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spondylitic of the L3-4 and L4-5 with mild stenosis

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This condition is due to mild annular buging and mild facet arthropathy. I do not believe injections are the way to go because they only put a bandaid on the symptoms but do not really heal the problem. Is there an alternative route to take to get the bulging discs back in place or is surgery the only way. I have been in chronic pain for over a year now with no relief.
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replied April 27th, 2011
Especially eHealthy
shanbeck,

I think you mean spondylosis, which is early degenerative changes between the vertebrae. Usually the facet joints are not or only minimally involved.

The discs bugling can be just the way you are made or they can be the early degenerative changes in the annulus fibrosis. As it ages, the water content decreases, it is less able to stand up to compressive stress, and bulges out like an underinflated tire. It is still not known if this is a significant pain generator in the majority of spines, as up to 70% of people without any back pain will show bulging discs on MRI. But, since it can be seen on an MRI, it is often pegged as the culprit. But, without degenerative disc disease and a concordant discogram, it is still speculation.

The mild facet hypertrophy is the early stages of degenerative arthrosis within the facet joints. You do not say where the stenosis is, but stenosis means narrowing. Narrowing is not a problem, unless it compresses another structure, such as a nerve root.

So, with just bulging of the disc, all you can do is treat the symptoms. You cannot put the water back into the annulus. Some people do swear by the joint proteins such as chondroitin sulphate, glucosamine, and hyaluranic acid as helping with cartilage structures. It can't hurt to try these supplements.

The mild hypertrophy, is again treated symptomatically. If NSAID's, weight reduction, physical therapy do not help, then placing steroid medicine right in the joints is tried (facet joint injection, not epidural). In some cases, radio frequency ablation is used to ablate the tiny nerve fibers that supply the facet joints. This too is temporary, but may last months to a year (sometimes longer).

These are things you really need to discuss with your spine surgeon or pain management specialist. Advise him/her of your concerns and desire to treat the problem if possible. But, remember, you can't turn back the clock. Wishing you best of luck.
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replied April 27th, 2011
Especially eHealthy
shanbeck,

I think you mean spondylosis, which is early degenerative changes between the vertebrae. Usually the facet joints are not or only minimally involved.

The discs bugling can be just the way you are made or they can be the early degenerative changes in the annulus fibrosis. As it ages, the water content decreases, it is less able to stand up to compressive stress, and bulges out like an underinflated tire. It is still not known if this is a significant pain generator in the majority of spines, as up to 70% of people without any back pain will show bulging discs on MRI. But, since it can be seen on an MRI, it is often pegged as the culprit. But, without degenerative disc disease and a concordant discogram, it is still speculation.

The mild facet hypertrophy is the early stages of degenerative arthrosis within the facet joints. You do not say where the stenosis is, but stenosis means narrowing. Narrowing is not a problem, unless it compresses another structure, such as a nerve root.

So, with just bulging of the disc, all you can do is treat the symptoms. You cannot put the water back into the annulus. Some people do swear by the joint proteins such as chondroitin sulphate, glucosamine, and hyaluranic acid as helping with cartilage structures. It can't hurt to try these supplements.

The mild hypertrophy, is again treated symptomatically. If NSAID's, weight reduction, physical therapy do not help, then placing steroid medicine right in the joints is tried (facet joint injection, not epidural). In some cases, radio frequency ablation is used to ablate the tiny nerve fibers that supply the facet joints. This too is temporary, but may last months to a year (sometimes longer).

These are things you really need to discuss with your spine surgeon or pain management specialist. Advise him/her of your concerns and desire to treat the problem if possible. But, remember, you can't turn back the clock. Wishing you best of luck.
|
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