Hello,
Thank you for your query at DoctorSpring.com
I could help you out by right suggestions if I have some more details. Your weight
Your lifestyle ( work, lifting weight, frequent long travels)
Treatment taken in Oct 2014 after the first consult and after MRI.
Have you taken any physical therapy
What is your current pain scale 0-10.
Also, can you send a scanned copy of your MRI?
With regards
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Patient replied :
Hello.
My weight is currently 103 kilograms
My lifestyle prior to october 2014 involved a lot of sport (roller derby - a contact sport played on roller skates), but has become quite senentary since. I do lot travel long journeys frequently.
No treatment has been taken since my Oct 2014 consult, though as of my most recent consult I have been referred to physiotherapy (though none has yet been undertaken) and given naproxen to deal with the pain in the short term. The doctor did not perform a physical examination in this most recent consult.
On a scale of one to 10, pain in this most recent episode rose sharply over the course of a day to around 7/10, falling to 5/10 over the course of a few days, and is now settled at around 4/10 upon standing, and 3/10 after the initial movements - it is currently sufficient to cause a limp while walking and to restrict range of movement.
I am afraid that the Lumbar MRI was performed and interpreted at an outpatient clinic, and that textual interpretation was sent to my doctor. No image from that MRI is available to either myself or my doctor, and I have given you full findings as reported to my doctor (they are pretty much quoted verbatim from the letter sent to my doctor. The only information I have failed to relay to yourself from that which is available to me is that the diffuse facet joint degeneration was observed on axial imaging
I hope this helps.
Hello The reason I asked for your weight and lifestyle is because the MRI report is suggestive of significant degeneration which is not usually seen in a 33 year old. And as I expected you are overweight and the lifestyle mandates an early degeneration.
A picture is worth a thousand words. I would have been fully convinced if I had a chance to look at the MRI images. But in any case I hope your doctor has discussed your condition with the specialist (neurosurgeon). If not please request to refer you to a neurosurgeon. As there are other points one has to make a note like the weakness in your foot, sensory blunting in your legs or foot, the leg raising test and others.
The report if I have to interpret, I would say there is no immediate need for surgery. But u need stronger analgesics and a physical therapy is a must. Slight slip at L4L5 and L5S1 raises a suspicion that if that means what is called a listhesis (which I can say only if I see the films) will require surgery. So I strongly feel that you should see a specialist with an MRI.
Regards,
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