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Neurology (Expert Forum)
Have Scleroderma and nasty disc problems
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Have Scleroderma and nasty disc problems
by Mike__0__0, Aug 12, 1998 12:00AM
Thank you in advance, I just completed MRI of Lumbar I have Scleroderma and my Dr. is out for the next 10 days. I hope you don't mind my asking a few questions? Sensory loss was found in my left leg and right forearm by EEG 2 years ago. I have had pain in my legs and lower back and hands on and off for 2 years and with the Crest diease pain becomes the norm at times. My MRI results are degenerative disc disease at L3-4, L4-5 L5-S1, loss of normal high signal in intervertebral discs - moderate central disc herniation at L5-S1 with protrusion larger on right. small focal left L4-5 disc herniation with compression of the left L5 nerve root. disc bulging at L3-4. no spinal stenosis. Facet joint degenerative changes at L4-5 and L5-S1, mild bilateral L5-S1 foramen narrowing and the bone marrow intensity is normal except for extensive subchondral degenerative changes in vertebral body end-plates at L5-S1. There is no paraspinal mass. Pain occurs sitting, bending, well...most always and burning in my legs at night. As I mentioned my Doctor is out for 10 days and I would like you to give me your oppion on what is the next step and do you feel my Scleroderma has something to do with this? Sorry this is so long, thank you again. Mike
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Dear Mike,
Your situation is obscured a bit because you have scleroderma with CREST syndrome,
which can cause numbness and burning of the hands and feet, among other things.
The MRI that you describe is consistent with mild-to-moderate degenerative
changes in the lumbar spine that are common in middle-aged and older patients.
Remember that 30% of the normal population are walking around with bulging
discs and don't even know it. These do not need to be treated with surgery.
Also recall that 90% of back pain can be treated without surgery.
Indications for surgery in a patient with a herniated disc are sharp, shooting
pain in the leg, variably with numbness and weakness in a particular distribution.
Conservative treatment with rest, analgesics and anti-inflammatory medication
may be a better option for you.
Speak to your physician when he returns and see whether he doesn't agree.
Good luck.
