joedaddydayMemberAugust 17, 2011 at 12:42 pmPost count: 2
hi doc i am 34 years old and in pain 24/7 i have seen to Doctors and they have not given me any clue on whats going on besides my back is bad and here is so meds i have had a mri done my results where multilevel degenertive changes predominantly involving the disc spaces with chronic Schmorl’s node type indentations of numerous vertebral body endplates L4 -5 level is the most involved with significant edema signal of the adjacent vertebral bodies and moderate narrowing of the right L4 nerve foramen and mild to moderate narrowing of the left L4 nerve foramen i was put on gabapentin and it helps with the constant feeling to pee i have seen your video on reading mri and my whole lower back is gray or dark i wanted to know what is my best choice on treatment if any i feel trapped and confused on the whole thingDonald Corenman, MD, DCModeratorAugust 18, 2011 at 12:34 amPost count: 8468
By your description, you have multilevel degenerative disc disease at the age of 34 associated with Schmorl’s nodes at many levels. I assume that there are irregular endplates involved too. If so, you most likely have had thoracolumbar Scheuermann’s disease when you were young. This is a softening of the endplates of the vertebra when you were growing in height. Did you participate in contact sports in high school or track and field as these activities are also associated with these endplate changes?
Regardless, your pain could be generated by this multilevel degenerative disc disease. You do not mention where you pain is located (lower back, buttocks, leg, upper back) and when it occurs (standing, lifting, walking, sitting, night, driving). That does affect your assessment. Did you go through a good rehab program using core strengthening and ergonomics? Have you tried medications like NSAIDs and Ultram?
If you have exhausted all conservative methods, there is a possibility that surgery could give you some relief. With multilevel disease, do not expect a cure of all your back pain. If there is one motion segment or possibly two that are heads and shoulders painful above all the others, you may be a candidate for a fusion of these segments. Your expectations should not be too high. You are not going to be a future olympic marathoner or work in heavy construction with your back but surgery possibly can give you pain relief.
You should find a good spine surgeon to look you over, perform some tests and give you an accurate assessment of your condition and chances.
Dr. CorenmanjoedaddydayMemberOctober 10, 2011 at 7:11 amPost count: 2
i have not tried core strengthening yet my pain is in my lower back and right leg and feel like above my hips its hurts me in all activities 24/7 i have had a consultative exam on 8/25/2011 and the doctors reports was cauda equina syndrome i have no idea what this is i have tried nsaids and does not touch the pains the gabapentin helps me a little as far as the feeling the need to urinate all the time feels like i have been holding it in four hours when i just went to the restroom i try and drink a lot of water to hydrate my self but it a horrible circle going to the bathroom is a job nowDonald Corenman, MD, DCModeratorOctober 10, 2011 at 8:54 amPost count: 8468
Cauda equina syndrome is a condition of the nerves of the lower back. The spinal cord ends below the first lumbar vertebra and the nerves that continue are called the cauda equina. Severe compression of these nerves is called cauda equina syndrome and is an urgent condition to treat (see website). These physicians probably misspoke.
You need to see a spine specialist to determine what the next step is.
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