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Have Disc Space Narrowing With Degenerative Type And Sacral Meningeal Tarlov Cysts. Relief From Pain?

Posted on Sat, 23 Feb 2013

Question: I have disc space narrowing at L5S1 with degenerative type end plate signal (hx of discectomy L5 S1) I have mild facet hypertrophy at L1 L2, L2 L3 nerve root with sleeve cyst within the L neural foramina.I also hacve an ostephyte complex at L5S1 and facet and ligamentous hypertropy there. I have sacral meningeal Tarlov Cysts. I have pain that keeps me awake at night, sharp pain when something slides out of place and then I can barely walk. This can occur over several times a day. I have been a nurse for greater than 35 yrs and walking is becoming harder and harder and the sharp jolts of pain can bring me to my knees. No meds. Just need to have clarification of this.I stretch and do the PT exercises for trunk stabilization with no relief obtained. Pain radiates down my left leg to calf and down anterior right thigh..please enlighten. Sometimes I can roll around and something slides into place but that doesn't seem to work anymore. I walked off a 2 inch curb Sunday and the jolt sent me through the roof with the knife like pain and from then on, I am having difficulty walking as it is so painful
I think the discectomy I had in 2000, may have contributed to the ostephyte formation. I saw a neurosurgeon who said she couldn't do anything from her perspective. I have had several steroid/lidocaine shot series which were effective for a while however, I think the time has come to see if I can really establish what is the root of the pain.

Answered by Dr. Saurabh Gupta (4 hours later)

Hello,
Thanks for posting your query.

I can understand your back pain. You are suffering from degenerative disease of spine. Degeneration involves bony structures and the intervertebral disc. During life the spine undergoes continuous changes as a response to physiologic axial load. These age-related changes are similar to pathologic degenerative changes and are a common asymptomatic finding in adults and elderly persons.

Osteophyte formation is not seems to be contributed by discectomy.These occurs as a general process of wear and tear.Intervertebral disc degeneration also characteristically results in the formation of vertebral osteophytes, or small bone spurs that can contribute to nerve impingement or spinal stenosis over time.

For this condition you have to do stretching & strengthening exercises of back in which you have to stretch tight muscle & strengthen weakened ones which will alleviate stress on facet joint and disc. You can start with swimming and mild aerobic exercises. These do help a lot in the back pain.

The following measures will help with the pain
• Lie on a hard bed.
• Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( do not repeat a dose before 6 hours) with food will help relieve the pain.
• Avoid forward bending.
• Correct your posture while sitting
• Avoid prolonged sitting
• Avoid strenuous activity & lifting heavy weights.Avoid all jerky movements of spine.
• Apply diclofenac gel on the affected area. Warm compresses will also help.

Hope this information helps you. Let me know if you need further assistance.

Wishing you good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Saurabh Gupta (11 hours later)

would a surgical intervention help as I have been stretching for over a year.I will try the swimming...

Answered by Dr. Saurabh Gupta (5 hours later)

Hello,
Thanks for posting your query again.

Conservative treatment is usually considered a temporary solution. The underlying condition is usually degenerative and will usually worsen in time. This is particularly true in the facet joint is overloaded due to disc height loss from degenerative disc disease.

If pain is severe and continuous, or if there are neurological deficits, surgery may be
recommended.Surgical goals include relief of nerve compression, allowing the nerve to recover, as well as the relief of joint pain and restoration of normal function.

Hope this discussion was useful. Please close this discussion, if you do not have any other queries. I would appreciate your reviews about this service.

Wishing you good health...
Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar