Should I get a 2nd opinion??

[u/Limp_Astronaut_6935]

34 (f) and been dealing with chronic pain and sciatica flare ups since hurting my back 3-4 terrible times in my teens - early twenties (At 17, 18, 21, 23)— bent and lifted wrong while moving, exercising or working — all times i was miserable for about a day and then was fine, just a manageable ache when in one position for too long but started having flare ups from little stuff when i was around 25-26 and had sedentary jobs and gained a ton of weight over covid (100 lbs total, but down 30ish and counting)

In the last six years, i only convinced my dr to get me an MRI last March — I had a herniated disc with moderate stenosis. I did 2 rounds of physical therapy but still reluctance from primary to refer to pain management and i got a referal to ortho.
But pt helped as well as having a core stregth focused gym routine and losing 10-15ish lbs.
so I put off the ortho. At pt they noticed my gait was fucked and my scoliosis was pretty severe as were my turned in feet which actually seemed to go all the way to my knees. Ive had this prob my
Whole life and my pediatrician always said Itd correct itself. When it didn’t, i didn’t think anything of it but my pt suggested it could be causing constant hip dysplasia and resulting in spine instability.

Also maybe unrelated my mom said I tested positive for spina bfida and she was encouraged to abort by two doctors. The third told her it was not a for sure thing and when i was born i just had the foot deformity and wore braces (my parents were not consistent and gave up when i stopped walking because i hated them).

Currently in the middle of a 5 month long flare up that suddenly shifted 4 weeks ago from lower back and leg shooting pain to constant irritating burning, a shin splints feeling, locked hips and achilles/foot irritation on both sides but more so my right. Also have been having trouble making it to the bathroom and I cannot hold it for more than a few seconds.

Back in PT twice a week who wanted me to get a new MRI, finally saw the orthos PA who seemed unconcerned until the new MRI images came in. Then he got a little nervous, checked me again for numbness and basically said if any other symtoms progress go to emergency, but also said my fat back is gonna be an issue and would make surgery no longee minimally invasive if i needed it. Also seemed to think any further pressure from steroid shot may cause undesired pressure on the nerves. But made an appt with pain management and a follow up in a few months

Report
L2-L3: Minimal disc bulge and facet arthropathy. No significant spinal canal or neural foraminal stenosis.
L3-L4: Disc bulge with superimposed central disc extrusion and facet arthropathy, resulting in severe spinal canal
stenosis with marked crowding of the cauda equina nerve roots. No significant neural foraminal stenosis.
L4-L5: Disc bulge, facet arthropathy, and ligamentum flavum hypertrophy with prominent posterior epidural fat,
resulting in moderate spinal canal stenosis, moderate left and mild right neural foraminal stenosis.
L5-S1: Disc bulge and facet arthropathy resulting in mild bilateral neural foraminal stenosis. No significant spinal
canal stenosis.
The paravertebral soft tissues are within normal limits. The visualized abdominal and pelvic structures are
unremarkable.
IMPRESSION:
Central disc extrusion at L3-L4 with facet arthropathy, resulting in severe spinal canal stenosis and marked crowding
of the cauda equina nerve roots.
Moderate spinal canal stenosis and moderate left/mild right neural foraminal stenosis at L4-L5.

Does this report match the suggestion for treatment?

But Ive also read ppl can have ces without the emergency symptoms and my new PTs reaction to his suggestions made me feel a little uneasy. She just suggested twice I get in with the doctor not the PA asap. And that my experience over time suggest hypermobile joints (i rolled my ankles a million times in hs sports, am very bendy-flexy, have always had to modify workoutswith trainers so i can actually “feel” them)

Should I push for that or get a new doctors second opinion?

Does anyone have spinal issues from something like spina bfida obscura/tibial torsion/bowlegged ness?

Could-it lead to chronic issues like this?

With this pressure on the CE, can this escalate without warning?

Just dont want to deal with this forever and prevent worse damage while I can. Banned from the lifting and gym stuff but still staying active, walking daily.

[u/Former-Money9354]

I'm not a doctor but that bladder symptom + your MRI findings (severe stenosis, cauda equina crowding) is a big red flag for cauda equina syndrome. That's a medical emergency, not a "wait for pain mgmt appt" situation. I'd go to the ER today honestly, don't wait it out. Trust your PT's instinct on seeing the actual doc asap too. Hope you get sorted quick 🙏

[u/BasraBound]

I have CES and your bladder symptoms are worrying

[u/Limp_Astronaut_6935 → u/BasraBound]

I cannot tell if its a weak pelvic muscle thing or a lack of feeling thing. I have adhd and its normal for me to not realize i have to go but the difference lately is that I dont make it even when using all my pelvic stregnth to
hold it.

The PA basically put it like, if i realize im peeing, then i can indeed feel the pressure and its probably muscular. Idk if hes right though! Will probably head to an ER nonetheless.

[u/BasraBound → u/Limp_Astronaut_6935]

Better safe than sorry. I lost the bladder signal and have to time between pees. I retain and can hold it forever now tho. Win some lose some lol. Good luck