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Back Problems Message Board

Back Problems Board Index

Some people swear by an inversion table. In fact, when I first began to be bothered with sciatic pain, I took advice I had read online and bought one. It sat in the box in my front hall for about five years, unopened! After buying it, I learned my problems were a bit more complicated and simply trying to create space between the vertebrae was not going to resolve them.

Unfortunately I do not think it will do much for your issues either. Generally speaking, it probably won't hurt things unless you have some instability in a spinal segment. I would suggest trying one before buying one!

Now to your MRI....first, to help you understand an MRI, there are specific words that function as a ranking system to help a doctor determine just how bad something is. In the spine they are: minimal, mild, moderate and severe. Generally speaking, if something is deemed to be minimal or mild, it will be noted but overlooked. Severe is bordering on "it cannot get too much worse" and moderate can go either way....but will be followed and probably treated where possible.

if you look to see where the "severe" is noted, you can begin to identify what is causing your issues. Let me digress again by mentioning that it is a mistake to depend too much on the MRI for diagnosis. Keep in mind that it is just one piece of the diagnostic puzzle. The spine specialist will correlate its findings to what the doctor finds upon physical exam, a basic neurological exam and after listening to your description of symptoms and how they affect your everyday activities.

At all three levels, L3-S1, there are small disc bulges. In addition, at L4-5, it appears that some disc material has oozed out of the disc and is pressing into the thecal sac which encompasses the nerves of the central canal on the left side. This is possibly impacting the L5 nerve on the left.

Two more terms: stenosis and facet arthropathy. The literal translation of stenosis is "narrowing." In the spine there are two areas where stenosis occurs: one is in the central canal; the other is in the foramina, which is an opening located at each vertebral level where a spinal nerve exits the spine and goes out to innervate a part of the body. The lateral recess is a tiny canal that connects the disc to the foramina which frequently gets blocked when a disc herniates. Each has limited space so when narrowing occurs, the nerve is affected ("pinched.")

The facet joint is a synovial joint located in pairs at each vertebral level. They are subject to arthritic change just like the knee, hip, ankle, etc. if you read up on "degenerative disc disease" you will see that each spinal segment includes a pair of vertebrae separated by the intervertebral disc, ringed by the two facet joints, one on either side. These joints allow the spine to bend and twist but keep us from bending too far.

Once the disc begins to break down, there are a series of cascading events that tend to of these being changes to the facet joints. It is this facet joint arthritis that affects so many people and causes lower back pain in so many people. As the discs flatten or dry out or bulge, the facet joint fights to maintain the segment's stability and functioning. Sometimes this results in the joint enlarging. Sometimes the cartilage wears away and will see that, particularly at L4-5, you have a series of things going on....including severe facet arthropathy, stenosis in both left and right foramen and severe narrowing in the central canal. Speaking from experience, this central canal stenosis at this level often results in intense sciatic pain. You can see how no amount of hanging upside down is going to counteract this narrowing. In addition, there are some cysts that are contributing to this central canal stenosis.

You will note that there is moderate to severe facet arthropathy at L5-S1 too.

There is a book I found helpful to understanding the workings of the spine. It includes some useful exercises that will help you more than an inversion table....The Back Sufferer's Bible by Sarah Key.

Have you made an appointment with a spine specialist? This can be an orthopedic spine surgeon or a neurosurgeon whose practice is limited to issues of the neck and back. ( you don't want an ortho who also does knee or hip replacements, or a brain surgeon!!). These two specialties are the best place to go for an accurate diagnosis and plan for treatment. It does not mean you will have surgery!

Good luck. I hope you can find some satisfactory answers to your issues.

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