Amitriptyline combined with Aleve and Tylenol. Been on this combo for 1 1/2 weeks, again no relief.

X-Ray #1 Findings:

5 mobile lumbar segments. Retrolisthesis of L4. Disc space height
loss seen at L4-5 posteriorly

Relatively minimal lumbar osteoarthritic findings

X-Ray #2 Findings:

3 views again show minimal retrolisthesis of L4 on L5. Mild
disc narrowing L4-5 and L5-S1. Mild facet joint hypertrophy at L5-S1.

Degenerative disc changes L4-5 and L5-S1. Minimal
retrolisthesis of L4-5.

MRI Findings:

There is minimal lumbar dextroscoliosis.

There is mild disc desiccation at L4-L5. There is mild disc height
reduction at L4-L5. There is a mild diffuse posterior disc bulge
at L4-L5. This does not cause nerve root compression or
displacement. Mild right lateral degenerative endplate changes are
present at L4-L5.

There is a mild diffuse posterior disc bulge at L5-S1. This does
not cause nerve root compression or displacement.

There is a small Schmorl's node within the superior endplate of L4.
Incidentally noted is a right-sided L2 vertebral body hemangioma.

No pedicular edema is present. No spondylolysis is present.

1. Mild disc desiccation and diffuse posterior disc bulge at L4-L5
without nerve root compression or displacement. Mild right lateral
degenerative endplate changes at L4-L5.
2. Mild diffuse posterior disc bulge at L5-S1 without nerve root
compression or displacement.

Bone-Scan Findings:

SPECT Imaging: Mild uptake noted in the L4-5 disc space. No
significant facet abnormality.

Degenerative disc disease at L4-5. No acute process identified.




  • txas99ttxas99 Posts: 3
    edited 02/05/2013 - 2:42 PM
    Hey Blue! Pain sucks amirite?

    I don't have the crazy hardware a lot of people on these boards have, but I have been around where you're at before. My doc put me on a small dose of nortriptyline (an anti-depressant, like your amitriptyline I think) at night and I've come to recognize some major personality change for the good that it's responsible for. Stuff like getting less anxious / dramatic / despondent .... at the prospect of permanent chronic pain. It's supposed to take a while to kick in anyways, and it certainly took me about half a year to recognize the benefits. Try to give it a chance.

    It also sounds like there are also other meds that you can explore. I found that Aleve didn't improve my ability to work, but that Mobic (meloxicam, an NSAID) helped a bit. In my experience, I found a rheumatologist to have a more effective command of the pain medication out there -- the pain managment doc just didn't know what to do with me -- they're used to people with chronic pain from arthritis. You may want to check with a rheumatoid specialist anyways, just in case. And I'll mention it because you didn't, I've found muscle relaxants can be useful too.

    Sorry I can't be more help with the reports -- in my experience if it's not clearly stated they won't know what to do with you except refer to PT.

    Take it easy!
  • davrunnerddavrunner Posts: 478
    edited 02/07/2013 - 7:18 AM
    It's amazing that some people with major findings on MRI will have little to no pain and someone with a near normal MRI will be in excrutiating pain. Proves that we are all truly individual. When my pain journy started approx 10 years ago, I had back issues before that but were always resolved with Chiro, all the Docs and surgeons said I wasn't a candidate for surgery. At that time the majority of my issues were cervical. I went to one surgeon for a 3rd or 4th opinion who said he'd operate but couldn't tell me what he was really going to do other than poke around.
    I eventually had a laminectomy in 2008 and now looking at both cervical and lumbar 3 level fusions in my future. I am doing everything in my power to postpone as long as possible.
    Rhuematologists may be able to help, mine doesn't do pain management but did determine that along with DDD I have sero-negative RA which justs puts a whole new twist on pain, sometimes it's hard to tell whether the swollen joints in hands, elbows, knees and feet are from back or RA. I am on my 3 month of trying humira hoping that it will help with some of the joint pain. If at 6 months it doesn't work I'll shift to a different RA med. Just have to keep trying until you find what helps you.
    Welcome to the forum and hopefully you can find some relief, may we all.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Tests aren't everything. They don't actually show pain. Clearly I have severe spine issues and I have certainly endured pain, but despite all of my "scary" test results/surgeries, I work a full time job and take care of my two small kids (with the help of course of my wonderful and understanding husband)... but I have seen/read on many boards where people who have only one level fusions are on disability for not mobility, but constant pain. Or some are able to work but have seen a significant decrease of normal "fun" life activities again, not so much from mobility, but from pain. My heart honestly goes out to these people. Go to another doctor, and if they don't start hunting answers and trying different treatments, find another doctor, and another. There will be someone out there not just willing to help you, but will want to help you. And don't fear the spinal injection. There are many people they don't help, but there are also many that see significant pain reduction from them. Best of luck!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
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