Why does my back pain increase while sitting or laying down?

Hello,

Welcome to icliniq.com. I understand your concern. I have gone through your provided X-ray and MRI (magnetic resonance imaging) images (attachment removed to protect the patient’s identity). The diagnosis is crisp and clear and correlated with your symptoms. However, it would have been more convincing and comprehensive if you had provided the CAT (computed tomography) scan images. Nonetheless, the findings of X-ray and MRI are: 1) Old fracture at the right-sided inferior articular process of L4 (lumbar), located just inferior to L4 and L5 facet joint (I am sure this appears on the CAT scan). 2) Left-sided nerve root compressions at L4 to L5 and L5 to S1 (lumbosacral) levels due to disc herniations. 3) Facet arthropathy at multiple levels. 4) SI (sacroiliac) joints are not included in the MRI, but they seem to be fine on the X-ray. Since you already have nerve dysfunctions, I suggest you discuss whether it would resolve through surgery with the concerned surgeon. For the fracture, which is perhaps the source of your intense and endless pains, I suggest you follow the decision of the orthopedics and spine surgeon as to whether surgery is required or not. I hope you will now have confidence regarding the imaging findings and diagnosis. I hope you get well soon. Thank you. the probable causes include: 1) Inferior articular process fracture. 2) Nerve root compression. 3) Facet arthropathy. The probable diagnosis may be 1) Inferior articular process fracture. 2) Nerve root compression. 3) Facet arthropathy.

Hi,

Welcome back to icliniq.com. I understand your concern. The fracture with sclerosis (old) is identified on the computed tomography (CT) (attachment removed to protect the patient's identity), and also easy to see the distorted configuration of the bones (malunion). That produces stress on the spine as it transmits your body weight through the distorted configuration. In that case, I suggest consulting orthopedics for appropriate treatment. The nerve compressions are present on the left side at L4 to L5 and L5 to S1 levels, and I think this produces the "mild chronic dysfunction on the S1 nerve" that showed up on EMG (electromyography). Your right-sided pain may not be associated with these nerve root compressions. I hope you now have a clear understanding of your CT and magnetic resonance imaging (MRI). Kindly revert in case of further queries.