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Old 11-20-2003, 10:01 AM   #1
b&g b&g is offline
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Arthritis in L4 - L5 L5 -S1 Questions

I have had back problems since I was about 18, I am now 48
It used to be just numbness and burning in my thigh but it is now in the hamstring and calf area along with my butt.
I always suspected a disc problem but never looked into it much with the exception of a few chiropractors who told me I had a disc problem.
So I went to my doctor a couple of weeks ago and she set me up for an MRI
They called me a week or so ago and told me I have arthritis in L4 - L5 L5 -S1 facet joints and they would send me to the pain clinic.
Well the pain clinic called today to set up an appointment and told me it would take two hours and bring a driver? I said why would I need a driver and she said that they would be doing an epidural steroid injection.
I asked if the doctor had seen my MRI and she said no, I told her I would come in but no injections until the docotor looked at my MRI and we talked about it.
Does anyone here have this problem and if so have you had injections and do they help and if so for how long.
Also how does arthritis cause leg numbness and burning in the thigh.
My appointment is tomorrow so any advice would be great


Regards

Mark

 
Old 11-20-2003, 12:40 PM   #2
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Re: Arthritis in L4 - L5 L5 -S1 Questions

Hi, b&g,
I'm a chiropractor and I wish that I could see your MRI report. If the sciatic nerve pain which you are feeling has not been determined to be from a disc herniation, the general "arthritis" diagnosis hold some key verbage which may be in the report. With severe cases, the joints grow larger with calcium deposits and those deposits can narrow the recess of the nerve causing irritation of the nerve. Also, a large ligament also thickens to add stability but that too can cause narrowing of the canal with the same result. Look for the key word "stenosis" in the report, which means "narrowing".
The injections of steroids are designed to reduce the inflammation in those sites. This allows the tissue to resolve the inflammation. Inflammation causes additional irritation which causes more inflammation (think: scratching a mosquito bite bakes it itch more). The injections help incrementally but top out at three because they can be caustic to the connective tissue, causing damage. If the first two do nothing then it's unlikely that the third will be a sudden success, but don't steal the doctor's thunder - just ask the pertinent questions! As far as how successful they are, it's different for everyone. I had a course of 2 that did nothing and, years later, a course of 3 that improved with each injection. E-mail me if you have more questions. I am more likely to get themthat way.
Later,
Chiz

 
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Old 11-20-2003, 09:28 PM   #3
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Re: Arthritis in L4 - L5 L5 -S1 Questions

I have facet joint arthritis in most of the spine and neck, I have gotten the epidural in all areas it seems and the only one it helped was in the lumbar and just for awhile at best. I can only get 3 in a years time and at times I never went to the 3rd round when the first 2 didn't do me any good. It's worth a shot to see for yourself.

 
Old 11-21-2003, 05:59 AM   #4
b&g b&g is offline
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Re: Arthritis in L4 - L5 L5 -S1 Questions

Thank you both, for the reply.
My appointment was canceled late yesterday when the clinic called me to let me know they do not take my insurance so I will look around.

"Look for the key word "stenosis" in the report, which means "narrowing"."
The nurse that called didnt go into detail but I will call and see if I can talk with my doctor on the phone about this.
Somthing must be pushing on a nerve to cause the numbness and sciatic pain that I have.


Do either of you take any medication for your arthritis and does it help, I see were some get relief from celebrex or something similar.
Although if I have stenosis I imagine that something like celebrex will not do much good.


Regards

Mark

 
Old 11-21-2003, 09:49 PM   #5
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Re: Arthritis in L4 - L5 L5 -S1 Questions

Quote:
Originally Posted by b&g
Thank you both, for the reply.
My appointment was canceled late yesterday when the clinic called me to let me know they do not take my insurance so I will look around.

"Look for the key word "stenosis" in the report, which means "narrowing"."
The nurse that called didnt go into detail but I will call and see if I can talk with my doctor on the phone about this.
Somthing must be pushing on a nerve to cause the numbness and sciatic pain that I have.


Do either of you take any medication for your arthritis and does it help, I see were some get relief from celebrex or something similar.
Although if I have stenosis I imagine that something like celebrex will not do much good.


Regards

Mark


It may help, I have mild stenosis in the lumbar and moderate in the neck and the Dr does not like to do surgery unless it severely impairs the quality of life. It hasn't mine yet but I have very bad days and then pretty good days. I will take a mobic from time to time but I hate to take anything unless it is very severe, so if I can handle it I take nothing but when it gets real bad I will take mobic for a few days, not the way you are suppose to do but if I don't need it why put my stomach through the turmoil.

Last edited by NancyH; 11-21-2003 at 09:50 PM.

 
Old 11-23-2003, 01:59 PM   #6
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ironhat HB User
Re: Arthritis in L4 - L5 L5 -S1 Questions

Hi Mark,
Sorry I'm late getting back online. First of all, you are entitled to a copy of your MRI report. You can have it faxed or pick it up at the facility, but you will have to go there in either respect in order to sign a release. Skip past waiting for the doctor to provided it for you - especially since you have to wait for another appt. Get back to me if you need explanation of any of the medical terminology. Use my e-mail address.

Nancy's experience is pretty normal for the use of epidurals provided by a prudent doctor. What I mean is that the practitioner did NOT proceed with the third injection when it was obvious that two were not helpful in the least. Every body responds in a different way to everything from meds to manipulations, cookies to coffee. It will take some experimentation with meds to find what works best for you but Celebrex and Vioxx only worked for me when Rx was a 400mg dose, but you can't repeat those and you can't take any more at all that day. It soon wears off. Let the doc give you samples until you find one that gives significant improvement. Good luck and God bless,
Later,
Chiz

 
Old 11-24-2003, 07:16 AM   #7
b&g b&g is offline
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Re: Arthritis in L4 - L5 L5 -S1 Questions

Thanks to everyone replying to my post.
Well I got the report and they show no stenosis anywhere, pretty strange.
There has to be something affecting a nerve. I will get another doctor to read the MRI and see what he says, maybe the first one missed something.
I think I will have them due a blood test to see how much TNF I have, I hear that to much TNF can irritate nerves and cause allot of pain.


Regards

Mark

 
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