Neurosurgeon answers: Spinal stenosis, can you get better without surgery? Nope.
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- เผยแพร่เมื่อ 6 ก.ย. 2024
- In this segment I go into detail about spinal stenosis.
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I am in late stage stenosis, and have been dealing with it for 25 years. I am a 75 year old female who weights 124 pounds. Weight has nothing to do with it.. I walked and stayed active,, despite the pain,, until I couldn't. I've had every treatment available. I've listened to dozens of spinal specialist, and you, sir, by far and large have been the most descriptive, easy to understand, and most informative doc I've ever ran across. Bravo! Thank you. Very much. My surgery was canceled twice during covid. It will be rescheduled next week. Thank the heavens and He who controls it.
Praise the lord, I've had surgery in 2017 emergency cervical decompression and fused c3 throughc7 had lumbar surgery this year l3 through L5, because of my Spinal stenosis and Spinal cord damage so I feel for you all and pray 🙏 the good lord will heal us all
Thanks so much for listening! I hope your surgery goes well. Please let me know!
How did your surgery go?
@@markoverline1983😊😊😊😊😊😊
@MrHerks HI, I couldn't walk when I had emergency surgery decompression 6years later I can walk short distance stand for a while but I always feel fatigue so I do what I can, go to YMCA and swim, lift some weights and take yoga classes to stretch and work on balance, life could be better, but it could also be worse, so I 🙏 pray to my Heavenly Father for Healing for all of us going thru this trial in life, peace be with you, Mark O
I must say, you have compassion for people with back issues. Finally someone who gets it! Thank you for teaching/sharing this video. Again, thank you!
You are so welcome!
It's now the end of August 2023. How are you feeling after your surgery?
I got a walker about a year ago and felt wonderful. However if I went shopping still every ten minutes I had to stop because of the pain. I had minor back pain for years and then it got series. I was not fat or fit because I was physically active. Now .I can't move so I've got over weight. I have many explosive things to say to a woman like that after trying everything for 7 years to be diagnosed. MRI finally told the story.
Thank you so much . My spinal stenosis is so bad now I find standing hard let alone walking . I am leant over and in excruciating pain . My back surgeon said we can’t keep chopping off bone spurs they will only come back . He said like your knuckles which are fairly enlarged. I have been fat shamed and told operating on fat people makes it an extremely hard operation . I am in severe pain and I truly believe I will end up in a wheelchair as I can’t walk far . My legs are heavy my feet numb on and off and freezing cold . I can’t cope anymore. I am losing my ability to lead any sort of meaningful life . I was always an active person but I am not anymore. I just am ignored . Loss weight and exercise but I can’t now . I am beside myself .
I totally understand, I'm same.
@@DeirdreOCarroll-hn4dl I feel for you as the pain is unbearable and you get told to lose weight and get moving when you can’t . That’s been my experience. ❤️
Thank you for this very compassionate video. My brother has been suffering for well over a year with severe spinal stenosis pain. His dr said he wasn't a good candidate for surgery because of his weight. He's since lost 60lbs and still in agony. He is officially disabled because he can barely walk and has to use a rollator. He had a series of spinal shots that didn't help. His mental health has collapsed because of constant pain and little hope of improvement. I'm encouraging him to pursue laminectomy because I honestly don't see any other option. He's a veteran and worked the same job for 30yrs. His problem didn't happen because he was lazy.
Its really hard to watch your loved ones suffer. Thanks for being a caring and concerned sister. You mentioned your brother is a veteran. The VA does have centers that specialize in spinal problems. If he has VA benefits that may be an option for him.
The most thorough presentation on spinal stenosis that I’ve ever seen.
Thank you very much!
Wow, thank you!
you beat me to the comment. i will be going in to see a surgeon next month for this problem.
God this explains why I'm in so much pain all the time. I haven't heard a more thorough answer. Thank you.
I’m 27 and 75kg and went to the gym twice a week, worked a physically demanding job. Stenosis hit me like a truck. Excruciating pain when I do physiotherapist, and walk.Slowly withdrew from my regular activites. Brings me to tears. Even loose feeling in my leg. Tell me to walk it off.Can’t wait for the surgery.
This guy has good presentation skills.
Excellent and professional synopsis.This is a great perspective on lumbar spinal stenosis and explicit, thank you!
I was officially diagnosed with this last year with stenosis in several vertebrae, but most in L4 and L5 with L5 diagnosed as severe. I've always have had some degree of back pain since I was in my early thirties. I started going to a chiropractor then for adjustments and that's when they said I had a curvature in the lumbar region similar to scoliosis. One leg being shorter than other due to hip higher on one side, my left.
I was told by a chiropractor it was in range of scoliosis, although not severe.
My pain is in left hip, glute,entire leg and into foot as well. I also have pain in the ilieum area inside hip that radiates thru my lower left abdomen from back to front.I also have arthritis from the left to right side in the back.
Decompression on a machine has helped the most over a period of time better than anything for me. Almost eliminating all numbness on left side at one time.
Physical therapy has shown me a few stretches and exercises that help a little, but I no longer can do other certain exercises or yoga positions.
The left side numbness, foot dragging and tingling along with the hip and abdominal pain has returned since I havnt maintained it with the decompression.
Maintaining is all you can do to keep from getting worse.
Hi, RB. Thank you for the comment! It sounds like you have low back pain with severe stenosis in the setting of lumbar scoliosis.
What a great coincidence! I just talked to a guy who had this same combination of issues. I'm posting my interview with him today on Best Practice Call in. This show is listed under the podcast section of the Best Practice channel. Check it and please let me know what you think. th-cam.com/video/OIKnG-rp0Ak/w-d-xo.html
@@BestPracticeHealth no
First off, thank you. This clarifies a lot.
Secondly, I feel like I'm playing Stenosis Bingo at this point.
I was diagnosed with Lumbar Stenosis earlier this year. For years I had thought it was just a pinched sciatic nerve. I had also thought I had bowel blockages as well because I would go three or four days in between bowel movements. I also have days where I would drink a gallon or so of water and only urinate once or twice in a twenty-four period while other days just a glass of water and I'm up every half hour or so peeing my brains out. As for sexual function, I had honestly thought it had to do with age, weight, and stress levels. In my 20's I could go for hours on end. Now, at nearly 40, 30 seconds and the hydraulics quit working for a few weeks to a few months. As for walking, I used to enjoy walking all over town. Now, I can barely walk to the mail box without pain and burning down my legs. I can barely stand to cook anymore. If I don't get the dishes washed in ten minutes or less pain starts in. I work 10 hour shifts and upwards of six days a week. I'm on medication for nerve pain that wears off a few hours in. I'm on my feet for those 10 hours. If I sit down for a few minutes, getting back up to move around again becomes a hell of a challenge. Often sitting down or laying down doesn't help the pain either.
Another big issue I have is that my limbs will start twitching uncontrollably. It will start at the feet, then the legs. It usually starts when I'm sitting for long periods of time. And when I lay down, it gets a lot worse. Like I'm trying to run a marathon. I have to sleep on the couch because I don't want to bother my wife. I'm afraid I will kick the crap out of her while trying to go to sleep. I even have this particular symptom in my hands and arms.
