Question
Hello
Thank you for taking my question
I'm a 52 year old female, Type II Diabetic, Post Cervical Cancer 2001,and have bi-lateral SI joint pain, never the back.I have been treated for this condition with the SI joints since late last year at UC Davis Medical Center in Sacramento CA. I have had MRI, Bone Scan, Xray, Cat done on my back with the following findings.
DDD withGrade 1 Spondylolthesis L4,L5,S1. I have Grade 1 Anterlithesis of L4 on 5. The combination of these findings produced marked narrowing of the bilateral neural foramen, right greater than left, which presses the bilateral at exiting L4 nerve roots. Schmorl's node also identified along superior endplate of L5. At L5-S1, there is a generalized mild bulging disc. Marked facet hypertrophic change narrows the transverse dimensions of the canal. Reactive changes are present at the anterior aspect of S1 with edema seen within this unfused secondary center  ossification. I also have osteoarthristis in lower back.
I cannot lay on my back at all, only on the side for a few short hours and I'm awakened with terrible pain. Walking and standing is limited to ten minutes, max. I use ibuprofen twice a day 1200mg total to help inflammation and pain. Do you think a Neurologist might help me? PT has given me exercises to help build core area, also have tried injections, not good for my blood sugars, and I still have 30 pounds to lose, but cant exercise, just watch my diet.
Any input would be appreciated.
Thank you
Lynda

Answer
Hello, Lynda.

The report indicates that you don't have SI joint pain, but pain in the area due to nerve root compression and (though the report doesn't say it), muscular contractures.

Core strengthening is the wrong approach; you're already too contracted, as evidenced by the bulging disc, spondylolisthesis, and osteoarthritis.

Neurosurgery may help for opening the narrowing of the bilateral neural formena but can't help with the heightened muscular activity.

I would refer you to my article, at

http://www.somatics.com/back_pain.htm

which contains instructions for "first aid for back pain"; that may or may not be sufficient, but it can't hurt and may help.

I would also refer you to a clinical somatic educator, who can train you in self-correcting the muscular tensions, which are probably central to the situation.

A word on inflammation:  It's not the same as pain, and people commonly confuse the two.  Contracted, sore muscles are often confused with inflammation.