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Date of last update: 10/01/2017.

Forum Name: Spinal problems and back pain

Question: back pain

 southernrain27 - Thu Feb 24, 2005 5:29 am

: i have alot of low back pain
my x rays show large shmorl nodes at l4 and at l3,
l2 morderate scheuermann's disease of the lumbar spine
scoliosis mild convexity to the left could be secondary to the scheurmann's.
....incidental spins bifida occulta at upper aspect of the sacrum....
.the l2 vertebral body show slight anterior wedging and chronic slight anterior elongation of l2....all the mri says is the
2-3 and the 3-4 disc are slighty narrowed and desiccated.
.these disc show mild buldging.
.there is also mild diffuse facet arthropathy noted..
there are early degeneration changes as described significant finding...
if everything is slight and mild then where does the pain come from i have reasearched and i just don't see it
i have been to chriopactor and now i am seeing a dr at the spine center any ideas or thoughts :roll: :!: :?: :shock: my next apt is coming up soon
 Dr. A. Saif - Wed Mar 02, 2005 5:47 am

User avatar Dear Southern,

Ah yes, I guess your problem is slightly complex, and I am only mildly surprised at your level of symptoms (....sorry abut that :-) ).

Some features that you describe can cause pain, others are incidental findings, but many are also found in normal individuals without any symptoms. The mildness or the severity of the disease, sadly doesn't always corrspond to the amount of pain you get. To complicate things further, the signs on X-ray often reflect a disease that occured in the past and has now resolved.

It is likely that the the scoliosis, and the Sceuerman's diesease actually was at its peak in adolescence, and these findings are just what is left behind. Certainly Spina Bifida is present from birth. These features can of course still be responsible for pain now, just as they can be found in patients with no symptoms whatsoever.

I would classify back pain into three overlapping groups...mechanical (because of abnormal distribution of stresses)...e.g. due to scoliosis, or facet joint arthropathy, or instability. Inflammatory (e.g. due to active Scheuerman's, other arthropathies, "discogenic" pains), and radicular (due to nerve root entrapment). You have reasons for any of these to cause the pain that you are getting. I guess your specialist will be able to elucidate what is the most likely cause of your symptoms...and the best way to address them...

Hope this is at least slightly helpful


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