So my husband got x ray results today. We were hoping to find the cause of his new intense hip pain. Instead he had a normal hip outcome but an abnormal spine x ray. It says l5 spondylolysis and spondylolisthesis l5-s1. It also says degenerative change most pronounced in the lower thoracic region where there is osteophyte formation and loss of disc height. I don’t know what this means and he does not quite understand either. Does this outcome sound familiar to anyone? I am going to keep looking into it but want to know if anyone else has had this type of problem. They gave him muscle relaxers but I don’t want to just think he is going to have to live on pills…
Another option he was given is cortizone injection in the back. It’s that or physical therapy.
Why not get the injection and do physical therapy? I've had a couple of injections and they do help for a while, but they aren't a permanent fix.
Do go to your doctor for a full and thorough explanation.I have had back problems for more years than I like to remember and back surgery. I will explain what I do know but this is only from my experience with my own back problems. Hopefully my laymans terms will help you understand.
I don't have the HLA-B27 gene which can pre-disposes people with PsA to get Spondylosis but 20% still get this without the gene. Spondylosis is when the PsA is in the lower back.
Hip pain can be because of referred pain from the L5-S1 vertabrae. There are five lumbar vertabrae and that is what the L5 stands for and the S is for the Sacral Joints which go down to the tailbone and there are 3 sacral joints.
Degenerative generally means there is some wear and tear which can often be arthritic. Loss of disc height happens eventually with everyone as we age and does not usually happen naturally until people get into their sixties.
Loss of disc height this could mean that some of the jelly type substance inside the disc has shrunk down or pushed down and possibly leaked out.
The Thoracic area is above the waist and below the neck. The word Osteo generally refers to bone and there could be some calcification or arthritic changes there.
The back muscles can go into spasm which is very painful and restricts movement and that is why Muscle Relaxants are prescribed and it is generally only taken until the spasm is relieved. Massage is good for muscle spasm and it sometimes takes a lot of heavy massage to break up any knots caused by the muscle spasm.
Your doctor will order a CT scan if they need to look at the spine more closely.
You will need to be understanding and tolerant as this type of pain is like the pain of a toothache but it is spread over a much larger area of the lower back and hips.
I have L4 and L5 disc problems which give me intense hip pain. The injections, massage and exercising in a warm pool help. My Ortho doctor told me that since the injections worked so well I was a good candidate for surgery. I am not sure I am ready for that but I am sure if the pain gets more often or happens at rest I may get ready very quickly.
They found the cause of his hip pain. The vast majority of folks with these problems are helped by good physical therapy and exercise
Pain meds (especially any of the opiads) will exasurbate the problem. Muscle relaxents don't do much BUT they may help you sleep. Unless used occasionally they become a normal and the problem gets worse over time.
Rest increases spasms A BUNCH. 24 hours at most when at the worst and then move A LOT. A tens unit will normally help the pain, a good chiro can help with the spondylolisthesis. The less yopu move and strengthen the muscles the worse it gets.
The other thing that helps is movement and stretching through the day along with cutting back caffeine, anything with diuretic effect (ie orange juice with extra vitamins C) high sugar content etc etc and drinking LOTS of water. I mean LOTS of water Everyone develops spondylolysis through the day (in one degree or another).
Osteophyte formation is also fairly "normal" IT CAN be a problem, but interestingly enough, those little buggers can (and do dissolve) with movement and massage.
The interesting thing and I'm not trying to minimize anything here is that this is where the quacks really start to line up for your $$$. Half the people in this country over the age of 40 have everything described in you husbands X-rays. (prolly not as much as you husband but have it none the less) of those folks Half have no symptoms. Of the half that do have symptoms half get better with no treatment at all (just time) Of the the half that DON'T get better on their own Half get better with exercise and NSAIDS Half don't. Of the half that don't and end up with surgery Half get better Half don't. (are you seeing a trend)
Now lets assume you end up with surgery and are luck enough to be in the half that get better..... What happens to them? 80% end up needing additional surgeries. Every time they have another surgery the 50 - 50 rule. applies There aren't any conclusive studies BUT the trend is from smaller studies is that those who need additional surgeries almost always have failed to keep up a regular exercise and back strengthening program.
