Complex jargon prevents understanding

DEAR DR. ROACH >>

After many bouts of pain in my left leg, I was referred for an MRI. They diagnosed me with left lumbar radiculitis, spondylolisthesis and lumbar spondylosis. There are many people in my independent living facility who have gotten similar diagnoses. As an RN with a masters in nursing education, I have a question: When the diagnoses are made, do doctors not explain the problem in layman’s terms? I only found out my list of diagnoses from a physical therapist to whom I was referred. — N.F.P.

DEAR READER >> Doctors certainly should explain their diagnoses in language appropriate for their patients. We can forget that the language we use is sometimes incomprehensible, but that’s not an excuse. A patient should always feel comfortable in saying they don’t understand a diagnosis, or any other word or phrase their doctor uses, and ask for more explanation. Many of the most effective communicators I have seen not only ask the patient whether they understood, but have made sure their patient can explain it back.

In your case, these specific diagnoses are generally not well known by nonexperts, and I am disappointed that they did not give you an explanation. Lumbar radiculitis is essentially sciatica — it’s an inflammation of the large bundle of nerve roots, which usually causes pain down the leg into particular locations based on which nerves are being affected. It is not a specific diagnosis, as it doesn’t say what is causing the damage to the nerves.

Spondylolisthesis is a condition where one vertebra overlaps another one below it (front to back, not side to side). Very mild spondylolisthesis will not cause any symptoms, but more severe cases can cause damage to the nerve roots. Spondylosis of the lumbar vertebrae is a nonspecific term signifying degeneration of the spine, usually due to osteoarthritis and often including degeneration of the disks in between the vertebrae.

So, these diagnoses together suggest that you have osteoarthritis of the spine, along with a displacement of one vertebra over another, causing damage to the nerve roots of the spine. These conditions would be likely to cause the back and leg pain you have on your left side.