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Old 11-16-2012, 05:41 PM   #1
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Best therapies for osteoarthritis, spinal stenosis, bulging discs

Hi, everyone! I am a new member and wanted to get some feedback from people who may have been in a similar situation. My back/leg pain started about three months ago. I went to a family practice doctor who examined me and said I most likely just had some inflamed muscle tissue causing my back pain/sciatica down left leg. So I went for a couple months of neuromuscular therapy. After I wasn't having much succes, the doctor, a d.o., did a couple adjustments and acupuncture therapy on me. These also did not give me any relief.

Looking for relief and answers, I went to a pain specialist, who thought I most likely had herniated discs (l5-l4, s1) and did a steroid epidural injection and ordered a MRI. After the first injection didnt offer much relief, I went back to see what exactly my MRI said. Well the np who saw me that day gave me a copy of the MRI results which indicated my suspected herniated disc were just bulging. So she said she didn't think the pain stemmed from that, but rather "the good amount of osteoarthritis" all through my mid and Lower spine, and the spinal stenosis.

Given this new diagnosis, I asked for a referral to physical therapy and plan to start that soon, she suggested I try more steroid epidural injections. I am willing to try anything, so I will go back, although my first experience was intense (as he injected the medicine, I swear it felt like what I imagine being electrocuted feels like, Or having my sciatic nerve ripped from my body and dipped in rubbing alcohol and paint thinner lol). but I am desperate and will endure that, if they say it will help (but part of me suspects it helps their pocket books more than my back and legs. Anyway, so my question is, besides what I have mentioned, is there anything else you guys can suggest I try. My daily pain is pretty umbarable, it has affected my work, home life, love life. I know the diagnosis might not sound "that bad," but I am only 28yo!!! Most importanly i have a 31 yo man and 7month baby that rely on me, and I cannot let this affect me and my family any longer. Please help, any and all suggestions appreciated!

 
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Old 11-16-2012, 08:31 PM   #2
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Welcome to the board.

Did you get a copy of the radiology report for the MRI? Do you know if you have any nerve involvement? Which disc is bulging and where is the stenosis located?
It would be helpful if you could provide a bit more information.

If you don't have a copy of the MRI and the radiology report, you might want to do that and start your own file. Sounds like you are going to continue to have some spine problems as you age...so you might as well get in the habit now.

 
Old 11-16-2012, 08:45 PM   #3
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Teteri, thank you for the welcome and reply! I have a copy of The final report that indicates there is no nerve involvement. I have bulging disc at t1, l4-5, and s1...which is also where the stenosis is, if I am reading it correctly. I don't know if the numb, decreased relexes, sciatica pain can be caused solely from the stenosis and arthritis, but np suggested it was.

Anyway, I am so discourage and wonder if oa and stenosis are common in people my age... if so, what is my prognosis look like? I am willing to do whatever it takes to stay active and healthy, so any suggestions would be greatly appreciated. Thank you for your time!

 
Old 11-16-2012, 09:08 PM   #4
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Ugh, sorry, I was horribly wrong about the disc involved:

Bulges at: t12-L1, L3-4 (with stenosis), L4-5 (with stenosis), L5-S1 (with stenosis)

I guess it also should be noted the MRI mentions and the np mentioned I have short "congenitally short pedicles" (the np said short vertebrae), which could be leading to the stenosis?

 
Old 11-16-2012, 09:27 PM   #5
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Does it indicate if the stenosis is in the foramen (might be called neural foramen)?

The pedicles are the arched part of the vertebrae. Some people are born with pedicles that are shorter than average. It generally means that there is just less space for the spinal nerves. It isn't usually a problem until something else shows up that contributes to the narrowing of the central canal, such as a herniated disc, arthritis in the facet joints which causes them to enlarge, or similar....

 
Old 11-16-2012, 09:46 PM   #6
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Teteri, thank you so much for your help and replies. It says no neural forminal, just central canal stenosis. Is this good news?! I sure hope so! Haha Thank you again for your help.

 
Old 11-16-2012, 09:52 PM   #7
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

The good news is that there is no nerve involvement. When a spine doctor tells you that you have osteoarthritis, it presents slightly differently than when in a knee or other joint. Sometimes arthritis is kind of a catch-all term doctors use to describe the beginnings of a degenerative process.

You are on the young side for most issues but, unfortunately, the human spine begins its aging process in our 20s. Many people who have MRIs for other reasons learn they have some bulging discs. The finding isn't that unusual and is meaningless unless this is causing pain.

