Of the doctor’s appointment.
He was much more attentive today. The student wasn’t present, so he could focus full attention on me. We ran through the results of the x-rays and ultrasound. Here’s a copy of the examination notes by the doctor at the radiological clinic:
XRAY LUMBAR SPINE
Clinical Details: Back pain on the right at L4/5. Previous sciatica.
Findings: There are five lumbar type vertebrae. There are some Schmorl’s nodes present within the superior aspect of the upper lumbar vertebral bodies, consistent with prior intrabody disc herniation. There is mild narrowing of the L5/S1 intervertebral disc space. The remainder of the lumbar intervertebral discs are of normal height. The pars interarticulares are intact. The sacro-iliac joints are normal.
XRAY PELVIS AND BOTH HIPS
Clinical Details: Left anterior hip pain. ? Acetabular dysplasia.
Findings: The hip joint space is symmetrical and normal. No radiographic evidence of acetabular dysplasia, the centre edge angle being within normal limits bilaterally.
The sacro-iliac joints are normal.
ULTRASOUND OF THE LEFT HIPS
Findings: The psoas tendon is normal. There is no distended psoas bursa. There is mild asymmetry of the anterior acetabular labrum. The left anterior acetabular labrum is slightly larger than that on the right and there is some minor hypo-echoic echo texture at its base. The appearances are not diagnostic of an anterior acetabular labral tear, but certainly raise the possibility of an underlying labral tear. There is no paralabral cyst that would indicate definite ultrasound evidence of a labral tear.
No other potential abnormalitiy at the anterior aspect of the left hip.
And now the interpretation.
Firstly, the back problem. I have Schmorl’s nodes some where on the upper lumbar part of my spine. The doctor didn’t really go into this. It seems to indicate I’ve injured my back at some point in time. Not that I remember. I read on Google (yes yes, don’t Google medical stuff, it’ll just freak you out) that some people are born with these nodes, but the radiological clinic doctor seems to think it’s from a disc herniation. Whatever.
Back to the point. The space between L5 and S1, where the discs are that separate the bony bits of the spine, is narrowing. The sports doc said that these intervertebral discs have a gel-like substance in the middle that gives the discs volume, and it’s hard on the outside. Seems as though I’ve ruptured the that disc between L5 and S1 somehow, and the gel has leaked out, leaving the space between L5 and S1 about 60% of normal. I have my xrays and I’ll try to take a photograph somehow to illustrate this later.
The pain on the right lower back could be due to some disc bulge. It may have also been some disc bulge that caused the left lower leg problem at the beginning of this year.
So anyway, this narrowing of the intervertebral disc is permanent. All we can do is slow the progression. Bummer.
Now onto the left hip. I have no structural abnormalities. That’s a BIG relief. That means I don’t have acetabular dysplasia. There’s thickening of the labrum on the left side, but only “slightly”. The examination notes also says there *may* be a labral tear, but it can’t be confirmed through the ultrasound. The sports doc said I could have a MRI contrast to confirm the tear, but what would that achieve? Not much.
I could have a cortisone injection, that *may* help and then again, it may not. I could have surgery to smooth out the tear and that *may* help and then again, it may not. Nice options huh?
Regardless of whether I go for further treatment, the outcome is not great. I will never regain full function of my left hip either way. I can live very comfortable without any futher interventions or treatments if I were to give up yoga, not that the doctor, or the physio ever suggested that I should.
The sports doc said for now I can wait another two months and continue with the modified practice that I’ve been doing and we’ll see whether I get better or worse.
To him, my injury is “relatively new”. Apparently two months is nothing. Since I’ve been getting better, he thinks I’m in the phase of recovery and that’s why I should wait it out a bit more.
He told me he’s done some yoga before, I didn’t pry what sort and for how long. Some yoga is better than a sports doc that knows nothing about it. His tips to me were:
- to keep the core muscles active, especially in the forward bends
- keep the spine neutral in the forward bends
- keep my practice exactly the way it is for another two months, then I can try to go further and see if I get worse, if I do, I’m to go see him
- be mindful and in the present in my practice (but not in those words, but that’s what he meant)
I’m going to sit on this information and let my mind digest it. I’m not sure how I feel about it yet. I’m bummed and happy at the same time. I almost wanted to cry twice today since finding out. I’m still hoping it’s not a tear. Hoping, wishing and even praying a little.
There will be no yoga tonight, got that cocktail function to go to.