Hi Dr Corenman!
You were correct, finally obtained MRI and there appears to be facet problems:
“Primary lumbar osteoarthritis [M47.816 – Spondylosis without myelopathy or radiculopathy, lumbar region]
Facet mediated low back pain” / “Sid has axial low back pain on the left greater than right localized over 4/5 and L5/1 lumbar facets. No radicular symptoms today. He has had 2+ years of pain without improvement conservative measures.”
Considering steroid injection or Ablation… I am thinking start with the steroid. I understand this may help but need to be repeated, but apparently the ablation often needs to be repeated as well and it seems like a more involved procedure than the injection.
Realizing you don’t have the MRI to review etc., in general, does that seem like an appropriate course of action or am I likely to end up having to have the ablation in any event? Any relevant data on outcomes I can review or look up?
I’ll be 65 soon and very active and I’d like to get back to running, assuming that is reasonable.
Thank you so much for being a great resource! I often think about you saving me from an unnecessary surgery