--in that it's entirely possible Alan has two things contributing to his lower pain: both autoimmune AND spinal compression issues, through the double crush hypothesis. His autoimmuinty may have comprimised his nerves enough that additional pressure on them, such as from bone spurring or disc pressure in the spine, may be enough to produce symptoms, whereas either alone might not, or at least not enough for him to notice much.

It does sound from this report that he has sufficient degenerative changes in the lumbosacral area to possibly pressure the nerve roots--those are the first peripheral nerves outside the spinal cord, and they connect with the cord in the neural foramina (spaces). (This is where the word radiculopathy comes from, by the way--radic means "root" in Latin, and a problem with nerve roots is a radiculopathy.) Normally, the nerve roots occupy about 25-35% of the foraminal space, but if that space is narrowed, by bone spur gwoth in the spine or by disc herniation, the nerve roots can be compressed and cause neural symptoms, and this can happen even without the more "normal" pain of backache--the muscles in the area may not be affected, but depending on what nerve root and what part of the root is pressed, one can get neural symptoms anywhere within that dermatome (body area that the nerve eventually serves).

It is good that they want to compare these films to previous ones. Almost everybody beyond a certain age (which Alan is certainly beyond ) shows some sort of arthritic deterioration of the spine--our spines were simply not designed to bear the loading they do for so many years. However, placement is everything--there are people with ugly MRI's that have no symptoms, and people with only slightly abnormal MRI's that have a LOT of symptoms, It all depends on just where that bend, spur, herniation, etc. is and does it impinge on anything.

I have an ongoing cervical spine radiculopathy, for example, secondary to a right side trapezius muscle tear two and a half years ago, which brought a bone spur close to the foramen--it's at the C6/C7 level and impinges on the right foramen sufficiently to cause numbness/tingling down my right arm medial nerve and into my thumb/forefinger/third finger. The symptoms vary in severity and I do a lot of stretching, occassional traction, etc. to try to keep it from closing the opening up more. What I can say is that in my case the symptoms from this, while definitely neural, are very different in kind from those I get from my original small fiber neuropathy--burning pain is not invovled. I do think it's likely that the original comprimise to my nerves, though, has led to more symptoms from the nerve root pressure than someone else might have otherwise gotten.

Alan's MRI might certainly explain why the neurologic chiropractic helped his symptoms-it relieved pressure on the roots to a certain extent. It remains to be seen, through comparison of the MRI's, if the spaces have narrowed and the pressure increased over the years since that occurred.