I honestly didn't realize that these symptoms were connected to this one condition. It's very depressing if I'm being honest. I'm really not looking forward to surgery, but everything I have seen and read this far is pointing to it. I am trying to put it off as long as possible because I can't afford to take the time off work for the recovery period I would need.
Thank you again Doc for clarifying a lot of these symptoms.
Thank you, you are compassionate and sympathetic, all my respect to you.
The person that sent you that letter shame on them! They don't know what it's like! I'm actually very active just found out that I have spinal stenosis in my cervical spine. Hoping to get an MRI soon to see if it's all the way down.. also suffering with bulging and herniated discs in my cervical spine. Hoping not all physical therapist think this way as that's not giving me a very good outlook on things like you said can't judge people if you're not going through it yourself. Still shame on that person. Also thank you so much for the in-depth look at what is going on with spinal stenosis. One of the most informative videos I've watched yet
I agree. It's nice to hear the real facts for a change.
I listened again to this and this doctor totally understands the crippling effects of spinal stenosis. We can’t just walk it off we used to until we could not any longer . One doctor who truly understands. Thank you for your compassion and understanding
Thank you. I have had spinal stenosis for many years and I agree with everything you say. I can walk or stand for, maybe, 10 minutes but then my legs lose feeling.
No exercise or weight lose can solve this.
You are so welcome. But what happens next? If you’re down to walking less than 10 minutes, it sounds like it’s severe enough to require laminectomy surgery. Have you seen a doctor? Don’t forget to find a neurosurgeon or orthopedic Spine Surgeon who meets the best practice criteria.
I've got severe spinal stenosis with 3 levels of pinched nerves on both sides. The neurosurgeon sent me for a epidural steroid injection. It only lessened the pain about 35%. I see the neurosurgeon again on july 3rd and if he doesn't suggest surgery I will ask about it. I also have DDD, Bulging discs, AnkylosingSpondylitis. I'll be 65 in October and have had the pinched nerves pain constantly for 15 months. I wouldn't wish this on my worst enemy. I never thought I'd be looking forward to a dr appt but this one I am. Thank you for the info & compassion.
Thank you! You’ve given me so much information. I’m a 76 year old female who’s been going though pt,shots,orthopedic with the pt and shots not helping. I found a spinal surgeon will hopefully fix me. Again thank you!
Thanks for the video. I got diagnosed with severe spinal stenosis, degenerative disc disease and osteoarthritis. My surgeon said my back looks like that of an 80 year old man. Also have disc issues in neck. Had a fusion in my neck in 2018, spinal fusion L3-L4 in 2019, L4-L5 S1 in 2022. Had a spinal stimulator put in in May 2023. Was told I’ll need L1-L2 also done down the road because the discs are shot. After the stimulator was put in they had me go to a PT for therapy to build my core strength. I was able to do some exercises yet others aggravated pain shooting down my right butt and thigh. PT told me it’s just my hamstrings and I said it’s not. She sent a note to my pain doctor saying I don’t want to get better because I’m not doing all the exercises. He actually agreed with me that it’s not my hamstrings and it’s my back. I’m now having pain just above my left butt area and has went down into my left hip and outer left thigh the last week or so. Feels better when I stand up but when I’m sitting or lying down it gets worse. Going to call my Orthopedic Surgeon and talk to him about this issue. Also have issues down my right arm with tingling and numbness now especially when lying down. Pain doc thinks it’s a pinched nerve in my neck and waiting on insurance to approve the MRI 🙄
Back pain that radiates to the butt and outer thigh is typically coming from an inflamed facet. This is common after fusion surgery due to stress on the adjacent levels of the spine. A good pain management doctor with a lot of experience in radiofrequency ablation is the best provider for this problem most of the time. th-cam.com/play/PLsYo8ENYsvpxK1Qd64vbWI81Ab4phZs6Q.html
Thank you for this video. It helps me to realize I am not being a baby about the pain I am experiencing and I am on right track for treatment. I had successful fusion in 2007 on L4&L5. Fast forward to 2022 diagnosed severe spinal stenosis now will replace original hardware and fuse L3 to L4. This video gives me peace that there is hope to be relieved of some of the severe pain I have had since Oct that no amount of exercise, shot, or walking can cure. Thank you for ur expertise.
You are so welcome! The best treatment for stenosis adjacent to an old fusion is controversial. Your doctor is recommending the traditional treatment of revising the fusion and extending it. Another approach is to do a minimally invasive laminectomy above and see how you do. If you have back pain then it could be treated with RFA.
Great video, very informative. I've been seen by so many for severe leg pain for the past 7 years and had no luck till my Dr had me get my back checked, diagnosed with degenerative disc disease, which has led into Spinal Stenosis. MRI July 15th and can't walk more than 5 minutes or stand more than 10 without horrible pain in my butt and legs. I'm only 54 and should not have to be thinking about losing my job and ability to function, its making life very hard to continue
Sounds so unfair. I recorded a video response for you. Please watch.
Here on my site: bestpracticehealth.tv/
Or here on youtube.
I hope things are going well for you
@@tarataylor6489 Thanks! They aren’t but I’m still breathing lol
Thank you for this video and explanations I've been looking for in trying to interpret my recent horrific MRI.
Glad it was helpful!
Thank you Dr. Lieberman. Your videos are by far the most honest information I have found anywhere! I have severe spinal stenosis and an L4-L5 fusion in 2018 which lasted about four years. Now my MRI reveals the same thing but mostly up around the L3-L4. I am under 200 lbs, and otherwise in good health at 74, but I cannot walk more than five minutes or stand two minutes without moderate to severe pain mostly in right buttocks (often both) and going all the way down to my foot. My prior surgeon suggests another fusion and/or laminectomy, but I am trying everything else first with the realization that I need to strengthen my core, a key factor to recovery no matter what I choose. Question: what do you know or think about stem cell therapy for my condition? Is it recognized as a feasible solution or do you think a second surgery is needed along with core strengthening afterwards? Thank you for all you do, and if you weren't retired I would certainly travel to see you for consultation! Bob
Thanks so much for the comment and the nice words! I totally agree with core strengthening for anyone with spinal stenosis as stronger muscles reduce back wear and tear and may slow degeneration. But unfortunately, core strengthening is not a substitute for decompression. I am concerned about you because a recent study showed a much higher (50%) rate of death for people who decide to live with severe spinal stenosis. If the MRI report says severe, then I recommend you have it addressed with a surgeon. These days you can often find a minimally invasive surgeon who will do a laminectomy above a fusion without the need for an additional fusion.
After 20 years and been told nothing wrong with me by a physical therapist with a bad attitude .Now diagnosed with Cervical stenosis C456 and Chiari malformation. 14 years ago my low back and feet started to hurt and for 8 years bad nerve pain in legs and weakness , My lower back and bum feels numb, I could nip it and not feel it I also can't lie face down in bed.. About 7 years ago I had facet joint injections L5 SI joints which did not help. My bum and low back worse when sitting and relieved by short walk but I also have a problem with low mid back, turning over in bed (rotation) and and I cant stand in one place for more than a few minutes (short walk easier)and also sore lying face down. If I am on floor to stroke the dog It feels like someone has stabbed me and have trouble getting back up. Can't do that now with upper body problems. They didn't call my facet joint problem Stenosis, they just said it is degenerative, that was 7 years ago and I have continued to suffer since. My name is on the list for spinal clinic again but I will have a while to wait. I am getting slower and slower in everything I do to try avoid pain and weakness . I can see what is happening and I know it not going to end well. Any advice would be helpful as fed up with popping pain pills and putting on pain gel Thank you for this channel. P.S I was a gym instructor , loved cycling and mountain biking, had to give it all up. Michelle
Glad to hear you do not have stenosis... a new study shows a higher death rate without surgery! The knife in the back pain is typical of discogenic pain. You may want to watch my plalylist on that. Chiari is uncommon... does the mri have a syrinx? Do you have headaches?
