Sounds about exactly like what’s happening to me. I am presently doing physical therapy and will be doing a epidural in l3/4 in two weeks. Then we shall see how that goes. My orthopedic spine specialist says he will know what we need to do if the shot helps. It’s such a guessing game ugh.

Hello @alex199407 - I moved your discussion on bulged discs and combined it with your first post on diffuse and bulging discs, "Multiple diffused discs in spine. 3 in neck, 2 mid back and 4 lumbar" - https://connect.mayoclinic.org/discussion/multiple-diffused-discs-in-spine-3-in-neck-2-mid-back-and-4-lumbar/.

I did this so members like @cathy2223 and @upstatephil could see your newest update as well.

I had neck fusion from C3-7 last May, plus L4-5 laminectomy. The surgeon found 2 synovial cysts on my lumbar vertebrae. Starting last September, I started having pain...
Last September, besides having rheumatoid arthritis, I was diagnosed with possible fibro, but the doctor decided it was myofascial pain syndrome. So with my ailments, I don't know what is going on! My pain in my neck has been figured out but I don't know what they can or will do about that.... My big issue is my back. Ugh! In January, I went back to have an epidural in the L4-5 (left side) plus aspiration of another cyst. Apparently, synovial cysts can grow back. The pain in the direct lumbar on the left side isn't so bad but the right side has really gotten fired up. Plus, I have weird pain in my left leg - from my hip to my knee, calf, and toes. It can be so bad my husband has to help me out of bed. I have an aching pain all day behind my knee which is worse in the morning and beginning again late evening. I don't know where to turn. I am being turned over to the pain clinic. Couldn't get an appointment until the end of March. Another wait and see.
I can understand your frustration about just wanting an explanation for the pain.

I can't address your complete results but I do see that you have bilateral neural foraminal stenosis at L4-L5 and L5-S1 as well as bilateral facet arthropathy and Ligamentum flavum thickening at both levels.

Bilateral neural foraminal stenosis refers to the narrowing of the small opening between the vertebra in your lower spine which nerve roots pass through. If your nerve gets compressed in the gap, this will be painful. Depending on how severe your symptoms are, you could have physical therapy, pain meds and/or corticosteroid injections to begin your treatment.

At this point, I would also suggest swim therapy. I have done a lot of walking and other exercises in our local pool to help alleviate back pain and strengthen my lumbar spine. This has been very helpful for me. Look for a pool that maintains a temperature of 83-90 degrees which will help soothe the pain in your joints and muscles. I found a local hotel that rented time in their pool for exercising.

Bilateral Facet arthropathy is also present. This is called facet joint osteoarthritis. Most of us will develop this with age, but it is not always painful. Over time this can lead to bone spurs which can narrow the spaces in your spine, causing spinal stenosis and nerve pain.

Ligamentum flavum is a ligament between the lamina of adjacent vertebrae. When this ligament thickens, it can also cause spinal canal stenosis involving both the spinal cord and spinal nerves. If this is severe enough, you will have pain, numbness, weakness, tingling, etc.

I can't diagnose your pain issues, but you do need to talk to a doctor about your results. My guess is the issues in your lower spine are severe enough, they are causing some compression of your nerves at least. It may not be constant compression, but you will need some treatment to help with the pain. At this point, I would focus on the reported issues in your cervical and lumbar spine.

I started treatment with my family doctor. When I wasn't getting any pain relief, I saw a physiatrist at Mayo Clinic and also had a consult with a neurosurgeon. For my foraminal stenosis, we started with a laminotomy at L4, and laminectomy at L5 after many weeks (2 years) of physical therapy, pain medications and steroid injections in the joints in my lumbar spine. I had a second decompression surgery about 5 years later and then 10 years after that in 2020 I had a 2 level fusion involving L4-L5-S1. I agree with upstatephil that spine conditions do not magically repair themselves. This is a lifelong journey.

Also, my sister-in-law died of ALS. Her nerve pain was not limited to her legs. She was having issues with her arms, shoulders, face and tongue also. Pain is common in ALS and she did have pain and twitching without any specific pattern. A neurologist would be able to tell you whether or not you have ALS if you still suspect this after addressing your spine.