Since you have no nerve involvement, you should have time to try to get the issues to resolve. Discs can and do heal on their own....It will be important to avoid activities that involve bending or twisting at the waist and limit the amount you lift. Use good posture and body mechanics and exercise to keep the core and back muscles strong and fit. This is something a physical therapist who works with many spine patients can help you with.

You might want to get a book by Robin McKenzie called "Treat Your Back." It is in its 9th printing so many libraries carry it, or you can find it at one of the online booksellers. McKenzie is a physio from New Zealand who developed a system for evaluating and treating back problems that is used now all over the world. The book has a program that, if followed religiously, has allowed many people to heal from bulging discs.

However, if your stenosis is in the central canal, disregard the McKenzie program. Putting your back in extension will only increase the pain. It is best to go to a physical therapist to be sure you are doing the right exercises, but you can also look online for exercise for sciatica from Spinal Stenosis and you will find many choices. Look through several and you will find those that are common to all websites...those are the ones that the PT will probably give you as well.

 
Old 11-16-2012, 10:00 PM   #8
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Thank you so much, you've given me hope... I will definitely follow through with the physical therapy. The bending and twisting is going to take a considerable effort (because of having to keep up with the baby), but I will try. Can I ask, do you think the steroid epidural injections will be of help?

 
Old 11-17-2012, 10:09 AM   #9
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

I can't say. It varies so much from person to person. I have a friend who was having sciatic pain at the very same time I developed mine...we
both went for ESIs at the same time. After her second one, her pain was pretty well gone and she was able to go on her three week trip to Israel for her grandson's Bar Mitzva. After two injections, I didn't feel one bit different and could barely walk to the mailbox to collect my mail.

It all depends on what specifically is causing the pain and how the person responds to the steroid...I'm sure there are other factors, too.

I did a bit more reading on the spinal arthritis--and it does mostly have an affect on the facet joints (which connect the vertebrae)...which makes sense since they are the only synovial (containing fluid) joints in the spine and are what allow us to bend forward, backward and to twist side to side. Most of the damage occurs to the cartilage.

As the cartilage on the edges of the facet joint wears away, bones begin to rub together which results in the growth of bone spurs. This can be a contributor to spinal stenosis.

 
Old 11-17-2012, 10:30 AM   #10
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

Teteri, I am happy to hear of your friends success with the injections. I'm sorry to hear that it did not give you any results though. I hope you are feeling better at present time. I cannot thank you enough for your Time and information! The information regarding the arthritis makes a great deal of sense, now that you've explained it as such. I think I need to do more research on ways to slow the progression of the oa..if there is such possibilities. Again, thank you and hope you have found and continue to find relief in dealing with your back.

 
Old 11-17-2012, 08:05 PM   #11
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

One of the best ways to minimize the damage of arthritis is to keep your back and core muscles strong. This will help support the spine and minimize the amount of slippage that might occur from the deterioration of cartilage.

Keeping the weight on the normal side also helps to keep additional stress off the discs...and exercising, gently, like walking, swimming, cycling, will help to keep things toned which will keep the ligaments and tendons in better shape so they can do their part in keeping the joints in place...etc.

I'm sure there is lots of information online as this is a very common problem.

 
Old 11-17-2012, 09:58 PM   #12
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

teteri66, am not sure if you will get this or not but I really need some help on this statement in my mri. It reads ; starting at the level of the mid portion of the L3 vertebral body extending to the level of the mid portion of the L5 is a mildly complex fluid collection with enhancing capsule. L1-2 is a broad based dicc bludge causing mild effacement of the ventral surface of the thecal sac. L5 S1 is a broad based disc bludge and degenerative changes causing bilateral neuroforaminal stenious at the L5 S1 interspace.: I have the whole report but cant write it all tonite. And I had my anterior posterior 3 level fusion in 2006. This MRI was done in Jan2009. I am going in for another one hopefully this week. I also have PAD. not enough blood going to my legs, I see a doc. on the 5th of dec. Thanks so much for all of the help you give on everyones post. As ever Georgie782.

 
Old 11-17-2012, 10:51 PM   #13
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Re: Best therapies for osteoarthritis, spinal stenosis, bulging discs

That is good to hear! I have a referral for the core strengthening pt. I hope it allows me the ability to at least be active once again, so I can maintain a better weight. I gained 70lbs with the kiddo, which was okay because I was pretty underweight. I've lost about 40 so far. But then this happened. Anyhow, I am very appreciative of your help and reassurance! Thank you so much

 
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