What could cause facet joint degeneration?

Question

Hello doctor,

I am a 48-year-old with back pain that radiates to my left leg. I currently take Gabapentin for my back pain, Tylenol and Tizanidine, Warfarin for blood clots, and Simvastatin for a stroke I had six years ago. My MRI shows degenerative changes in the discs and facet joints in my lower lumbar spine, most prominent at L5-S1.

The noncontrast MRI of my lumbar spine was taken from T11 through S3. My vertebrae are properly aligned, and the bone marrow signal looks normal. The soft tissues around my spine appear normal. The end of my spinal cord (conus medullaris) is at L1-L2, and the distal spinal cord and cauda equina nerve roots look normal.

At L5-S1, I have a bulging disc with a left subarticular disc protrusion and mild facet joint changes. This causes mild narrowing of my central spinal canal, significant pressure on the left lateral recess, and mass effect on my left S1 nerve root, along with mild narrowing of the nerve passageways on both sides. At L4-L5, I have a left-sided bulging disc with mild facet changes and slightly thickened ligamentum flavum, causing mild pressure on the front of the thecal sac and mild narrowing of the nerve passages on both sides.

Kindly help me understand this report.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You have degenerative arthritic facet joints. These are joints that connect the vertebrae. The discs are shock absorbers that connect the two vertebral bodies. At the level of L5-S1, it is bulging behind and compressing your spinal cord and the left-side nerves, which exit from there and supply your legs, causing you to experience radiating pain in the legs.

The same compression is also at the L4-5 level, causing left nerve compression; Hence, clinically, you should have left-sided leg pain and back pain. Also, due to facet joint arthropathy, bending the back backward will cause you pain.

I hope this has helped you.

Thank you.