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Lower back pain and sciatica/pudendal nerve pain
9/26 9:27:13

Question
Hello, I recently had an MRI scan for lower back pain and sciatica, and this was the result-

Lumbarisation of the s1 vertebral body. The lowest fully formed disc will be referred to as s1/2.If intervention is planned, please discuss with radiology dept to define levels. ( What does this mean?)

Normal vertebral alignment and marrow signal throughout. The disc spaces are preserved at all levels with no sign of significant degenerative disc disease.
At L5/S1, there is a shallow disc bulge and bilateral severe facet joint arthropathy. No neural compression.
No sign of significant central canal, lateral recess or exit foraminal stenosis.
Normal appearance of the conus and cauda equina. Pars inter-articularis are intact at all levels.

Could you interpret what this all means as my doctor doesn't seem to know?  I would like to be informed , and also what I can do about the 'severe facet joint arthropathy" if anything as they are offering steroid injections for my pain ( mostly sciatica on the left side which I have had since pregnancy)  I also seem to have a type of pudendal nerve pain on the right but I did have an operation on my womb a year ago.  I would greatly appreciate your input.

Thank you,

Regards,

Lou

Answer
Lou,

The pudental nerve pain is the major clue:  it's a symptom of a displaced sacrum, which also causes a rare form of sciatica.  Displaced sacrum also goes with lumbarization (forward displacement) of the S1 vertebral body.

Arthropathy means that the facet joints where vertebrae meet are damaged, generally from rubbing against each other from being too close to each other.

Please see this entry on sacro-iliac joint problems: http://lawrencegoldsomatics.blogspot.com/2011/04/understanding-sacro-iliac-joint
this one on sciatica: http://somatics.com/sciaticasymptoms-piriformissyndrome.htm
and this one on lower back pain:  http://somatics.com/chronic_back_pain.htm

"If intervention is planned, please discuss with radiology dept to define levels."  That means, if you plan to do something about it, discuss it with (or have your doctor discuss it with) the radiology department.  

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