@@BestPracticeHealth Yes headaches, and impulse headache when looking left and right ie when driving No syrinx though at last appointment I didn't get told a lot., dizziness and tingling that comes over top of head and a lot of other symptoms like jaw pain , blocked ear feeling ,difficulty swallowing pain and tingling all the way down to fingers. They also thought I might have Cervical Instability, I was to have a CT scan with movement and ended up with basic static extension then static flexion even though they said it had to be with movement for the diagnosis for CI. I am hoping when I go back to clinic for lower back they will do something to help as leg pain been really bad for years. I hoping to get Chiari surgery and Cervical Stenosis surgery soon. I will look at your other videos, thank you.
Dr. Thank You. I have severe Spinal Stenosis. I have had two heart attacks in the last 3 years, I've noticed my pain is gone far worse, since I spend more time in bed but much of that is due to pain. One of my family members told me recently that I'm getting fat because I gained 20 lbs in the last 2 years. I was deeply hurt. I have a very complex medical history and I am very proud that I've made it this far at age 56. I have congestive heart failure, survived two myocardial infarctions, history of diverticulitis, osteoarthritis, left temporal lobe flaring. I was told this is a form of epilepsy. I have had two bouts of Bell's palsy that has never fully resolved and I still have left facial paralysis 26 years later. I have osteoporosis, osteochondroma, interstitial lung disease caused by valley fever, now COPD, neuropathy, irritable bowel syndrome, I need knee replacement but I am not a candidate because I have knee Baja, caused by two previous knee surgeries. I often suffer from sciatica problems but I'm able to deal with that with ice easier. I have other things wrong with medically as well. I just can't remember everything at the moment. I've had about 16 broken bones in my life and 14 medically necessary surgeries. I recently developed a problem with not knowing when I need to go to the restroom to urinate oh, I have no feeling that Clues me into that anymore. I've had no sex drive for about 10 years. Listening to this video has really helped me not feel so guilty about gaining weight. I am very happy to be alive at this point with everything that has happened to me, including sepsis due to pneumonia, after my second heart attack. I know I shouldn't let somebody's comment about my weight bring me down but people are very judgmental. I was deeply hurt by the comment I have to be proud of myself that I have survived. After thinking about it this family member has had a weight problem her entire life, so why I let it bother me is beyond me but I would have never hurt her that way. Listening to your video has been very informative. I will be speaking to my doctor about considering surgery fix my stenosis, if I'm a candidate due to blood thinners excetera. Thank you for all of the information you've provided. You have taught me a lot and I am thankful. Have a very blessed day! 🙌
Prayers for you and all of us, I pray our heavenly father will heal all of us, I'm ready for the Rapture so I can go home with Jesus
Dawn, I'm so sorry to learn of all the problem. But your light is still bright and shining through the rain! Keep up the good fight! You've got this. I hope you have a good medical team backing you up.
Reading your story, you have been very courageous dealing with all the health issues you have suffered, and you should be proud of yourself. Your friend has no understanding of what you have been through,and is lacking empathy. Best wishes from Britain.
Really sad to hear your story. Sending you prayers and the power of the universe to heal and help you.
Sir I have also stenosis. I am suffering from formillnal stenosis. Can it be cured with exercise??@@BestPracticeHealth
Literally found out that I have multi-level degeneration with moderate to severe central stenosis at C4-C7 just this week. I guess this explains my symptoms of headaches, tingling with pain, etc. IT sucks, because I've been dealing with SVT for the last two years and the last two weeks or so, I've had 2 episodes that was above 200 BPM...Just problem after problem.
Wow. I'm sorry you are going through all this. Have you seen a spine surgeon? Severe stenosis is dangerous.
@@BestPracticeHealth No I haven't. I have a visit with my primary care doctor at the end of the month. I'll be getting her to refer me to a specialist. I'm only 35 years of age......didn't think I'd be dealing with this much health issues.
I was diagnosed with Spinal Stenosis over two years ago, after an MRI. I spent a year and a half doing Physical Therapy exercises, and six months doing Pilates exercises specifically directed towards the problem. I am not overweight, I work out three-four times a week, and I'm generally active. The pain and numbness subsided to a considerable degree, so I felt pretty optimistic. I then had another MRI. The result? No change whatsoever to the stenosis. I have just had the corrective surgery. So, the 'fat and lazy' thing? No.
Oh, so sorry. But your experience was predictable. You would never know it by looking at the internet, but exercise cannot reverse spinal stenosis. It may (and often does!) suppress the symptoms, which is fantastic. But exercise cannot make a small hole larger. Only laminectomy surgery can do that.
Exactly. I was in shape and worked out for decades. Spinal Stenosis put a halt to everything!! That PT in the email needs a huge dose of compassion and a walk in our shoes!!
@@Webbgurl2000 Quite right. I hope your situation has improved.
Can I ask what surgery you had and what results you are experiencing now? Thank you for your time.
@@krhunt1014 I had a decompression at L4/5. The surgeon removed some ligament and what he described as a bony ridge .That was eleven months ago, and today I still have some numbness and altered sensation in my left foot as a result of the nerves being impinged by the stenosis. I have been told that this may or (most likely) not get better, but fortunately it is no more than a mild inconvenience. All of the other symptoms I had been experiencing (leg pain and weakness primarily) seem to have been resolved, thankfully. I do get some occasional back pain, mostly if do something dumb like bending and twisting at the same time, but this is nothing like as severe as it was before the surgery.
Are we talking about severe stenosis as in the central ones being the dangerous ones? I ask because this is what I had on my MRI “grade 1 anterior spondylolisthesis of L4 on L5 leading to moderate to severe stenosis of bilateral neural foramina. There is evidence of bilateral spondylolysis of the pars interarticulares of L4. No significant central canal stenosis noted.” I get flare ups a bit of tingling on left foot when I do weightlifting and low back is never feeling “normal” and often hurts locally on the joint area (almost always). Sometimes I can’t bend forward during flare ups.
I was told that I have severe spinal stenosis in a text message from my doctor's nurse. I didn't know that it was life threatening until I heard your video. Thank you.
Yikes! Make sure you get the care you deserve.
Thanks for your sensitivity Dr 😊
No kiddin'
You are so welcome. Thanks for the comment!
This talk is concise and informative - thank you
So is your note! Thanks so much for taking the time to reply. You seem very kind.
Thank you for schooling
You're welcome.
Where is this doctor at! I have spinal stenosis and it's progressing fast, I have been seeing a crappy doctor who just wants me to do physical therapy and I simply can't, I can't even pick up my kids at this point.
i’m sorry to hear your spinal stenosis is preventing you from being the parent you wish. That must feel so frustrating. There are lots of good doctors who can do laminectomy surgery when necessary. Look for one who meets the best practice certification for spine surgery. That someone who is board-certified in orthopedics or neurosurgery, if their orthopedist that they have completed a fellowship, and they do a lot of laminectomy surgery through a tube or using a minimally invasive approach.