Okay... Are we together still? It takes time to rehab your back. In my case it was 18 months of PT, pool time, injections (they work) cases of 9 volt batteries for my tens etc and IT HURT. The worst was coming off the Drugs. THAT REALLY HURT. Did I mention I also lost 150 pounds????
That was 20 years ago. (well I've fought the weight battle a few times) The change to my back are SIGNIFICANT, the pain levels are not.
Talk ONLY to a neurologist about your back NEVER an ortho (especially in a spine center) and never a neuro surgeon. They will all TELL you they are attempting to avoid surgery BUT they don't make money as surgeons unless the do surgery. In order to get surgery approved they have to "attempt" less invasive methods. (they don't say how hard they have to try) A referal by a none surgeon for surgery has some theeth (not that I would go for it then either unless i had some level of actual neuro damage (I don't mean pain) drop foot etc....
I guess I should have given the short version not the soap box version eh?
Those reports make things sound a lot worse than the BAD they are......
Well, he does have DDD, degenerative disc disease.
I have spondylesthesis also, if i spelled that right?
I've done the nuerosurgeon, whos ays i will be back to see him to get hardware in my back..yea, right
Done the ortho/spine guy, same thing, smartass..i got all the reports, he says how many doctors are you going to see?...u need L4/L5/S1 fused..a cage in me?
ANd i am terrified it's not going to work, and i will be crippled....this isn't as easy as a knee replacement...It might not work ( like my foot/ankle fusions)
The spondylesthesis, is from DDD, which causes my sciatica...hurts to sit..blah blah, and on and on..LOL
But i got a deep manage by my chiro...he is not a cracker.....and i felt the best, on the sciatica....a deep massage
also, i got my miracle man , my hero, who handmade my orthotics for shoes, so i don't need more fusions, or replacement in ankle...it's pulling my foot right, the orthotics......and he called the nuerosurgeon big shot
i had a script from him, for a back corset..he called big shot, and says let me try a custom back brace...i had a mold of my back, it's like a ninja turtle brace, hard plastic shield back, velcroes under bosom....and i will wear that for pain, if i need it.
this orthotist ( back brace)..and pedathorist ( orthotics)...is now with Hanger prosthetics, a national company
I did learn the hard way, sometimes the pain, right side, groin, i mean they did every test, even colonoscopy..MRI, back, hip....it went away...bulging disks do that sometimes..and they do dry up, go away, sometimes
I agree, Lamb, that MRI report can make you think, u might need an operation this minute...
I'm ok, i can drive local, and don't need the store scooter anymore...sometimes, walking can help the back problems...and definately try a back brace, OTC, or from the doctor.....nah, they won't give you one....Walgreens has them!
touchy subject Lamb, docs telling me to get my back fused...I saw a general surgeon, because they were trying to rule out this pain, and i have had iliac crest grafts to the foot ( pelvic), and a hernia.....and he said his father a nuerosurgeon, says UNLESS the patient CAN'T even walk in on his own into his office, do not rush the back fusion...WHAT A DOCTOR, RIGHT ON!
The soap box version is fine with me! This is confusing and complicated. I wish his doctors would communicate and tell me what all this means! God knows we are paying enough for everything. My heart sinks a bit every time I look at a remacade statement! I NEED explanation. I was the girl in college that sat in the front row and would not leave until I understood completely. I find that trying to understand this disease is more complicated than anything I have ever tried to learn. I don’t even research his meds anymore because I was making myself crazy with all the potential side effects and interactions. I am only reaching out to try to understand more because I was on the verge of leaving and realized it is not all his fault. I would be a total b***h also if I was always in pain! I am going to urge him to do the physical therapy but he is not convinced it will work. (And yes rest does tend to make it worse) I thought that sitting would help but it does not he told me the other day that he was about to stand up at the table and eat,
He has the ortho shoe inserts but needs new ones. His toes have changed and are fused. I am wondering why a brace was not given as an option. I do notice that his back has a bump in it and he is a little shorter than when we got married. Tkrlady your explanation of pain sounds a lot like his… Bella tooth pain is terrible its even uncomfortable for me to think about it…