[kunal]

#7748

HELLO,Dr.CORENMAN I AM KUNAL MANNA.I AM 22Yrs. OLD.I AM A STUDENT.MY PROBLEM IS THAT I AM FACING HORRIBLE PAIN IN LOWER BACK POSITION.THE IMPRESSION OF MY MRI REPORT OF LUMBOSACRAL SPINE IS AS BELOW,
“THIS SUGGESTS THE SACRALIZATION OF L5 VERTEBRA ON LEFT SIDE WITH EVIDENCE OF RIGHT SIDED ACUTE SACROILIITIS.THERE ARE DEGENERATIVE CHANGES IN LUMBOSACRAL SPINE WITH POSTERO-LATERAL DISC HERNIATIONS AT L1-L2 TO L5-S1.THESE DISCS ARE COMPRESSING THE THECAL SAC & CAUDA EQUINA NERVE ROOTS.THERE IS NO SECONDARY CENTRAL CANAL STENOSIS.
SUGGESTED CLINICAL CORRELATION & FURTHER INVESTIGATIONS IF CLINICALLY INDICATED.AN INFLAMMATORY SPONDYLOARTHROPATHY LIKE ANKYLOSING SPONDYLOSIS NEEDS TO BE EXCLUDED.”
NOW,AFTER AN ANTIBIOTIC COURSE I FELT A LITTLE BIT RELIEF.BUT THE PAIN IS COMING BACK.SO,WHAT SHOULD I DO?IS THERE ANY PHYSIOTHERAPIC TREATMENT OR OTHER EXERCISE?IS THIS CURABLE?
LOOKING FORWARD TO YOUR KIND VALUABLE INFORMATION.

[Donald Corenman, MD, DC]

#7756

You have two potential problems. One is a spondyloarthropathy (something like ankylosing spondilitis (AS) but AS occurs typically on both sides of the sacroiliac joint). You could have Reiter’s syndrome or a GI generated inflammatory syndrome which are one-sided.

The MRI report is confusing as it states you have disc hernations at L1 through S1 or maybe only at two levels (L1-2 and L5-S1). One section notes “POSTERO-LATERAL DISC HERNIATIONS AT L1-L2 TO L5-S1.THESE DISCS ARE COMPRESSING THE THECAL SAC & CAUDA EQUINA NERVE ROOTS.THERE IS NO SECONDARY CENTRAL CANAL STENOSIS”.

The report notes “NO SECONDARY CENTRAL CANAL STENOSIS” but then notes “THESE DISCS ARE COMPRESSING THE THECAL SAC & CAUDA EQUINA NERVE ROOTS”. This does not make sense as either the roots are compressed or they are not compressed.

If the pain is from an inflammatory syndrome, treatment typically starts with non-steroidal anti-inflammatories (NSAIDs). Treatment should be under the care of a rheumatologist.

Dr. Corenman

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