Thank you for this helpful tutorial. The time you’ve taken to explain this is very appreciated!
Hello Dr. Thank you for laying down the facts and truths. I am a healthy 72 yr young active male. 5'7"; 137 lb. Diagnosed with S.S. 04/2022. Yikes! A former dancer/gymnast and have had 3 KYPHOPLASTY procedures since . L5, 4 & 2. I continue to teach my fitness exercise classes for seniors weekly. Brings joy for both sides. I've been to 2 different surgeons (Northwestern Hosp. & Weiss Memorial Hosp.) Both highly regarded. And at this juncture they both concur with..."to hold off on anything invasive/surgery for now" Please, any Chicago surgeons you'd recommend? As I'd like a third opinion. Let me know if and when you may be here in town. Are you located in a near by state? I thank you. David A Harbin
Can you go into detail more on “bowel” issues… I’m dealing with cervical issues and having surgery next week. But now I’m dealing with back pains and abdominal pain
How screwed am I? From MRI written report: Impression:
1. L1-L2: Left lateral/foraminal heriated nucleus pulposus with annular tear (2 mm) causing left neuroforaminal stenosis.
2. L2-L3: Concentric broad-based herniated nucleus pulposus (2 mm) causing bilateral neuroforaminal
stenosis.
3. L3-L4: 5 left lateral/foraminal herniated nucleus pulposus (5 mm) causing left neuroforaminal stenosis.
Central vertebral canal stenosis exacerbated by facet arthropathy
4. LS-S1: Far left lateral/foraminal herniated nucleus pulposus with annular tear (3 mm) causing left neuroforaminal stenosis.
5. Neuroforaminal stenosis as a consequence of diffuse bulge of the annulus fibrosis, bilaterally, L1-L2, L2-L3, L3-LA, L4-L5, L5-S1 exacerbated by grade 1 anterolisthesis L3 on L4 and L4 on L5 and grade 1 retrolisthesis L1 on L2.
6. Bilateral facet arthropathy, most apparent at L3-S1. Large bilateral facet joint effusion at L3-L4
I’m concerned about those severe bilateral effusions at L3/4. That often occurs when someone has degenerative instability. Ask your doctor about standing flexion and extension x-rays of the lumbar spine. Hopefully you’re not unstable, but if you are fusion is your only real treatment.
I was actually told I am not eligible for physical therapy because my legs are already numb and I'm having trouble feeling my pelvic region, due to spinal stenosis.
Sounds serious. Again, I think we should review the MRI on the show. How does that sound?
I developed severe spinal stenosis and severe facet stenosis a year after a single level fusion. I just have tingling in one of my legs. Do you think that I should get surgery sooner than later while I have no issues with walking. I am in my mid 60’s.
Good presentation. If I lean forward, I get the sharp stabbing pains in my left foot. I have L4/5 showing reduction of disc height and a diffuse disc bulge. Facet osteoarthritic changes bilaterally with mild ligamentum flavum hypertrophy. This results in a mild canal and moderate bilateral foraminal stenosis. Standing up straight gives me some relief but sitting is painful. I feel sorry for everyone who is going through this.
The MRI changes listed do not explain the foot pain. Pain with sitting is usually due to an annular disc tear. But the MRI report does not mention that either. Have you seen a doctor? Someone needs to figure out what is causing these symptoms so that you can get proper care. You can come on the show and we can go over your issues, or submit a question by video to me with a pic of the MRI here: bestpracticehealth.tv/
@@BestPracticeHealth Hi Doctor Daniel, thanks for your reply. To keep my previous comment short, I did not mention that in a MRI and CT scan three years prior, that a annular tear was detected in disc L4/5. From what I have learnt since then, is that it is possible nerves have grown into the annular tear. I have viewed many of your videos and I have come to the conclusion that I should have laminectomy or spinal fusion. I do not have facet joint arthritis/spinal stenosis symptoms so much, mainly the painful electric burns down through my shins and into my second and third toe. Also, a cold water sensation down the front of my left leg when I walk. I am seeing another neurosurgeon soon and I will be asking a number of questions that you have suggested. They will be surprised about how much I know because of your informative videos. For that, I am very grateful.
Oh wow, Thank you for this video. I have had stenosis for years. I can tell it is getting worse. It is amazing how many people say it would help to lose weight. I will be asking the dr for a referral at my next appointment. I have always been afraid of back surgery, now I fear not having the surgery.
You are welcome. I'm so glad you are going to get the stenosis addressed. Let me know how the visit goes!
Great video. Benevolently functional manner in which you address this. Thank you.
You're very welcome!
I just had an MRI a few weeks back an my condition remains the same from 2013 my 1st MRI so from 2013 to 2023 10 years, no change in my condition, glad I'm not getting worse
Totally! That is good news.
Hi can you PLEASE tell me what have you done for it not to progress and stay the same?
Always looking forward to listening to all your great advice 👏👏
I appreciate that!
Yes! I’ve only watched the first few minutes so far, but GOOD LORD, I’ve learned the hard way that you can’t “walk this off”. In the past I wondered, “Why don’t older people just walk more?”, not realizing that it could be pain they’re just not whining about. I’m 5’7” or so, maybe 130lbs or less and I did something related to a Hypertrophy squat, etc. plan that then got worse after a long walk trying to recover. Haven’t gotten the MRI yet because I’ve been more concerned with trying to recover and want to allow whatever’s going on to heal a little, especially if it’s a disc (but more likely stenosis, some arthritis issue because I have seen that in my knees and I think hips and shoulder. Not sure if I ever had a back MRI.
My walking went from being able to do 15 mm or better to 33-1:25 mm with so much pain I just wanted to sit down in the middle of traffic! I did in fact stop a few times. So, no, if they’re in that level of pain from piriformis and sciatica, they can’t walk. It feels like really bad IT band pain too. Exercises are only temporary and things like “flossing” Only seem to make it worse later.
I have a very different experience when I see older people walking slowly now.
Fortunately, I can still go out and bike 47 miles at a Z1, Z2 pace, but I’m understanding more has to be done if I want to walk. Either healing or invasive, but I really don’t want a bunch of fused vertebra either. Sigh. I also learned I have some scoliosis I didn’t know about.
My walking is still very slow even with a methyl prednisolone pac. It’s crazy!
Hang in there! Keep walking but do get an MRI to assess the severity of the stenosis if possible.
I agree with you Doctor. I will be get in touch with you after I get my mri videos. I just did one more mri recently. But it looks no different than earlier. I have no pain though but still my nerve are doing funny things.
Awesome! I am looking forward to meeting you!
My doctor's have let mine get so bad that I'm bed bound most of the time. They say moderate shouldn't cause those issues. I can't walk more than a few minutes at a time. I can't stand in one spot. They kept telling me that I needed to lose weight. I lost 135 and it didn't help. I'm sure I'm going to die within the next couple of years. I feel like I already am.
I'm so sorry you are going through this! Hang in there. Did you have an MRI? It would really help to know what you are dealing with.
