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Back Problems Message Board


Back Problems Board Index


Welcome to the board.

The MRI is but one piece of the diagnostic puzzle. The results need to be correlated with what the doctor finds upon physical examination, a basic neurologic exam and patient history, including a detailed description of the pain symptoms.

It is hard to tell from your MRI report the severity of any nerve compression that may be a result of the retrolisthesis and stenosis.

Oops -- I see you had Xray but you don't mention MRI. The X-ray is only capable of showing what's going on with the bony structure. It cannot see the soft tissue, discs or nerves...so the doctor would not be able to assess the extent of compression that you are experiencing.

The spinal nerves carry signals out to the rest of the body in very particular patterns called dermatomes. The lumbar spinal nerves bundle together to form the "cauda equina" which runs down to the end of the back and then splits or branches into the two sciatic nerves that run down the back of the legs. A compression of a spinal nerve in your lower back can cause the pain you are feeling in your leg, buttock, and foot. They do not innervate the shoulder, so any pain you feel there may be due to you compensating for the pain in your leg. It may have affected your posture and gait; you may be favoring the one side, putting additional stress on the opposite side.

Your problems do not sound particularly severe, even though it is causing you lots of pain...but I personally think it is a good idea to consult with a spine specialist just to be sure you are getting an accurate diagnosis. This would be either a fellowship-trained orthopedic SPINE surgeon or a neurosurgeon whose practice is limited to problems of the neck and back.
Even though these specialties are trained as surgeons, they will explore all conservative modalities of treatment, leaving surgery as a last resort.

I wasted a year letting my well-meaning internist treat my back. He told me my MRI looked normal for someone my age. Turned out he had missed the most important issue which was causing an instability that resulted in horrid sciatic type pain. I might not have ended up with permanent nerve damage in my feet if I had not wasted a year when the nerves were compressed, believing that it wasn't anything significant and would get better on its own.

The retrolisthesis you have is a similar situation. It is a spondylolisthesis where one vertebra slides over the top of the adjacent vertebra. It is graded from 1 to IV with Grade I being from 1-25% slippage. Generally, Grade I does not cause major problems, but depending on whether a nerve is caught up in the slippage, it can be a pain generator....and if I were in your shoes, I would want to know whether it is causing the pain, or not, and I would find this out by going to see a spine specialist.

If your sciatic pain does not clear up within a couple weeks, you may want to get a lumbar spine MRI to see if there is more going on than is showing up on X-ray.

In the meantime, you can ice the area over your lower spine 15-20 minutes per hour for pain. Take NSAIDs if you tolerate them for any inflammation. Limit activities that require bending or twisting at the waist, pushing, pulling and lifting anything more than about 10 pounds until you know why you are having pain. But do not take to your bed. Gentle exercise will be good for you...like gentle walking on a flat surface (no incline or hills). Or walking in a pool is even better, if you have access to one.





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