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What is the treatment for severe facet hypertrophy?

Apr 2014
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Practicing since : 2004
Answered : 6487 Questions
I have a severe facet hypertrophy, narrowing of the lateral recesses of the traversing l3 & l5 nerve roots.VA thinks laumbar steroid injection and PT. Am I a candidate for surgery or am I overthinking? Seems like a treatment of a symptom rather than fixing the problem. Your thoughts?
Posted Wed, 19 Feb 2014 in General Health
Answered by Dr. Indu Kumar 1 hour later
Brief Answer: Physiotherapy should be tried first. Detailed Answer: Hello XXXX Thanks for writing to us According to history you have degenerative disc prolapse of spine in lumbar region. Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis which allows herniation of disc that causes narrowing of lateral recess. Treatment for degenerative lumbar disease includes physiotherapy or surgery. Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes. In acute cases,ideally physiotherapy should be started after pain subsides . You can have steroid infection in neural foramen.After pain subsides,you can start physiotherapy. Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc. Treatment can be planned after consultation with neurosurgeon. You should also modify your life style like don't abruptly bend forward and avoid standing for long time.Don't lift heavy objects. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
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