Quote:
Originally Posted by mmglobal
Lance, welcome to the forum.
You said that your four year-old MRI shows...... Do you have more current imaging? I'd be cautious about moving towards procedures that destroy tissue or ablate nerves without having an updated look at how things are now.
Does your pain syndrome present with mostly facet type issues?
All the best,
Mark
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Thanks for the welcome, Mark!
Yes, the MRI is my most recent imaging. I had a CT scan a year or two before that which diagnosed osteophytosis in the lumbar spine. Also, the MRI identified some central canal stenosis at L4-L5.
My pain is in the lower left lumbar and is most acute when bending forward and reaching toward my feet and exceeding a specific range of motion. In fact, it was a similar motion eight or nine years ago that was the precipitating incident of my current problems, although I had had some prior symptoms that I now realize were preliminary evidence of a developing chronic lumbar issue(s).
Apart from the range of motion issue, a dull, aching pain is present upon a very few minutes of standing or walking which becomes unbearable after twenty-minutes or so. This duration can be extended somewhat by wearing a compression belt.
My pain is usually fully mitigated upon sitting down. I have no referred pain in the buttocks or down the sciatic nerve.
Two neurosurgeons (the most recent being a year ago) have declined me as a surgical candidate. I was hoping my problems could be addressed by a mechanical interspinuous spacer, like the X-stop, but I guess not.
Epidural series and four different rounds of PT and two chiropractors have been to no avail.
The procedure I'll have on the 21st is a diagnostic medial nerve block on both sides of the lumbar spine and at multiple levels to see if, and to what extent, the pain is reduced by anesthesia and thus indicative of a successful ablation at a follow-up appointment.
I don't know how to distinguish my pain from a facet vs. stenosis origin, but I suppose if I walk around with a "numbed up lumbar" for four or five hours and still have the same physiological demand to sit my butt down after twenty minutes we'll know that the facet joints are not my primary problem.
And if that happens, I'll be one sad, depressed puppy because I don't know what we do after that.