Hello doctor,
In 9th grade, I experienced back pain and had to wear a body cast for a year. At the age of 14, I was diagnosed with Crohn's disease. I used to be 6'2" tall, but now I am 5'9". For the past five years, I have been experiencing lower back and tailbone pain that gets very intense when I stand up. This pain is usually followed by a burning sensation in my right leg and then numbness in both my legs and feet. I am also very clumsy, and I have had to wear five casts on my feet in the past three years. It became impossible for me to stand for extended periods as my legs felt weak, and my back felt like it was being bent in half. I have undergone a lot of physical therapy over the years, but the pain has only worsened. In the past year alone, I have been doing physical therapy four days a week, but the pain, numbness, and burning sensations have not subsided, and I am now unable to walk even short distances. I also experience bad headaches and hip pain, which feels like my hips are coming out of their joint, and my sacrum hurts. Recently, I have been diagnosed with Marfan's syndrome and Ehlers-Danlos syndrome, but my blood tests, including CBC and cholesterol, have come back normal. I have always been heavy, but I have excellent stamina, and I exercise regularly. I rarely get the flu, but I always have sinus problems, and my ears never feel clear. I have Raynaud's disease, arthritis, osteoporosis, anxiety, and agoraphobia. I have only been taking Xanax for the past year, and I do not take any pills for pain or other psychiatric medications. I do have a problem with sugar addiction, but I only drink water, no soda, and no white flour. I eat fish, fruits, veggies, and ice cream, but I drink tons of water. Overall, I consider myself healthy and have a high pain tolerance. However, I am unable to walk even short distances, and I desperately want to walk again. My primary care physician thinks that I am mentally unstable and do not take my pain seriously. I am not seeking attention or being a hypochondriac. I need therapy that can help me without any invasive or surgical procedures. I am also attaching the report of the test I undertook six years back.
Exam taken in: January 2017.
Type of Exam: MRI Lumbar Spine without Contrast.
History: Low back pain, spinal stenosis.
Comparison: Plain films on June 2007.
Findings: The lumbar spine MRI was performed without intravenous contrast, multiplanar sequences. There are 5 non rib-bearing lumbar type vertebral bodies with the lowermost transitional segment designated as L5/S1. Prior to any surgical intervention, confirmation of this numbering scheme is recommended with plain radiographs of the chest and abdomen.
There are pars defects at L5 with 5 mm of anterolisthesis of L5 on S1. There are discogenic signal changes along the anterior aspect of the L5/S1 endplate. There is hypertrophy of the interspinous soft tissues at L3/L4 secondary to exaggerated lumbar lordosis. There is a small cyst along the inferior aspect of the L3 spinous process. No additional focal osseous signal abnormalities are noted. No abnormal curvature is seen in the coronal plane. The visualized portions of the kidneys and abdominal aorta are normal. The sacroiliac joints appear normal in interval. The visualized spinal cord is normal in morphology. The conus medullaris terminates at L1/L2.
Level by level findings:
T12/L1: No spinal canal or neural foramen narrowing.
L1/L2: No spinal canal or neural foramen narrowing.
L2/L3: No spinal canal or neural foramen narrowing.
L3/L4: No spinal canal or neural foramen narrowing.
L4/L5: Mild facet hypertrophy. No spinal canal or neural foramen narrowing
L5/S1: Small disc bulge. Mild facet arthrosis. Moderate bilateral neural foramen narrowing.
Impression: Moderate bilateral neural foramen stenosis at L5/S1 secondary to disc disease, spondylolisthesis, and facet arthrosis. Abnormal articulation between the spinous processes, greatest at L3/L4 with associated cystic changes along the inferior aspect of the L3 spinous process.
I am willing to work hard to get better, but I need therapy that can help me.
Thank you for your time, and any advice you can provide will be greatly appreciated.