@@BestPracticeHealth I did. This is the result of my most current which is a week old.
at c5-c6 there is a broad disc bulge with mild bilateral degenerative changes of the uncovertebral joints more prominent in the left side. this produces moderate segmental spinal canal stenosis with moderate left foraminal stenosis without significant right foraminal stenosis.
at c6-c7 there is a broad disc bulge with small overlying osteophyte eccentric towards the left side producing moderate segmental spinal canal stenosis without foraminal stenosis.
at c7-t1, t1-t2 and t2-t3 there is no disc herniation, spinal canal or foraminal stenosis.
I also have a herniated disc in my thoracic. This is 4 years old and I haven't had an updated since. I can no longer wear a bra due to pain from thoracic and cervical pain.
FINDINGS: Thoracic segments maintain appropriate alignment. No fractures. No destructive lesions. Benign vertebral body hemangiomas are noted at T5, T6 and T2. There is mild multilevel degenerative disc desiccation and loss of disc space height. Broad-based disc protrusion left paracentral position T6-7 measuring 2.3 mm in AP dimension. This impinges upon the thecal sac and flattens the left anterolateral aspect of the cord but does not produce a significant degree of canal stenosis. There is no cord edema. No other protrusions or extrusions. There is mild facet arthropathy. No abnormal signal in an intradural position. Cord maintains normal signal at all levels.
Postcontrast imaging demonstrates no abnormal intradural, dural, epidural or osseous enhancement.
IMPRESSION:
Slight interval decrease in size of the disc protrusion at T6-7. This flattens the left anterolateral aspect of the cord. Cord maintains normal signal at all levels. No other protrusions or extrusions. No significant canal or foraminal stenoses. Multilevel degenerative disc disease and facet arthropathy as discussed above.
I've asked for a myelogram so that they can track the nerves to see if the MRI isn't catching an impingement and have been refused. They make me feel like they think I'm mental and refusing to get around and just urinating and defecating myself. I also can't get pain medication for it, either.
I'm so thankful for seeing this video to know that my symptoms are real. Thank you so much.
impression:
stable mri of the cervical spine with degenerative disc disease, facet arthropathy and degenerative changes of the uncovertebral joints at c5-c6 and c6-c7.
The person who sent you letter are the type of doctors and physical therapists Ive been dealing with. Yea, its been maddening. I use a walker now, 67 just to leave the house. Used to love to walk. Now i walk with my walker 60 feet.
It sounds like you have severe spinal stenosis and are becoming non-ambulatory. That is typically a surgical problem. Have you seen a surgeon?
Thank you dr. I am currently in a back rehabilitation program where I see a biokineticist and physio therapist(advised by my medical insurance). I was diagnosed with spondylolisthesis?- L4 slipped over L5 with resulting narrowing of spinal canal, also a few osteophites. I do not know if the slippage can be corrected with excercises, so far I feel no difference after 7 sessions of back rehabilitation. I am scared of open back surgery and especially fusion as I am still active and would like to remain so for the next 10 or15? years. I am currently 70.
I suffer from constant sciatica pain.
What the heck??? Im not overweight, im very active, mostly healthy, but my spinal stenosis is really deteriorating my quality of life. Iam in constant pain.
I love your way of describing the case,
Is there such a thing such as one-sided, sudden onset spinal stenosis? I went from zero symptoms to serious buttock pain overnight after a day of easy paddling and swimming.
I have sever spinal stenosis and l have terrible pain and l am getting worse. It's hard to walk and l used to be super fit. I am not overweight. I feel like my body is slowly going paralyzed. I love listening to you as you help me to understand what is happening to me. I'm not even 50 years old yet. It affects me daily 24/7 and terrible pain. Thank you for being so kind and understanding. I am getting worse, and l was first diagnosed in 2019 and l am getting worse - whoever wrote that is rude and doesn't understand anything about Spinal Stenosis. I can't even clean my home anymore. I am an ongoing outpatient with my hospital and now my Neurosurgeon is sending me for a 2nd MRI. My first MRI was done in 2020. Sadly my condition is getting worse and it's freaking me out. Do you recommend surgery? Or it won't make any difference? As there is no cure for Sever Spinal Stenosis.
I am so glad you are seeing a surgeon and getting good care. Surgical decompression (laminectomy) is the only effective treatment for severe spinal stenosis. Period. The longer you wait the more risk you take. A recent study showed a higher rate of DEATH for people who don't get surgery. Any surgery is scary, but it sure sounds like you need it!
@@BestPracticeHealth Thank you so much for your help. I will talk with my Neurosurgeon about Laminectomy. As l have severe left C6/7 foraminal stenosis irritating the left nerve root and moderate left C4/5 and bilateral C5/6 levels. This was in Sep 2022. Surgeon is sending me for another MRI of the whole spine as something is happening in my lower spine also. Scared. :(
@@BestPracticeHealth Good afternoon from the UK. I'd be very interested to view the study you mention about a higher death rate if severe spinal stenosis is not treated by surgery. Are you able to provide a link please? Thank you.
If it put pressure on the spinalcord you need surgery
@@markoverline1983 Yes lovely l know. I'm so scared. :(
Your description fits me exactly. ❤ I Freak some people out when my legs go stiff from numbness, and I bend over to relieve the pressure. They think I am collapsing. 😂 I am having surgery next weak.
Good luck with surgery! I hope you found the right doctor, and we can both expect everything to go well. Please let me know how it turns out.
You are a very informative in your opinion and presentation. I have it can’t walk much very bad groin pain thighs butt lower L4/5 S 1 had leminectomy some 50 years ago had very bad fall 6 months ago very frustrating bone spurs and slippage also T 11, 12 fractured also C5,6,7 both arms waiting now for Fussion now waiting for 6 months very very worried if I can take it fussion But I can’t kept going on like this as I lay down all time. I am 72 year old male retired law enforcement now many years ago.
First, thank you for your service in law enforcement-a career that is undoubtedly tough on the spine. Also, I appreciate you watching the videos. I understand you are awaiting ACDF surgery. I hope your surgery is scheduled soon. Performing ACDF was one of my favorite procedures because of its significant benefits and the typically smooth recovery. I wish you a successful surgery and a swift recovery. Please accept my hope, best wishes, and gratitude.
Some time pain but my back gets very tired have to stop walking 😮 why I have spinal stenosis operation soon laminectomy
Sounds like a good idea! Please let me know how it goes.
That initial comment you read is the fault of many doctors who don't practice preventive medicine. They only want to push pills, so how do they expect patients to react when that is the type of care they are use to receiving? I stopped going to the doctor years ago because of their tendency to only want to push pills. Unfortunately, I now have severe lumbar stenosis, involving L4/L5, L5/S1 discs pushing from the front of spinal canal and bone spurs pushing from the back of spinal canal. Standing or walking DOES NOT help my pain, it makes it worse, and I am in excellent physical condition. However, there are many other activities that do help, such as various stretches and core strengthening exercises. I am currently doing a 4 week PT program, but I already know it's not going to be a permanent solution. Next we will try steroid injections and I hope that works because I absolutely do not want to have surgery.
Great points. My grandfather was a family doctor and he took care of people from birth to death. Prevention made a lot of sense back then. But one thing to consider today is that medicine has become so large and complicated that not everyone does the same thing. Chiropractors and physical therapists do the preventive medicine for the low back. Medical doctors and surgeons usually don't come in until those things have failed. It's just become so complex we need specialists to get the best care to the most people.
