SLW

Thank you, Dr. Corenman, your expertise has helped me better understand. I have pain centralized in my lower area of lumbar with pains across top of both legs, Focus has been more on the sciatica pain. Injections that I had received did help for the traveling pain down the legs. Heel to toe walk can not do, I still work at balance and did get a massage table to excercise at home. I do feel that therapy aggravated with the tilts, but the leg stretches helped reduce the leg spasms with less tension on my spine. Are there good excercises at this level that would be better? I do know now that when you go to physical therapy, all seems to be the same therapy for lumbar. When it came to neck therapy and discussion of vertigo, seemed hesitant and gave me excercises I could do at home to help. Would I be safe for neck therapy are would it be possible to cause harm? This is a natural process and I had already come to terms of not having surgery, but taking better care of myself by eating right and focusing more on posture and working with levels of how far I can walk. The only true regret I have was being given the choice of which one was to be addressed first. When a person has painful areas of concern, both were not accessed to determine what the best approach would be first. This is 8 months in now, not including time before the realization break down. I again thank you.

Dr Corenman this is my lumbar spine
CLINICAL INDICATION: Back pain or radiculopathy, > 6 wks
COMPARISON: CT lumbar spine same day
FINDINGS:Severe/grade 4 anterolisthesis of L5 on S1 with bilateral L5 pars defects. Leftward curvature centered at L1-L2.
Severe degenerative endplate changes related to the anterolisthesis of L5 on S1 with partial osseous fusion of the L5-S1 endplates. Degenerative endplate changes and loss of disc space height within the lower thoracic spine and at L1-L2 and L2-L3.
Vertebral body heights are maintained. Osseous fusion of the posterior elements from L3 to S1.
The conus medullaris is normal in morphology and terminates at L1.
At L1-L2: Disc bulge asymmetric to the right. Facet joint hypertrophy. Mild spinal canal stenosis. Moderate right and mild left neural foraminal stenosis.
At L2-L3: Disc bulge asymmetric to the left. Facet joint hypertrophy. Mild right neuroforaminal stenosis.
At L3-L4: No spinal canal or neuroforaminal stenosis.
At L4-L5: No spinal canal stenosis. Mild bilateral neuroforaminal stenosis.
At L5-S1: No spinal canal stenosis. Moderate to severe right and moderate left neural foraminal stenosis.
IMPRESSION:Severe/grade 4 anterolisthesis of L5 on S1 with partial osseous fusion of the L5-S1 endplates. Moderate to severe right and moderate left foraminal stenosis at this level. Outside of this, no high-grade spinal canal or neuroforaminal stenosis.
Review of Systems
Cardiovascular: Positive for leg swelling. Both legs
Genitourinary: Positive for frequency and urgency.
Musculoskeletal: Positive for back pain, gait problem and neck pain.
Neurological: Positive for dizziness, weakness and numbness.
Psychiatric/Behavioral: Positive for sleep disturbance.
All other systems reviewed and are negative.
Right lower extremity muscle tone and strength are normal except 4/5 EHL
Left lower extremity muscle tone and strength are normal, except 4/5 Hamstring
Sensation to light touch is intact for bilateral lower extremities.
Lower extremity reflexes are normal and symmetric with no long tract signs (babinski or clonus).
Lower extremities are well perfused with no signs of DVT.
Tender to palpation bilateral troch R>L
DEXA scan shows a T-score of -1.6 consistent with osteopenia.
Lumbar CT scan shows a solid fusion L5-S1 with grade 5 spondylolisthesis at L4-L5
Lumbar MRI shows mild to moderate central and lateral recess stenosis L1-L2 and L2-L3.
DEXA scan shows a T-score of -1.6 consistent with osteopenia.
Had physical therapy and pain management injections

Hi Dr Corenman,
Thank you so much,
Mostly the pain in the neck, shoulder, some tingling and pain in arms and fingers, at times back of head hurts expecially laying back in chair. I have had vertigo short minute spans and adjust head and stops. 2016 trip to hospital 1st time uncontrollable sickness, no findings. When I was working on feet 12+ hrs legs would not want to go and hurt, at times pain would radiate out the right side of my neck. I have tingling, numbness in toes both feet and have had regular muscle spams back of legs and feet close to a year, occasionally now. Originally went to Dr in Feb. I thought having lower back issues and neck would both be addressed. So I literaly had to choose, walking issues I chose back, I have had on/off issues for the last few years. I have facial tingling, top of head tingling and even outer ears can hurt. ENT no ear problems, have pain in front of neck. I have not worked since the end of December. I had 2 incidents in November and December of last year back pain, neck pain and hard getting in and out of car. I have had previous back surgery in early 80’s it was thought at that time it was growing pains. I have on and off sciatica pain that occurs in both legs including hips. Recently going now to foot doctor over the numbness, 1st visit. I loose balance out of no ware and last month fell on concrete with small fracture in elbow, healing well no cast.
I get stiff and hurt if sit to long, I hurt if up to long, can be walking fine and suddenly just take a turn. I had back surgery for spondylolisthesis, had knot that protruded and sciatica pain 1 leg got really bad, if no surgery at that time I would be crippled by 30. All went well. I recently rubbed by knee and now experiencing the tingle down the lower front of leg. I have had shots in my back twice. I am at lost of what comes from my back now and what comes from my neck. I appreciate your feedback so much. I am 61 and have worked retail all my life in a very demanding atmosphere, from unloading trucks weekly, pushing freight, running registers, computer work covering shifts and sitting at computer in length. I do have barrettes and ear pain, I do not go to the Dr for ear pain anymore because I never have an ear infection. Went to ENT for pain in neck and I have a cir. bar at C5, I believe referred to as slight dysplasia. I’m sure I left something out. Thank you again