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What are my next steps with lumbar stenosis and spondylolisthesis?

Posted by gravity3 @gravity3, Oct 28 5:44am

I have both of these conditions. I have not received any clear direction on next steps. I have had two injections of steroids and the both helped with spine discomfort. I began to have burning pain near my right knee and learned that I had deterioration of cartilage so am trying hyaluranic acid injections. The burning pain that would also radiate to my calf continues and now I have some tingling and slight numbness. It seems that this may have to do with my spine issues. What are my next steps? How and where can I get evaluated and get treated. I am willing to become a patient at Mayo if that is the best even though I live in NC. Duke medicine is also an easy drive if it is a good choice. Thank you in advance for your help.

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windyshores | @windyshores | Oct 28 6:15am

Is it possible that the calf sensations are coming from the knee? Is it the same side?

Have you had any recent MRI's of spine? Are you being told you need surgery?

I have radiculopathy, myelopathy, with stenosis as well as listhesis and scoliosis (and 7 spinal fractures) . My PT does massage only, no exercises. The massage helps quite a bit. I sometimes take a muscle relaxant as well as Baclofen (which interferes with communication between spine and muscles) since much of the pain that stenosis and fractures cause is muscular.

Tai chi helps me if I do it enough. I have aavoided surgery so far and see an orthopedist who does not do surgery, for now. Also a functional medicine doctor who is trying different approaches that so far don't work (curcumin, glutathione) but I have found alpha lipoic acid helps sensations.

I do a lot of patches: lidocaine, menthol, capsaicin or topicals lie Ben Gay or BioFreeze. I have a capsaicin patch on my neck right now! I am not supposed to take NSAID's but every once in a while I take flurbiprofen. An MD gave me 5 pills of hydrocodone but I have not taken it yet. I cannot take steroids but they are always suggested until I mention they trigger afib.

What are you doing to help at this point?

REPLY
1 reply
gravity3 | @gravity3 | Oct 28 9:25am
In reply to @windyshores "Is it possible that the calf sensations are coming from the knee? Is it the same..." + (show)
@windyshores

Is it possible that the calf sensations are coming from the knee? Is it the same side?

Have you had any recent MRI's of spine? Are you being told you need surgery?

I have radiculopathy, myelopathy, with stenosis as well as listhesis and scoliosis (and 7 spinal fractures) . My PT does massage only, no exercises. The massage helps quite a bit. I sometimes take a muscle relaxant as well as Baclofen (which interferes with communication between spine and muscles) since much of the pain that stenosis and fractures cause is muscular.

Tai chi helps me if I do it enough. I have aavoided surgery so far and see an orthopedist who does not do surgery, for now. Also a functional medicine doctor who is trying different approaches that so far don't work (curcumin, glutathione) but I have found alpha lipoic acid helps sensations.

I do a lot of patches: lidocaine, menthol, capsaicin or topicals lie Ben Gay or BioFreeze. I have a capsaicin patch on my neck right now! I am not supposed to take NSAID's but every once in a while I take flurbiprofen. An MD gave me 5 pills of hydrocodone but I have not taken it yet. I cannot take steroids but they are always suggested until I mention they trigger afib.

What are you doing to help at this point?

Jump to this post

Yes it is possible. I have worn out the cartilage on the right side of my right knee and just had a hyaluranic acid injection to see if it would help I am three weeks out. My osteos PA wondered if it might be referred pain from L4. I thought it might be helpful to have a thorough evaluation of my back issues and a treatment plan. I have been icing, taking Tylenol, icy hot topical.
I have an MRI but I don't want surgery if I can use otheretoda and surgery has not been discussed. I appreciate your help
This aging stuff !!?? Time consuming to try and support these bodies

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jenatsky | @jenatsky | Nov 5 7:56am

You’ll know when it’s time for surgery when the pain is unrelenting. I recommend finding a PT to give you a home exercise program to maintain your flexibility, muscle mass, and help decrease your pain. You can take NSAIDs to help your inflammation in your low back since steroids are off your plate. I cannot take NSAIDs and have OA, stenosis and PN and had back surgery in 1990. Good luck in your journey.

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1 reply
gravity3 | @gravity3 | Nov 5 8:04am
In reply to @jenatsky "You’ll know when it’s time for surgery when the pain is unrelenting. I recommend finding a..." + (show)
@jenatsky

You’ll know when it’s time for surgery when the pain is unrelenting. I recommend finding a PT to give you a home exercise program to maintain your flexibility, muscle mass, and help decrease your pain. You can take NSAIDs to help your inflammation in your low back since steroids are off your plate. I cannot take NSAIDs and have OA, stenosis and PN and had back surgery in 1990. Good luck in your journey.

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Would you explain why steroid injections would be "off my plate". Thanks

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jenatsky | @jenatsky | Nov 5 8:49am

@gravity3 my apology but I read incorrectly that you were allergic. I mixed you up with someone else. But steroids can lead to increased bone destruction which is why they are limited. Again, sorry for my error.

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1 reply
windyshores | @windyshores | Nov 5 9:17am

@jenastsky and @gravity3 steroid injections are unlikely to cause bone density problems:
https://newsnetwork.mayoclinic.org/discussion/occasional-cortisone-injections-unlikely-to-have-negative-affect-on-bones/
Many doctors don't know about this (orthos for instance) and recoil at any mention of steroids for those of us with bone loss!

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1 reply
gravity3 | @gravity3 | Nov 5 11:37am
In reply to @jenatsky "@gravity3 my apology but I read incorrectly that you were allergic. I mixed you up with..." + (show)
@jenatsky

@gravity3 my apology but I read incorrectly that you were allergic. I mixed you up with someone else. But steroids can lead to increased bone destruction which is why they are limited. Again, sorry for my error.

Jump to this post

No need for an apology. Actually it was a good wakeup call. I hadn't done my research on steroid injections. I am so tired of buying time and treating symptoms

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gravity3 | @gravity3 | Nov 5 11:41am
In reply to @windyshores "@jenastsky and @gravity3 steroid injections are unlikely to cause bone density problems: https://newsnetwork.mayoclinic.org/discussion/occasional-cortisone-injections-unlikely-to-have-negative-affect-on-bones/ Many doctors don't..." + (show)
@windyshores

@jenastsky and @gravity3 steroid injections are unlikely to cause bone density problems:
https://newsnetwork.mayoclinic.org/discussion/occasional-cortisone-injections-unlikely-to-have-negative-affect-on-bones/
Many doctors don't know about this (orthos for instance) and recoil at any mention of steroids for those of us with bone loss!

Jump to this post

Thank you for this information. It certainly dispels some of my concerns.

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