Best treatment options, future pain managment action to be taken

[ZIPITNOW]

What would be the best treatment for what my MRI reflected:At  L1 L2 central canaland neuroforamina are patent,  AT L2-L3 the neuroforamina are patent.  AT L3 L4 there is facet overgrowth, there is mild narrowing of the central canal with mild moderate narrowring of the neourforamina.  AT L4 L5 there is as well facet and ligamentous overgrowht, there is mild moderate narrowing of the central canal and modedrate narrowing of the neuroforamina.  AT L5- S1 there is also moderate narrowing of the neuroforamina. IMPRESISON: Multilevel degenerative change most pronounced from L3-L4 through L5-S1.

[ZIPITNOW]

Thank you for your info.. Yes I was sent to therapy but the pain was not reduce, went back to the neurologist and  was given pain medication and a set of oral steroid. Looks like it has help work in progress, much better than the physical therapy. Hope that with this second treatment I will be able to strat to work on and strengthen the supporting structures of the spine I can now see the importance of the physiotherapy.

I wanted to avoid what is call epidural injections. Very concern with the risk.  I my case it looks like it would be facet injection by a pain managemnt specialist.. Have read on this but continue to be concer about the process if I have to go there and the risk involve. Any additional information on this is wellcome.

[Tuckamore]

Hello and Welcome to the Pain Mangement Forum. I am glad that you found us.

You did not tell us how much pain you are experiencing and in my opinion the approach would depend in part as to your pain level.

Based on my limited experience in interpretation of MRI results it would appear that many of your changes are part of the normal aging f the spinal structure. As is most common with our spine the lumbar area shows the most wear and tear as indicated in your L3-L4 and L5-S1.

If your pain in minimal, maybe even moderate I would guess that your physician will take a conservative approach through PT, daily exercise, possibly a TENS unit and maybe a calcium supplement and a NSAID. These approaches may slow down further deterioration and strengthen the supporting structures of your spine. If your pain is great your physician may add a narcotic pain med to help you through PT and strengthening. He may also consider a ESI or oral steroid burst to reduce inflammation.      

If your spinal canal continues to narrow than surgery may be required. Each physician is different and as I stated earlier much depends on your pain level and symptoms. What ever approach is taken I wish you the best of luck. Your condition may very well require observation as your spine continues to age. So be sure you are confident and comfortable with your medical professional before you embark on any treatment procedure. Your MRI results are not uncommon though if you are in pain I know that brings you little if any comfort.

Please let us know how you are doing. I will look forward to your updates.
Take care,
Tuck