Dr Adriaan Liebenberg My Spine Lumbar | Page 37

My Spine - Lumbar It does not allow for spontaneous remission as sometimes seen in interverte- bral disc disease, but rather has periods of slow deterioration interspersed with periods of quick deterioration in a permanently progressive condition. What are the symptoms? The inflamed facet joints and discs lead to local back pain and referred pain to the thoracic spine (chest) and down to the upper part of the legs. The nerve roots that are compressed lead to discomfort and pain in the legs called spinal or neurogenic claudication. This is a discomfort that typically occurs when walking or standing, and becomes better when sitting down. Spinal stenosis is frequently part of a crooked spine (scoliosis). The degenerative discs in combination with the scoliosis compress the nerve roots leaving the spine, causing radicular symptoms (see the chapter Lumbar Slipped Disc). How is it diagnosed? A clinical examination by your specialist or therapist will allow for a reason- able suspicion, but the only definite way is by doing a magnetic resonance imaging (MRI) scan (see the chapter Tests and Scans). Sometimes, because of technical factors, a CT scan is performed (see the chapter Tests and Scans). This is usually when an MRI scan cannot be performed due to the unavail- ability of an MRI scanner, when there are contra-indications to doing a scan or when technical factors such as the presence of certain metal fusion appa- ratus in the spine make an MRI scan unreliable. See the chapter Tests and Scans for the terminology that you will find on your MRI scan report and what it means in plain English. Other tests that might be used are discograms and nerve blocks. Sometimes EMGs are also used (see the chapter Tests and Scans). 37