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Is there any treatment for bilateral facet hypertrophy? Have back pain, numbness and tingling.

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General Surgeon
Practicing since : 1980
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I have been dealing with low back pain for about 2 years now. I went to a Orthopaedic Spine Surgery who had me do 12 sessions of physical therapy. I also complained of burning in my thigh area with numbness and tingling. They diagnosed that as Meralgia Paresthetica. I have had 2 nerve blocks of the lateral femoral cutaneous nerve which gave me temporary relief. After many complaints the doctor finally ordered an mri. The results of the mri where disc bulges of of 2 mm each at L1-2, and L2-3, 3 mm at L4-5 and 4 mm at L5-S1. Bilateral facet hyperthrophy which is mild at L3-4 and moderate at L4-5. L4-5 slight to mild right neural foraminal narrowing. The doctor says that I will just have to live with this and that there is nothing he can do.
Posted Sat, 21 Apr 2012 in Back Pain
Answered by Dr. Rajinder Bajoria 20 hours later

Thanks for posting your query.

Low back pain for the last two years confirms beyond doubt that that there is some spine pathology causing nerve compression or entrapment.

MRI has clearly revealed Prolapsed Intervertebral Disc between L1-2, L2-3, and L4-5 and L5-S1, with bilateral facet hypertrophy at L3-4, L4-5 and L4-5 resulting in narrowing of right side neural foramina.

Compression or damage of lateral femoral cutaneous nerve is due to prolapsed intervertebral disc, causing numbness and tingling on the outer aspect thigh known in medical science as Meralgia Paresthetica.

As you are very young and living a life with such pain constantly appears very tough.

In such cases first all conservative management in the form of physiotherapy, intermittent pelvic traction, analgesic, local application of gel and high doses of B-complex and methycobalmine should be exhausted first.

Physiotherapy along with extensor muscles exercise has a great role to play.

If you are smoker, stoppage of smoking will help to some extent.

If all conservative management fails then Neurosurgeon can help you and surgical intervention can give long term pain relief.

So opinion of Neurosurgeon is desirable for long term benefit.

Hope, I have answered your question well to your satisfaction.

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