Question
I have been suffering from low back pain and bouts of severe low back pain for almost 3 years.  MRI done on 11/19.  Referred me to neurosurgeon.  MRI results as follow: Chronic Schmorl's nodes at L1 and L5.  Moderate disc degeneration and mild disc height loss at L5-S1.  Mild reactive endplate changes at L5-S1.  At L3-L4 no disc bulding or protrusion.  Minimal facet hypertrophy.  At L4-L5 mild diffuse disc bulging and mild bilateral facet arthropathy with bilateral facet effusions.  There is mild canal stenosis.  No disc protrusion identified.  Neural foramina are within normal range bilaterally.  At L5-S1 there is diffuse disc bulding and moderate bilateral facet arthropathy.  There is mild canal stenosis.  No disc protrusion.  No focal lateralizing disc protrusion identified.  Mild bilateral foraminal narrowing.
IMPRESSION:
1.  Chronic Schmorl's notes at L1 and L5
2.  No acute or chronic compression fracture
3.  Disc bulging and minimal canal narrowing at L4-L5.  Bilateral facet hypertrophy with facet effusions.  No periarticular edema is seen.
4.  Disc bulging and facet hypertrophy at L5-S1 and mild cancl stenosis.  Bilateral facet effusions.  No periarticular edema is seen.

Can you put this in normal language for me?  What can be done to relieve the constant pain (sometimes extreme pain)?

Answer
Sandy,
First of all, do not have surgery done, as this is usually a big mistake that many people make.
Now, all this fancy terminology  means that you have a disc or discs that are out of place,  degeneration in some of the discs, and extra bone growth on some spinal bones while others have some bone loss.  There is also a pressure that is entering into the spinal canal and this is most likely from a disc or spinal bone misalignment.

Now please understand this, I am not by any means diminishing your pain or your condition or your findings from the MRI report, this is a very serious matter indeed.
What I AM telling you is that surgery needs to be your last option rather than your first.
Too many times have I seen patients come to me after surgery has really botched them up good only to have their original symptoms return along new problems.
So, lets keep surgery on the back burner for now and know that it is there if we need it but that it is not actually a sensible or logical option at this time, OK?
Now, what should you do at this point?
First of all, we need to understand how you got yourself in to this situation in the first place if you are going to do something that makes sense in correcting it.
Without running the risk of making this answer too long, I want to ask a question of you:
Look back at your LIFE and examine the last 20-30 years, what sort of Head or Neck Injuries have you suffered from?
Car Accident, Football Injury, Got into a Fight, Knocked Unconscious, Fell off of a Horse, Skiing Accident, Etc.
Answer that question for me and then we can proceed.

Yours in Best Health,
Dr Arnone
Upper Cervical Specific Doctor
"Brainstem Specialist"
St Louis, MO