Low Back Pain

In this video post, Dr. Castanet will show you the MRI images of a gentleman with low back pain. There are some interesting notables including Schmorls nodes, i.e. intravertebral herniated discs, a couple of small herniated discs, obesity, mild stenosis, and pretty good muscle presence, although with some left-sided, focal, paraspinal muscle atrophy. This male’s MRI doesn’t look too bad, so his prognosis is probably good. I haven’t seen him yet, but was able to retrieve his diagnostic imaging for review before he came to see me.

This man’s previous doctors were also evaluating him for hip pain so he also had hip x-rays taken, and Dr. Castanet reviews the pelvic x-rays too. Of note, there is a small, inconsequential, discrepancy in leg length.

The usual reason for hip evaluation, including imaging, in the context of hip and low back pain, is to evaluate the hip joints to rule out pathology of the hip, and, in fact, his hip joints do look fine, so his hip pain is solely attributable to low back pathology, and that is important to know, so that we can focus on his low back with effective treatment.

Also evaluated on pelvic x-rays, are the sacroiliac joints, which we evaluate for sclerosis, an indication of inflammation, which we may see in autoimmune cases of spondyloarthropathies. And, of course, we are also examining the patient, clinically, with provocative movements to try and ascertain the source of the pain. But sometimes in older patients, especially, there can be several problems present simultaneously, and we have to try and apportion the relative severity of the pain amoung the several sources of pain, and image-appreciable pathology.

If I can help you with your neck or back problems and pain, please call me at 404-558-4015. And if you want to learn more about other topics related to neck and back pain, you can click on the Youtube icon at the top of this website page to go to my Youtube channel and watch many more instructive videos on a variety of topics.