Lumbar Diagnosos

[MotorCity Romo]

I had an MRI because I have been struggling with moderate pain that seems to be similar to sciatic symptoms, but I can actually feel muscle spasms in my TFL and piriformis. I had laid off squats and deadlifts for a while but I have since restarted both and I notice no difference in symptoms whether I do or do not squat and deadlift. I have heard Rip say many times that almost all back issues are not serious and can be trained through. I believe this is the case for me, but I thought I would drop the official diagnosis here and see if any of you guys feel like I could be doing any permanent damage having seen so much of these things. Of course I know I should only seek medical advice from a doctor and all that disclaimer stuff. Any insight would be much appreciated.

The lumbosacral spine is normally segmented and anatomically aligned with a normal lordotic curvature and normal lumbosacral angle.
There is no fracture or compression deformity. There is a mild-moderate spondylosis with slight loss of disc height and signal intensity on
the T2-weighted images at L2-L3, L3-L4, and L4-L5 with some localized Modic type I change in the anterior inferior aspect of the le side
of L2. More advanced disc degeneration striking Modic type I change is noted at the L5-S1 level. This may be a painful condition. There is
no bone destruction or sign of disc space infection there is no compression fracture deformity.
Imaging through the intervertebral disc levels demonstrates no significant extradural defect in the upper lumbar region. There is mild
degenerative facet arthritis at L3-L4 and L2-L3. At L4-L5 there is minimal disc bulging with flattening of the thecal sac. There is associated
vertebral endplate spur formation and rather marked degenerative hypertrophy of the facet joints. There is a radial tear in the annulus
and extending into the right neural foramen. There is mild lateral recess and neural foraminal stenosis on the le and moderate lateral
stenosis on the right. At L5-S1 where there is accelerated disc degeneration there is also disc bulging and vertebral endplate spur
formation. There is facet joint arthritis and hypertrophy which causes neural foraminal stenosis bilaterally, slightly worse on the le.
The distal spinal cord, conus medullaris, and proximal cauda equina are normal.

[Chris Palladino]

Motorcity,

a few follow up questions..

Age, height, weight?
Any bowel or bladder problems?
When you DL, are you currently pulling from the floor? Where in the range of motion do you experience pain? Top, initial pull, midrange, throughout?
What are the weights for the squat and DL? Does the pain come on at a certain weight?

Chris

[MotorCity Romo]

50 years old. 5’8” 185 lb. no bowel or bladder problems. No real pain during deadlifts or squats. All of the pain happens when I stand in one place for more than a few minutes. Deadlift is 310 for 5. Squat is 275 for 5. I have noticed some pain after squatting when I push out my knees real hard.

[Chris Palladino]

a few more questions...

You mentioned you laid off the training for a while and recently started back up. Did you ramp right up to your heavy numbers again or run LP?
310 DL and 275 squat are current numbers?
Describe your posture.
What do you for a living, standing work?

[MotorCity Romo]

I restarted LP vey low and worked back up for about two months and progressed to intermediate(added 8 lbs to body weight) , which I have been doing for 5 weeks. My posture has not always been great, but I pay very close attention now. I am a desk jockey but I have added a kneeling desk and standing desk. So I rotate all day from sitting to standing to kneeling to laying down. I have seen a PT who says I do tend to bend at a point little higher than I should but not horrible. I looked back at my log and noticed there is a definite correlation with putting a focus on pushing out my knees during squats and pain the following night and next day that starts in the Glute Medius and travels down to my lateral shin on the left side.