Expert: Dr. Brendon J. O`Brien, D.C. - 4/14/2008

Question
I recently had another MRI due to increased onset of sciatic nerve pain, and not really sure which route to take.  I have had 6 epidural nerve blocks for the facet pain; however, now it has increased to so much sciatic pain that it hurts to sit, squat, bend, walk and stand.  I showed it to my chiropractor, and he suggested the possibility of another nerve block (depending where the previous nerve blocks were administered) and traction during my visits to the chiropractor.  I did allow him to do traction on my recent trip, but it did not feel good at all, and didn't feel any better afterwards.  Would there be a need to seek other medical attention.  See below the MRI findings:

Fairly advanced bilateral L4-5 facet degeneration and mild disc degeneration are present.  There is a minimal grade I spondylosisthesis and posterior annular bulging.  Moderate-to-severe central canal stenosis is present.  There is at least mild bilateral L4 foraminal narrowing.

Mild L5-S1 disc degeneration is present.  A small posterior midline annular tear is noted, associated with minimal posterior disc buldging.  There is no evidence of impingement.  

Answer
Hello Mary,

   You may want to see a neurologist to determine if the central canal stenosis is increasing.  Also to make sure your pain is not stemming from the facet arthrosis (which can cause similar symptoms).   The disc and joints are slow healing, anything you can do to reduce tension and swelling in the joint will increase recovery time.... icing (no heat), traction, stretching, pool therapy (no impact), Chiropractic treatment.

Have a great day,
Dr. Brendon O'Brien D.C.