I feel worse in pain when I walk or do exercise; it’s my body! I’m the one who should to know! I love to exercise but sometimes I can’t! And then about the weight; I feel better whenever I eat; I feel like the muscles stop to hurts so bad if I’m not hungry! I just don’t know what to do
How can I send you an MRI of my lower back and get your opinion? I have severe pain in lower back and right hip. It’s unbearable and getting worse. I have lost bladder control, ED. I’ve had 2 fusions at L3-L4 and L4- L5. I use to have above average balance, I now have bad balance! I’m a career martial artist of 46 years. Right hip replaced, both knees replaced. I do not have a normal stride any more- I walk like an 80 year old. Like you said, I walk bent over a shopping cart to help with the pain. I have a back surgeon, Cory Wallach, Anderson Clinic, Virginia, but I’d like to see someone for a 2nd opinion. My quality of life sucks. Your explanations of back problems were the clearest I’ve heard. Please get back to me.
Oh, man. I'm so sorry you are suffering like this. And that fusions have not helped as much as expected. If you want to review your issues and MRI together call 602 256 2525 and come on the show. I will look forward to meeting you.
I have finally saw my MRI with an ortho. My back is mess. So bone spurs pinch nerves, 4 herniated disc, and spinal stenosis. I did not go into details yet. I guess I was in shock when I saw the picture. All I remember is pain injections. The Ortho does not want surgery. I'm in tramadol and gabapentin.
I have been comfortable if I don't move a lot threw out the day. I feel that I have been this way for 3 years so why wouldn't I want surgery instead of more pain treatment? Please help. It is July 25, 2023.😢
First of all, if you don't have a pinched nerve that requires surgery then you should probably not be on gabapentin. In addition, if your surgeon does not see a role for surgery, then why would you want it? It sounds like you need strengthening and rehabilitation.
MRI confirmed spondy grade 1 with broad based disc herniation at L-3/4.
Radiology report. 1. At L3-4 there is a grade 1 anterolisthesis and disc herniation with facet hypertrophy resulting ni severe central canal and lateral recess stenosis.
2. Mild bilateral foraminal encroachment at L3-4-
5. 3. No acute fracture. Conus medullaris intact..
Question? Considering MILD procedure …your thoughts as neurogenic Claudication getting worse.
Trying to avoid fusion.
Several studies have shown that the outcomes of laminectomy alone are just as good as laminectomy with fusion for grade 1 spondylolisthesis. Given the severity of your L3/4 stenosis, I would recommend opting for a minimally invasive lumbar laminectomy performed by an excellent spine surgeon rather than the MILD procedure.
Thank you for your input. Yes, the MIlD procedure is concerning in that it is performed by pain Mngt as it seems it’s in a neurosurgeon’s territory.
i had triple bypass in april worked up till the day before and knew about heart surgery for almost 2 months
want allowed to do much for 6 weeks and have had problems since
constant pain unlike the back pains i had for the last 30 years that would lessen or go away
You would be amazed how many times I’ve heard this story. Often times activity keeps us healthy, as we say, motion is lotion. And someone becomes inactive often due to a heart condition and suddenly the back is a huge problem. Although it’s happening right after a heart condition, and surgery is almost certainly not an option as it requires you to be off blood thinners, it’s a good time to find out what’s wrong and what you need to do about it. The best way to do that is to pick the right doctor, have appropriate imaging, and then follow up and match the imaging to your symptoms. Once you know what’s causing your symptoms, then you can use this channel to figure out the appropriate treatment for when you’re ready. Good luck with your heart condition. Stay safe.
I'm crying now. You are talking about my problem. I'm 47 and i feel like zombie. My QofL is zero. Spondylolisthesis and spinal stenosis. I can walk 500m only, i can't work ( i'm a farmacist). Surgerry (cito) im my country 2026 march. This is a joke. I'm slim. I swimm and do excercises. This is unfair.
I feel ya, I'm 35, and the same situation, non stop pain, need surgery, insurance sucks, can't afford it. Blood pressure is nuts cause of pain. I'm a farmer, no one cares. Feels like grabbing a electric fence all day while working/walking.
I was in a car accident in 2013 and 2015, I was very athletic playing basketball a few times a week! And I have been living in pain ever since, I walk and sometimes try to get to the gym, if I do too much my back swells up and the pain spreads to my solar plexus, once it goes to the front I'm finished, some days are better than others, I work with my doctor's an have done water PT an still seeking treatment for my injury that I feel like I will have to live with for the rest of my life, if my disc swells up my blood pressure goes up, cause of my stenosis an pain I could go into the emergency room, true story an have my blood pressure recorded at 120/80 and go back and lay on the bed and had them record my blood pressure and it would be like 160/100 just like that rough estimate, so I have to watch my blood pressure, this all occured from the accident not from poor diet or anything, I have to grab a 🛒 to walk thru the grocery store
The only effective treatment for severe stenosis is surgery. A recent study showed a higher death rate for people who avoid surgery. Have you seen a surgeon?
Thankyou Sir excellent presentation 👍
I don’t get the pain down the leg but I can’t stand or walk usually longer than 5 minutes before my low back is excruciating and have to sit down. I had an mri done and the doctor told me I have congenital spinal stenosis and the lowest disc is black. I also read on the report spondylitic changes at L5-S1 cause mild central canal narrowing and mild left neural foraminal narrowing. It also says l4-l5 ligamentum flavum hypertrophy and facet arthropathy. It says other things too but I’m worried because I am having sudden urges to pee and then if I don’t hurry and go pee I will go in my pants. It’s like I can’t control it no matter how hard I try.
Thank you for your comment. I’m sorry for the late response. Spinal stenosis can present as back pain more than leg pain. Claudication is traditionally pain down the leg, but everyone is different, and sometimes that’s just not the way it works. Balon bladder incontinence requires really severe stenosis. The MRI report that you shared really wouldn’t normally be sufficiently severe so has to cause ball and bladder dysfunction. That means you have incontinence of unknown ideology. This really needs to be worked out quickly. Have you seen a doctor? It’s essential that you get evaluated by, a trained medical professional and get the care you deserve.
So how do you find the best surgeon available and what do you look for in that surgeon, to have the best outcome for s.s.
How does scoliosis affect it? They just said I've had some narrowing in the spacing but they didn't use the SS word after my MRI
Dr. I don’t know if you still reply to this video but I really need your help. Everything you have said I experience I had an MRI done the radiologist has filled half a page talking about the different things going on in my lumbar. I injured my lower back at work and all this came to light. It was suggested that I go three rounds of shots. Company Insurance denied that. My Dr said he won’t suggest surgery just shots. In the meantime Im suffering.
It gets worse even after an eight hour surgery which afforded eight months of pain relief followed by laser surgery with four months of pain relief and then nothing but increasing pain. Physical therapy aggravated whatever is happening and now I have nothing to look forward to but a life of increasing pain or the possibility of??
