Concerns Raised After Radiology Report
A 36-year-old female, approximately 5'5" tall and weighing around 200 pounds, is currently prescribed sertraline, Wegovy, and vitamin D supplements. Recently, she began experiencing significant discomfort in her lower back, which was particularly severe upon waking but tended to ease somewhat as the day progressed. She also noticed some pain radiating to her hips, all without any preceding injury. Due to unavailability with her primary care physician, she consulted a nurse practitioner (NP) at the same practice. The NP recommended ice therapy and prescribed methocarbamol, a muscle relaxant. Despite the NP's belief that an X-ray would not alter her treatment approach, she agreed to proceed with the imaging. Upon reviewing the X-ray results, the NP indicated mild arthritis and suggested continuing the use of ice. However, upon exploring her medical chart further, she found the radiology report which identified some degenerative changes but was not discussed by the NP, leaving her uncertain about the implications. The report detailed: "The lumbar curvature is preserved, with a 2 mm retrolisthesis at L4 on L5. No defects are visible in the pars on the oblique views. The heights of the vertebral bodies remain normal. There is minimal narrowing of the disk space at L4-L5, accompanied by small endplate spurs, as well as minimal facet joint disease. The surrounding soft tissues appear normal." Given this information, she is now questioning whether these findings might worsen over time and whether it would be prudent to seek a consultation with an orthopedic specialist.
Answers (1)

7/11/2025, 1:30:54 AM
OpenHealth AI
It's understandable to feel concerned after receiving radiology results, especially when they're not fully explained. The findings you've shared suggest some mild degenerative changes in your lower back, which can be typical, particularly as we age. Here's a breakdown of what this means and recommended steps forward.
Overview of the Findings:
- Mild Arthritis: This can cause discomfort and stiffness, particularly after being inactive (like when waking up in the morning).
- Retrolisthesis: This means one vertebra (L4) is slightly shifted back relative to the one below it (L5), which may not be uncommon and often doesn’t lead to significant problems.
- Other Degenerative Changes: These include minimal disk space narrowing and small spurs, indicating early signs of wear-and-tear.
Understanding Your Concerns:
It's natural to worry about whether these changes will worsen over time. While degenerative changes can progress, not everyone experiences increased pain or disability as a result. Many people live full, active lives despite similar findings.
Next Steps:
Here are some prioritized actions you can take:
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Symptom Management:
- Continue using ice therapy as recommended.
- Consider additional self-care methods such as gentle stretching, physical therapy exercises targeting lower back strength and flexibility, and maintaining good posture.
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Monitoring Symptoms:
- Keep a diary of your discomfort and any activities that exacerbate or relieve your pain. This can help identify patterns and track changes over time.
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Consider Follow-Up:
- If pain persists or worsens, think about discussing a referral to an orthopedic specialist. They can provide a deeper evaluation and discuss treatment options or lifestyle modifications tailored to your needs.
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Educate Yourself:
- Learning more about back health and management strategies can empower you in making informed decisions about your care.
Remember, you are not alone in this, and it's okay to seek clarity about your health. Don't hesitate to reach out to your primary care team or specialist for more personalized guidance, especially if you have lingering questions about your X-ray findings or treatment options. Let me know if you need further information or support!
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