Pain Management Forum - Low Back Pain, Dysmmenorhea, and Understanding the Language

Conditions and Diseases > Pain Management Forum > Low Back Pain, Dysmmenorhea, and Understanding the Language

What structures make up the spine? We review basic spine anatomy here...before identifying potential causes of back pain....

Q: Low Back Pain, Dysmmenorhea, and Understanding the Language

asked by: DoctorQuestion on February 25th, 2006

Dear Doctor,

Please enlighten me regarding my recent MRI of the Lumbosacral Spine. I had been suffering from a terribly exacerbating low back pain, left side, for 4 days before I decided to see a Physiatrist. I can not lie in bed on my left side, nor can i get up from the same. Sitting, standing and walking, and even jumping creates terrible pain in my back, localized to one area only. I am suffering so much and my studies is affected as well because I could not concentrate. The pain is comparable with that feeling when one's tooth is being drilled by a Dentist. I can not sleep well because I can't move from side to side in bed. My current medication is 1 tablet of Arcoxia and 1 tablet of Nexium to be taken together before breakfast for 9 days. I will be seeing my Doctor on Wednesday yet and could no longer futher put on hold my querries regarding the result of my MRI. Please help me. The MRI reading is as follows:

A transitional lumbosacral junction is present. For the purpose of this report, the transitional vertebra will be labeled as a partially sacralized L5.

There is mild levoconvex curving of the lumbar spine. The vertebral marrow signal is normal.

L1-2, L2-3 and L3-4: Normal

L4-5: Mild disc bulging. No associated focal disc herniation. The central canal and neural foramina are patent.

L5-S1: Normal.

There is subcutaneous fat edema involving the posterior soft tissues of the lower back. Partially visualized on the sagittal plane is a retroverted uterus with thickened endometrium (approximately 13 mm. in full thickness).

Impression:

1. Transitional lumbosacral junction, with partially sacralized L5.
2. Mild L4-5 disc bulge. No evidence of disc herniation at any level.
3. Subcutaneous fat edema involving the posterior soft tissues of the lower back.
4. Retroverted uterus with thickened endometrium (approximately 13 mm. in thickness). This may represent secretory endometrium, although other processes cannot be excluded. A gynecologic consultation may be useful, if clinically indicated.

Please enlighten me. I have been having bloody spottings since 1st quarter of last year, and i noticed that I bleed when i am tired, nor stressed out.

Thank you so much for your time and attention. I will be looking forward to a reply. Thank you.

Charmyn

Replies(1)

Dr. Nikola Gjuzelov , MD

replied on March 27th, 2006

Pain Management Answer A549

It seems that your MRI-report is almost normal; it does, however, offer some explanation for your back pain. According to this MRI-report the back pain can’t be explained by spondylotic changes of the vertebral column. The mild levoconvex lumbar curve, sacralised L5, and mild bulging disc were the only vertebral abnormalities found; these indicators are not enough to cause such great pain. The “subcutaneous fat edema involving posterior soft tissues” is probably the result of some muscle and fat inflammation. THIS COULD BE THE reason for the back pain. Non-steroid anti-inflammatory drugs and corticosteroids combined with physical therapy could be very useful for treating this condition. The MRI-report for the uterus is only suggestive. A retroverted uterus is an anatomical variation found in 20% of all women. Dysmenorrhea is one condition that is caused by a retroverted uterus. A retroverted uterus can also cause low back pains. The spotting you are experiencing can be caused by myoma of the uterus or by another organic disorder of the uterus. Now, a vaginal ultrasound is necessary to explore the uterus. I recommend you visit a gynecologist.

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