No. There are good treatments for back pain, but they must be matched to the cause of the pain. Check out our playlist to be sure you know what is causing your pain.
th-cam.com/play/PLsYo8ENYsvpwuYzaOvGl_yCxIWhtcX5mI.html
Frequency Specific Microcurrent won't hurt , may help 👍
Thank you sir. You explained this better than any Dr I've been to. I know this is a long shot being it's been a yr since you posted this , but I would like to get your feedback on a few things. I'm 53. I have a 9.7mm anterolisthesis of L4 over L5 in standing Xray. It's 4.1mm on supine MRI. Broad based disc bulge with moderate canal narrowing. Narrowing of bilateral subarticular zones, contacting the descending L5 nerves in the lateral recess. Advanced facet hypertrophy with moderate to severe foraminal stenosis. that's what my MRI says. I also have broad disc bulges at all the other lumbar spaces. The Neurosurgeon I saw earlier this month says I can go another 10 yrs without needing surgery. He did not do a physical exam. I have severe back pain but most of the pain is in my inner calves and feet. Along with intermittent numbness from the waist down. I can not feel toilet paper when I wipe. I was told to just get injections. What is your suggestion? BTW I had NCS/EMG that was abnormal. I have been told to lose weight and stop smoking and I would just feel better. I'm struggling with both due to the fact that I can hardly walk or stand for 5 min and my only pain reliever is bc powders and an occasional Tylenol. The stress from being not listened to and taken seriously is why I'm struggling with the smoking. Basically I'm asking what would you do for someone like me? One more thing. I was diagnosed in 2022 with the spondylolisthesis and mild DDD. Sorry this is so long but, I'm tired of being brushed off because I'm not the "perfect" patient. Like I don't matter because I'm a little overweight and I smoke. Thank you for taking the time to read this(if you do).
Interesting. I got better - completely out of pain - from spinal stenosis without surgery. It took several months. Pain started in June; pain was completely gone by the following April or so. It is possible.
Very informative, but scary as hell. 6 weeks ago, I was relatively fine, with minor backaches when I overdid it on fix-its. And I was jogging a mile 3 days a week. Then, one of my little projects was a concrete slab outside requiring moving, mixing and placing some 30 bags of concrete. The next week was a progression from achy back and legs to crawling back from the bathroom. The MRI indicates "There is severe central canal stenosis and severe bilateral neuroforarninal stenosis". Mornings suck, but after that I can walk 15 or so minutes without too much pain. But based on the info you've shared, it appears I'm headed for surgery regardlesss, and the requisite physical therapy and pain management are just a waste of time.
Wow. What a strange way to find out you have severe stenosis! Hang in there. You're headed for surgery. Don't get nerve damage first, it may not be reversible.
It appears I have a TLIF ahead. So, like it or not, I'm going to have to have all sorts of hardware installed. Not sure which is worse - the persistant pain, or the fear of the surgery.
Im so scared. Now I don't know what to do. I've already had fusion on L4L5. Now that I have been diagnosed with severe spinal stenosis I don't know who to talk to. Seems like the people assigned to help me don't really care.
Laminectomy is the only correct treatment for severe spinal stenosis. Find a good spine surgeon near you and talk to them.
How come after the screws broke in my lower back ,from my hardware "surgery inplant, I am haveing Bruning and bowl problems, night and day ,and my bum hurts the same ,injury was L1incomplet,28, years later ,anybody know .
Thank you
Well, I'm physically fit and I got spinals to nurses. And it has nothing to do with weight. And PT does not do a d*** thing for somebody with spinal stenosis. Physical therapy is great for a lot of things but not spinal stenosis. These people have no idea what they're talking about by I know if I went to PT. I could walk in there. But after they'd have to wheel me out in a wheelchair. That is how spinal stenosis works. It is the most weirdest painful thing.
Sir, I am from India, and I am recently detected with Spinal stenosis in my L4-L5 (9.5mm), L5-S1 (7.5mm). I have pain in my lumbar area and difficulty while I stand up straight and then within 5mins I am normal. There is no problem in my legs as I can drive 2 wheeler, 4 wheeler for hours and walking as well climbing stairs. My neurosurgeon asked me to do some yoga exercises and regular exercise.
Nice to meet you! The normal spinal canal is around 30 mm, so the fact that you have 7.5 mm at L5/S1 is pretty scary! As stenosis gets worse one goes from pain in the legs with walking to pain with just standing. This is worrisome. What is your life like? Are you healthy? I don't even know how old you are. But you need surgery, not exercise. Watch my video on lumbar laminectomy here: bestpracticehealth.tv/spine/#SpineLumbarLaminectomy
lumbar laminectomy procedure is safe? I am scare too . I am Asian 44 years old . Already have L4-L5 it narrowed press down the nerve . My surgeon send me to try pain management shot . I just get the shot done 2 days ago and rest . The pain management doctor she told me your surgeon, should do the surgery for you ? As I have terrible sciatica, limp , limited mobility . And have arm /hands numb and /tingling/migraines started terrible. My surgeon also send me to get the shot now too. My MRI came back with C5-C6 nerve pinched down . I can not walk /sleep /stand or walk . I walk around with my walker . I can not able to drive more than 20 minutes to the store . My sciatica leg left shooting pain , and when I drive my right leg is start to numb/tingling/shooting down pain . My surgeon doctor will try pain management shot first before the lasted decision is surgery. What do you suggest about my symptom . I am now can not able to work . I use to be nails technician/seat all day and use my hands/finger to work and now I can not lift anything more than a gallons water ? Or a cabbage head on my left hands. Both Hands and both legs weaks
Does leg pain happen with cervical stenosis or only lumbar? I have cervical, so only my left hand and sometimes arm has problems at the moment, nothing in my legs.
Thank You 😊 🙏 😊
You're welcome 😊
Thank you 🙂
You are so welcome. Thanks for watching.
Then Why do the Insurance companies wait so long to ok for surgery,, I am at severe age 53 ,pain with wallking, and the insurance company still says no....
. That’s hard to understand. Every insurance company is required to publish their criteria for surgery. Look up the guidelines for laminectomy for your carrier. There may be some information that Carrie requires that was not included by your doctor in your packet.
Please don't judge me but I weigh 400 lbs.
I have severe pain in my lower back with spinal stenosis and other problems as well.
My question is will a surgeon fix my back at this weight?
Judge not lest you be judged. And yes, you can get fixed at your weight. You definitely need the right surgeon. Come on the show to discuss..we need to talk. phoenixspineandjoint.com/resources/best-practice/.
Hi Doctor, I have pain on my left side leg from hip when I standing but nothing while walk, sleep or sit. please tell me why the pain very hard while I am standing [ can't even stand a minute ] I am 65 older. Thank you.
Burning pain on the outside of the thigh when standing is typical of a facet problem. Watch my video on facet mediated low back pain and see if that makes sense.
Life doesn't seem worth it, when you have to live this kind of life. People always have something ignorant to say about others. Im tired of chronic pain in my back an the Drs in Iowa don't seem to understand that living my life this way , is Truly not living!!! I'm very Sick of being ignored!!!!
You have got to find a new doctor. Everyone deserves help when they are sick or in pain. Sounds like you are not getting the help you deserve. It is really easy to fall into depression with chronic pain. RESIST! Use this channel to figure out what is wrong and FIND THE RIGHT DOCTOR to get better.
I have neurological? Spinal stenosis. I have had an MRI but the surgeon recommended an injection first and if that didn’t work maybe go for an operation. The injection did work for quite a while but I had to have a colonoscopy and that seemed to stop the effects. I don’t really have a lot of pain just that heavy feeling in the tops of my legs and only recently when I get up from seated it takes a while to start walking properly. I can walk for maybe a mile without having to sit down.
