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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Pain Be Caused By Facets?

in august I was stopped at the rotary and another care hit me from behind. I felt a pain to left of l4 l5 and it shot to straight across to left of my lower back and stopped. it felt like an electrical shock. two days later when I sat down the pain was horrible. I was diagnosed with lumbago and a S1 ligament/joint strain. my mri revealed an asymmetric disc bulge to left at L4-L5 which contacts descending left L5 nerve root in the lateral recess and also results in mid left foraminal narrowing at this level. I have a had two epidurals and one trigger point injection. trigger point injection had kenalog, which hurt like a bee sting and continued to hurt for weeks. this area sometimes still feels like a bee sting. now my back doctor wants to give me facet injections at L4 to S1. pain is really bad to left of L5-S1. pain radiates down to tailbone and both sides of sacrum can hurt. sitting and bending backwards can really hurt. the area can feel like a rug burn. pain from bulging disc no longer goes down left leg. Also I no longer have pain to left of L4, but my doctor wants to put a facet injection in this area. I a very fearful of these injections. I also have mild diffuse degenerative disc disease thoughout the lumbar spine without central canal stenosis and facet arthropathy at L5-S1 resulting in mild bony foraminal narrowing. my back doctor thinks MVA jumpstarted facet pain. could pain be caused by facets?
Mon, 6 Jul 2015
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Physical Therapist or Physiotherapist 's  Response
Hello There !
Its good that there is no radiating pain from the disc bulge. Facet pain could be one factor , however there could be pain originating from other aspects too in your case like ligaments , due to the mva. If there are no motor and sensory defects , like muscle weakness , numbness or sensory loss ,my suggestion would be to give a try to conservative pain management remedies. a PHYSIOTHERAPIST has a host of tools to manage your pain and can also assess where it comes from . Kinesiotaping , Ultrasound , TENS etc and gentle manual therapy as indicated can be applied with excellent results for pain in low back and sacral areas. Be aware of your postural habits though , some lifestyle changes could be suggested by your physio to help you correct your body mechanics and manage pain better. tc
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Could Pain Be Caused By Facets?

Hello There ! Its good that there is no radiating pain from the disc bulge. Facet pain could be one factor , however there could be pain originating from other aspects too in your case like ligaments , due to the mva. If there are no motor and sensory defects , like muscle weakness , numbness or sensory loss ,my suggestion would be to give a try to conservative pain management remedies. a PHYSIOTHERAPIST has a host of tools to manage your pain and can also assess where it comes from . Kinesiotaping , Ultrasound , TENS etc and gentle manual therapy as indicated can be applied with excellent results for pain in low back and sacral areas. Be aware of your postural habits though , some lifestyle changes could be suggested by your physio to help you correct your body mechanics and manage pain better. tc