Back Pain Forum - severe bilateral facet arthropathy l4-5,l5-s1

Conditions and Diseases > Back Pain Forum > severe bilateral facet arthropathy l4-5,l5-s1

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Q: severe bilateral facet arthropathy l4-5,l5-s1

asked by: mitchmom on October 13th, 2009

New User

I am 47 years of age and was a long distance runner for a long period of time. I have for the past 15 years had several diagnosis pertaining to conditions for my back. I have DISH throughout spine, which was diagnosed back in 1997. since I have been diagnosed with spondolytheosis, arthritis and now sever bilateral facet arthropathy. My back pain has been consistent for at least 10 years and is now so severe that I can not sleep and sitting and standing is getting difficult. I have a high tolerance of pain but am finding that the pain is getting harder to work through. I have had physical therapy and injections, also medication that does not help. I am wanting to enjoy the next 20 years but am having a hard time seeing this through the pain. I have been seriously thinking of surgery but have not really discuss with anyone. I have been seeing a DO and a primary physician and now am being referred to a rhuematologist. What should I do at this point and is the rheumatologist the physician I should be seeing???

Replies(6)

littleonefb

replied on October 13th, 2009

Extremely eHealthy

No, You need to see a spine specialist; either and orthopedic surgeon that specializes in spines or a neurosurgeon that specializes in spines only.

You need a full evaluation, maybe some new MRI's and a diagnosis.

Once you have a diagnosis, then you will get a treatment plan to help you and ease your pain.

Surgery may or may not be the correct way to go. Depends on the diagnosis.

If surgery is suggested, please get other opinions before you make that final decision to have surgery.

Surgery should always be the last choice, when there are no other conservative treatments left to try and you no longer want the pain you have.

Good luck

Fran

Users who thank littleonefb for this post: mitchmom

mitchmom

replied on October 13th, 2009

New User

Thank you for the information. I will contact my primary care (I am in an HMO) and see if I can get a referral to both or either physician specialists that you recommended. I was not sure which direction to go but did not think the current referral was going to resolve my questions. The pain has gotten so much worse and I want to be active again without pain...Thanks again

Surgeryx3

replied on October 14th, 2009

New User

you need to see a neurosurgeon you do not indicate if you have had a MRI but that should be a priority. good luck

rollar64

replied on October 15th, 2009

Experienced User

I don't see why you should not see a rheumatologist. Rheumatological disorders of the spine are common. DISH is a rheumatological disorder.

I think when you say you have spondolytheosis, arthritis you mean that you have Spondolythesis which is when one vertebra slips forward on the other. but i am not sure of the spelling and there are other conditions that start with spondy and some are rheumatological conditions. Also bilateral facet arthropathy is arthritis although is could be caused by many things.

I would encourage you to see any type of specialist who has a good reputation and an MRI is also a good idea,but your primary physician should be thoroughly aware of your details and is in a great position to recommend a specialist ( are you happy with their treatment )to put it simply your doctor is recommending a rheumatoligist you have a rheumatological condition why not see one.

Good luck

mitchmom

replied on November 4th, 2009

New User

i have now had 2 MRI's cervical and lumbar. Lumbar results are multilevel disc and joint degeneration of the lumbar spine, worst at L4-5, where severe facet arthropathy causes moderate central canal, moderate right and severe left neuroforaminal stenosis. Superimposed large lateral disc setrusion effacing the left subarticular and lateral recess with resultant posterior compression of the exiting left L4 and traversing left L5 roots.

Then there is the multilevel disc and joint degeneration of the cervical spine, worse at C4-5, where there is mild central canal stenosis and severe bilateral neuroforminal stenosis.

I'm not sure of all of this but I think I am looking at surgery. I hope so anyway as I am getting tired of were I am now...

rollar64

replied on November 6th, 2009

Experienced User

Yes i think if a good surgeon recommends surgery you should seriously consider it.

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