Spinal Stenosis, Bulging disc, diagnosis?

Background:I am a 25 year old female who started experiencing severe pain and debilitating fatigue about a year and a half ago in my sacroilliac area, buttocks and hips.  I tried all sorts of treatments such as physical therapy, diet change, and nsaids and stretching and heating pads, etc.  They provide very little relief and It always gets worse after standing and walking for long periods of time and is relieved only somewhat by laying down or sitting and resting.  I had an MRI done at first showing only minimal facet degeneration in the lumbar area and I have had a herniated disc in my c-4,c5 disc since I have been imaged as well.  I had posterior fossa decompression surgery in August 2011 to relieve my Chiari 1 malformation symptoms.  I am also on 4mg prednisone daily because I have stopped producing my own cortisol. My testosterone, estrogen, progesterone, fsh and lsh are also low and prolactin 5.0. I have not been tested for any arthritis or anything like that but have ruled out celiacs and limes disease.  

In the past 3-4 months I started getting much worse and the pain is now radiating down both of my legs it wraps around my legs and groin area and goes all the way down to my calves. I cannot stand more than an hour before I am in excruciating pain even on 60mg of ms contin and percocet for breakthrough pain. I have a constant deep ache or pressure feeling in my very low back/hip area and buttocks even when I have not been active, but it is tolerable until I am walking or standing for more than 30 min to an hour.  It is partially relieved when bending forward, sitting down or lying down or bringing knees to my chest while lying down.I was finally able to get a second MRI since it had been 9 months since my last lumbar MRI and the results are significantly different they are as follows:

L1-L2: There is minimal facet joint degeneration without thecal sac or foraminal stenosis
L2-L3:Facet degeneration and slight disc bulge are present, without thecal sac or foraminal stenosis.
L3-l4:Facet degeneration and bulging disc are present,without thecal sac stenosis or definite nerve impingement.The l3-l4 foramina are mildly stenotic.

L4-L5: facet joint degeneration is present at l4-5. A concentric l4-5 bulging disc is present, with moderate left and mild right degenerative foraminal stenosis. The thecal sac is also mildly narrowed.
L5-S1: There is slight facet degeneration witout thecal sac or foraminal stenosis.
Impression:  Relatively mild mulitlevel disc space and facet joint degeneration is described in detail above. at l4-l5 , this leads to mild narrowing of the thecal sac with moderate left and mild right degenerative foraminal stenosis.No discrete disc herniation or areas of thecal sac or severe foraminal stenosis are identified.


So my question is , what does this mean? Nobody will tell me why my back mri has this, from what I read only older people should have stenosis, I am only 25 and have had no injuries or any trauma at all.  Is this a degenerative disc disease, arthritis, just something that wont get worse or better or what can I expect? Can the above mri results cause such severe pain? I just want to know what I can expect.  I also was fired from my job recently due to inability to be at work, and don't know how I am going to be able to work if I am in this much pain all of the time and am thinking about filing for disability, but is this something that would qualify me for disability is this fixable? I just need some more information on how my back went from just mild facet arthritis to all of these changes in less than 9 months?

[selmaS]

  Hi  Jen,

  It is true that de- generation of disks is usually found in older people as it is the break down from the constant pull from gravity...stinosis is a narrowing, not always an aging process...as it can be congenital as well as from an injury...

I was also dx'd with stinosis of the spine at age 27, so close in age to u....

And I would consider looking at ehlers-danlos since u also have chiari, it is a related condition which can cause all sorts of spinal issues like these.

   And all over pain.

  I too get it mostly in my lower back and legs, but I also have TC as well....

    Was EDS ruled out?

    "selma"

[jenniferk86]

No, how do I have then check for it? I have Dr oro, but he never asked or checked for it.

[selmaS]

  Really?...there are clinical neuro exams that can indicate it and then u go to a rheumatoid Dr to get it confirmed.....

We do have a EDS group here on MH with  videos  that a Dr with EDS made...u may want to check those out....http://www.medhelp.org/forums/Ehlers-Danlos-Syndrome/show/417?controller=forums&action=show&id=417&camp=msc

This is a helpful link as well
http://www.reumatologia-dr-bravo.cl/para%20medicos/crit%20y%20diag/DIAGCRITJHS.htm

[jenniferk86]

Guess what?? I was sent to a rhematologist and got a beightons score of 5/9, so technically I have Ehlers danlos due to the other minor criteria that I meet, but I am worried, because I think I may have the vascular type.   I have a geneticist appointment in February of next year, but am wondering if there is any way I can see someone sooner and how long does it take to get the genetic testing back to determine if you have the vascular type of Ehlers Danlos?

[selmaS]

  Really...wow, see I was not far off suggesting it huh?

I have yet to get to a geneticist as I have been trying to get into a EDS specialist....it is out of state and they r booked a yr out...kinda hard to ask someone to take u when u do not drive to an appoint  that far out.

rylansmom from the Chiari group had the genetic testing and does have the vascular type EDS u may want to talk with her, send a PM as she is not on the forum much these days.

I did have my heart checked to rule issues with that...and I was fine...so I hope that helps put that type to rest...but not 100% on that.If u r worries about vascular, have ur heart checked if it wasn't already.Mine was part of reg pre op testing.

May I ask y u think u have the vascular type?

I was a 7/9 I could not attempt to put my palms flat on the floor for fear of falling over just bending....lol...