My question is, I can play 18 holes of golf but only in a buggy, I jump on and off and everyone thinks there’s nothing wrong, But it takes me a week to recover, Is this going to make my condition worse?
Thank you for your video, Doc. I have spinal stenosis in my L5S1 due to disc extrusion (disc herniation). I did an MRI and the doctors said I have had for the past 5 or 7 years but its been around 3 months that I have numbing, tingling and shooting pain on my right leg while walking or standing and pain in bed too while turning over to another side. I am doing PT exercises and walks to maintain the pain. I am in my 30s. My question is that is my condition absolutely surgical or it might get better over time or when should I do surgery? What would be the severe case and symptoms which would require surgery?
Great question. Microdiscectomy surgery for disc herniation is advised when you have unbearable pain or a neurological deficit. Since your body typically "digests" the herniated disc, laminectomy surgery for stenosis caused only by disc herniation is not typically needed.
@@BestPracticeHealth Thank you very much, for your valuable response, Doc.
Same situation here 😭
Hey there Dr. You mentioned your weight in this episode. Do you believe it could be a low functioning thyroid? Had the same sort of issue as a child and youth. Tend to always be on the heavier side. Never been a couch potato. Always into sports and active.
Believe it or not, I was actually treated for high thyroid as a child. That was when I first got fat! I don’t think my problem is my thyroid now. I think it’s more over eating.
I have severe stenosis in the lowest 2 disks. No one will operate because I'm too heavy, the symptoms are too severe to exercise, and I didn't lose any weight at all on a 1500 or 2000 calorie diet. What do I do?
If you have obesity that is affecting your health and you have failed a medically supervised diet then consider bariatric surgery. The results from a gastric sleeve are excellent, and the safety profile pretty good.
Yep just had surgery
I’m praying that surgery will help my pain go down
I certainly hope so, too. Hang in there. Let me know how it turns out.
Just got MRI results back - severe spinal stenosis
I heard surgery guarantees only 50% of positive results. What are your thoughts on that?
The waiter evaluate the effectiveness of surgery is to look at groups of people who had the same condition you do, underwent surgery, and their complications and outcomes. There is no surgery that is 50% effective, cause quite frankly, that would not be good enough to Justify the risk of undergoing the procedure. What exactly is wrong? Is it stenosis and you need a laminectomy? Is it a herniated disc and you failed epidural and want to consider microdiscectomy? It’s really worth your time to get specific, understand the problem, and the proposed solution, and then ask your doctor for the information that shows the effectiveness rate.
My Dad walked into this surgery ...... never walked again after..
I'm really sorry to hear that. Would you be willing to come on the show? I'd love to hear his story.
In other words - I’m F***ked and I’m only 38 ‘ mild stenosis ‘ ‘ mild scoliosis ‘ ouch ! It’s scary stuff , it’s a grim reality:(
Can you see the level of stenosis without contrast with an MRI?
yes. Ghoniem contrast is not helpful for the visualization of stenosis. MRI without contrast, in particular, the T2 series, are effective in showing the width of the spinal canal, and how much cerebral spinal fluid has been pushed out by the process. Gallium is most commonly necessary to assess a herniated disc if you’ve had prior surgery, or to evaluate for the presence of a tumor.
sorry for the transcription error, it’s Gadolineum. That’s the contrast agent typically used for magnetic residence imaging.
Thank you so much for answering my question.
How long does sciatica nerve take to get better?
Ninety-four percent of people with non-specific low back pain (which includes those with sciatica) get better in 12 weeks. I wish it were faster. But it takes a long time. Given that reality, most people with MRI showing a herniated disc and sciatica will have a series of 3 epidural injections 2 weeks apart from a pain management specialist.
I'd love to hear more about what's going on with you. Contact me by filling out the form here:
phoenixspineandjoint.com/resources/best-practice/
Heyy doc i am only 21 and have moderate lumbar stenosis with 2 moderate size disc bulges in l4-l5 in a lot of pain everyday,my symptoms improved with physical therapy but they never cleared up enough to give my life a purpose,what are my options?😢😭
The first step in overcoming back pain is to educate yourself about the cause to prepare yourself to work with a doctor to get better. In your case, I can't really suggest where to start without looking at your imaging. I'd recommend my playlists on low back pain and herniated discs with sciatica.
I know this is not very specific! Please contact me and upload the images and I can give you a better answer.
How are you now
@@sultankhan3085 im getting surgery soon bro
Hi thank you an excellent summary. My mri showed severe spinal stenosis at l 3/4 due to hypertrophic facet joint arthripathy, ligamentum flavum hypertrophy and circumferential disc bulging. Mild to moderate spinal canal stenosis at l2/3. Multi moderate to severe facet joint arthropathy. Plus a mild scoliosis convex to the right and centred at the l1/2. I’m nearly 70 n yes until my bilateral knee replacements I was active cycling a 100 km twice a week. Now I’m nearly at my wits end tried facet injections and rhizotomy at 12 levels still no joy. I go to a sports physiologist 3 Tina a week but I feel I can’t go on. I can now only walk 200 metres n fall in a heap. I go to a neurosurgeon in Western Australia but he’s advised to do nothing but exercise what would you suggest to get walking again?
Never stop walking. Motion is lotion, and the more active you can stay, the better and healthier you will be. Having said that, the MRI report you shared is typical of people who need L3/4 laminectomy. That can be done these days through a tubular retractor in 45 min. The risk of pretty low, and it will likely change your life.
Have you seen a surgeon? Stenosis will only get worse.
@@BestPracticeHealth thank you for the reply. Yes I see a surgeon here in Perth. He’s referred me to a pain management specialist who has completed a rhizotomy n facet joint injections. He doesn’t want to do the laminectomy has recommended this b a last resort. Maybe the surgery is more refined in the US as he’s said it wd b huge n require screws. Thank you Heather.
Sir can stenosis be cured with exrecises? I have forminal stenosis. Can it be cured?
39 y.o. I already have degenerative disk disease, scoliosis, osteoarthritis and now I think I've spinal stenosis too. Is it possible for me to get the stenosis surgery with all these other conditions present? thank you
Yes. Laminectomy for spinal stenosis almost always happens int he setting of arthritis and degenerative disc disease. It is also usually not needed at such a young age. Have you seen my playlist on back pain? Figure out what's causing the pain, then what treatment is best for you to pursue at this time.
I was diagnosed lumbar spinal stenosis 10 yrs ago, but have yet to have any associated pain or issues. ? I workout 5 days a week and still do dead lifts and squats. I'm guessing my workouts and activity have paid off ? I'm 55.
Please guide me what excercise you will......I diagnosed with mild canal stenosis l4l5
you are so awesome! Thank you for the comment. Motion is lotion. Not just for joints, but for spinal stenosis. The longer you can stay active, the longer you can enjoy no symptoms, and hopefully remain strong and slow, the progression of the underlying problem. Just be aware that it is a progressive problem. At some point you’re likely to require treatment as you get older. Get an MRI at the first symptoms of any nerve problems or spinal cord dysfunction. You might even consider getting an MRI just for radiographic surveillance at some point to see what’s going on in there. I wish you the best.
Doc anything coming down the pike that is minimum invasive ?
Yes. Growth factor injections for discogenic pain is coming.