Husband's MRI Report

[memasix]

Impression:
1. Moderate central spinal stenosis at L4-L5
2. Degenerative spondylosis at several levels most pronounced at L2-L3 and L3-L-4
3. Foraminal stenosis worse on the left at L4-L5 and on the right at L2-L3 and L3-L-4

My husband is in a significant amount of pain.  Can this get better with physical therapy and a pain clinic?
Thank you.

[wiseazz]

I have been there.  I had it all from PT to several steriod injections under anesthesia. You can only have so many though.  Ultimately, I got a second opinion.  I researched and found an ortho surgeon renowned in this field studying the latest in back surgery.  He walked me through the MRI on the screen and explained the importance of nerves having space so they're not pinched by herniated disk tissue or debris,  like arthritis that can build up (even in your 30's).  It can cause bad pain and sciatica.   Injections won't help that and PT will never fix it.  Pain meds will help a little, but regular exercise and trying not to sit or lay down a lot is very beneficial long term. I was given a choice of a less invasive surgery to clean out the bulging disk tissue and arthritis that had built up or disk fusion.  I always err on the cautionary side... I know you can always go bigger later, but if you fuse...you can't take it back.  They're working on new stuff where they can put cushion in between now...at least in some places and I'd like that option if I need it at some point.  I know lots of people who habe fused and they seem to have issues later on with flexibility and the disks above and below tend go give out as a result.  Now, it's not all doom and gloom...take care, get a kneeling chair if you sit at work, and you'll be jumping out of olanes and running the rock and roll marathon like I did last year!!  =)

[sblythe]

You don't say where he has pain. If he is having pain radiating down an arm or into the shoulder from one of the pinched nerves, this can often be helped with an "ESI" - an epidural steroid injection. These are done by pain management specialists, and are either done in an operating room with x-ray guidance (very expensive) or some docs are good at doing them with ultrasound guidance, which makes it an in-office procedure and far less complicated and costly.  If the pain is right in the spine itself, such treatments may not be useful.  If he has pain from a pinched nerve, my personal experience is that pain medications don't do a whole lot to help it.  Given that degenerative spinal stenosis ("spondylosis") is a progressive disease, and this will get worse over the years, he should establish a relationship with a spine surgeon - this would either be an orthopedist who has done specialized training in spine surgery, or a neurosurgeon who does spine surgery.

[silverfox67]

   I have a friend with this problem also.  She has pain patches.

[illinois633]

Have the same problems and I know how painful this is. Physical therapy will not help. You need to get to an ortho clinic and talk to a pain doctor, you can get injections that will eliminate most of the pain.

[RockRose]

Memasix,  it's unlikely that anyone on this forum could interpret this data as well as the doctor who ordered the MRI.  

Have you discussed your question with his doctor?