Why does my back hurt even more?

Four Days After some MRIs

New Year’s Eve, we hosted a party. We had two families from relatively far away who stayed the night.

11 PM New Year’s Eve, I tried to change from pants into pajamas. I put my hand on something and leaned while I tried to lift one of my legs out of my pants. A moment later, I found myself on the floor gasping and crying with pain exploding in my lower back. KrisDi came up shortly after and found me on all fours trying to get control of myself again.

I got back downstairs somehow. I don’t clearly remember how, but I think KrisDi helped. I sat on the couch with our friends. G False Alarm, drunk as an ox and not particularly sensitive even when sober, kept bugging me by nudging or something similar, and neither my spine nor my attitude really appreciated it, which may have been evident when I followed through on a mild threat and nearly broke his finger.

I endured until we finished our New Year’s toast, then went back upstairs (again, don’t know how I got there). More crying and gasping, learning that crawling was no less painful than standing or walking, and I had gotten myself into bed, where I spent several minutes trying to find a position where I could relax that wasn’t painful. Eventually, I was in a position lying kind of on my back but rotated maybe 30-45 degrees to my left, with a huge pillow between my knees, using both my arms to pull my left knee toward my chest. This was painful, but bearable. I held it for maybe an hour before KrisDi came up for bed.

We decided I should go to the hospital. Logistically challenging, since all the adults in the house had drunk rather generously (and I was in too much pain to drive anyway). KrisDi asked Les to drive up from Bonney Lake to drive me to the ER, which he very kindly did. KrisDi helped me get down the stairs; I (comically) used Chilkat’s cut-down cane to try to help keep some of the weight off my back.

After getting to the hospital, I let Les go home as quick as I could so he wouldn’t have to wait while all I was doing was waiting. I squirmed uncomfortably in the wheelchair for what felt like forever but was probably 30 minutes before they took me in the back, did some simple tests and questions and looked at my four-day-old MRI results before declaring I should basically proceed with my existing plans to follow up with my back doctor. They gave me three prednisone pills and two oxycodone (on an empty stomach, after a sleepless night full of drinking — party time!) and prescriptions for more.

KrisDi got me home somewhere around 6 AM. Everyone was still asleep; we got me to the recliner upstairs and propped me up with pillows, where I entered drug-induced sleep for about two hours, before waking up and joining everyone for breakfast with my ER bracelet still on my wrist.

The initial pain, up to the point where I got to the hospital, was the most extreme pain I’ve ever experienced — by a large margin. However, it also marked a change in the pain I’d been experiencing since October. It wasn’t really going down my left leg at all any more, I wasn’t getting the numbness or shooting pains down the left leg; it was dominated by local pain directly in the lower back, but with some pain in the hamstrings and buttocks. After several days of prednisone, the bulk of the pain is now right hamstring / buttock centered, and not really shooting pains — feels like I badly strained or overworked the muscles.

Between “too much pain to drive without percocet” and “shouldn’t drive while on percocet”, I skipped work on Wednesday and Thursday, I set up a silly lying down workstation and spent some time on my back on a computer (worked surprisingly well). I got a little work done and got some silly old home computing things done as well. I finally went in today (now with a grown-up sized cane!) — holding off on the percocet until I was already at work (and only having one in the morning so I was OK to drive home in the afternoon). It was a fairly productive day that wasn’t terribly challenging for my back.

Follow up appointment with my back doctor Monday morning.

Happy New Year, everyone! Hope your new year celebration was less painful than mine.

Radiology report from thoracic MRI on 27 December

FINDINGS: Flattening of thoracic kyphosis is present. Multilevel Schmorl’s nodes and disc dehydration changes are seen lower thoracic spine suggesting Scheuermann’s syndrome.

AP dimension of the spinal canal is unremarkable.

Spinal cord is well-visualized without evidence for syrinx.

Upper thoracic levels show unremarkable posterior disc margins at T1-2 through T6-7. Nerve root canals are widely patent upper thoracic levels.

Lower thoracic spine shows T7-8, nerve root canals and facets show mild right facet degeneration.

T8-9: Broad-based minor bulging is seen on the right without nerve root flattening or cord contact. Nerve root canals are widely patent.

T9-10: Mild bulging is seen bilaterally. Right facet shows mild degeneration.

T10-11: Posterior disc margin is unremarkable. Facets show small amounts of joint fluid bilaterally.

T11-12: Posterior disc margin is unremarkable. Facets are unremarkable.

CONCLUSION:

  1. Multilevel Schmorl’s nodes and disc dehydration suggesting Scheuermann’s syndrome.
  2. Mild right-sided annular bulging T8-9.
  3. Bilobed annular bulging T9-10.

Thank you for this interesting referral.

Radiology report from lumbar MRI on 27 December

FINDINGS: The alignment of the lumbar spine shows mild scoliosis. Multilevel moderate disc space narrowing and dehydration changes are seen with multilevel Schmorl’s nodes suggesting Scheuermann’s syndrome.

The AP dimension of the spinal canal is narrow on a congenital basis. Pseudoarthroses are developing between spinous process L3-4, L4-5.

Conus is unremarkable in configuration and position.

L5-S1: The posterior disc margin shows mild bulging. Facets show minor degenerative changes. Nerve root canals are widely patent.

L4-5: Broad-based left-sided 10 mm disc protrusion markedly narrows left subarticular recess and creates marked flattening traversing left L5 nerve. Right subarticular recess is moderately narrowed and there is moderate to marked central stenosis. Right nerve root canal is moderate to moderately severely narrowed. Left nerve root canal is moderately narrowed.

L3-4: Mild bulging is seen. Subarticular recesses are mildly narrowed. Facets show mild degeneration. Nerve root canals are widely patent bilaterally.

L2-3: Mild bulging is present. Facets show right greater than left mild degeneration. Nerve root canals are widely patent.

L1-2: Minor bulging is visible on sagittal images only. STIR images show high STIR signal between spinous processes at L3-4 and L4-5 suggesting Baastrup’s syndrome and inflammation in these locations.

Prior imaging is available for comparison dated 5/18/2018. That study also showed multilevel Schmorl’s nodes, disc dehydration and narrow AP dimension of the spinal canal. Minor annular deformities L1-2, L2-3 and L5-S1 are unchanged. L4-5 left disc protrusion is markedly larger than prior study. High STIR signal between spinous processes was seen at L4-5 and L3-4.

CONCLUSION:

  1. L4-5 left disc protrusion creating central stenosis and marked left subarticular recess narrowing.
  2. L5-S1 mild bulging with mild facet degeneration.
  3. AP dimension of the spinal canal is narrow on a congenital basis.
  4. Mild annular bulging L2-3 and L1-2.
  5. Multilevel Schmorl’s nodes and disc dehydration changes are seen suggesting Scheuermann’s syndrome.
  6. Pseudoarthroses are developing between spinous processes with high STIR signal at L4-5 and L3-4 suggesting Baastrup’s syndrome.

Thank you for this interesting referral.

Posted by snaotheus

2 comments

I still say you need to either find or get a referral to a neurosurgeon. You know your back specialist and it’s your decision, but I’m going to fret. It’s still part of my job description.

[…] as I previously wrote, I had a lower back event on New Year’s Eve. That appears to have been my L4-L5 disc […]

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