Has anyone had synovial cyst from facet joint degeneration and bulging disc

Lumbar back pain and radiating nerve pain in leg

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03/03/2013 at 12:05

Hi

Has anyone ever had same or similar diagnosis.  I had an MRI scan following 19 months of right lower back pain, at times radiating to buttocks and pain down right leg.  I had cut my running back and was only running about 2 - 3 times a week, short distances.  Still had problems.  I was back and forward to my GP with these issues - advised to stop or curtail  running, take up pilates and swimming.  I was advised to see a private physio.  All in all I have seen private physios, chiropractioners, osteopaths, sports massages - all to no avail. (All of them said there was nothing disc/boney wrong it was muscular - how wrong were they!)  I carried out all the advice given and did my prescribed stretches etc.

Anyhow I went back to my GP and basically demanded an MRI.  I have received my MRI results - still to see GP in one weeks time.  The results were not good.  I am 52 years old and I have facet joint degeneration at L4/L5 and L5/S1 and degenerative broad based bulge in discs at same region.  But I have something a bit more uncommon - a  small synovial cyst arising from the L4/L5 facet joint which is displacing the L5 nerve root.  The report states this corresponds with the symptoms I have described.

I am waiting to be seen by the GP for next course of action.  I have looked up the internet as to the causes of these diagnosis and its treatment.  It looks like surgery is the last resort but the best outcome.  Reports state conservative management is poor, as is injection of the facet joint - the cyst will still be there causing the same pressure - and may get larger.  Surgery is very drastic, but what options are there.

I would be grateful if anyone can share their experience if they have the same misfortune.  And did they also give up running, I expect people who have, will not be reading runners world anymoreI   do not know what has caused it - I feel genetics are part of it, as is my gender and running - although I do not think I ran excessively - who knows!

I obviously am not running now, I am going to the gym and using the rowing, bike and epilator machines and swimming.  I have arranged to have a programme for weights to build up core and strength and stretching.  I am feeling very low in mood - I have gained well over a stone in weight since my symptoms began 19 months ago.

03/03/2013 at 18:20

I know a few people who've had these cysts and all have been helped with medication and injections in the short term. The problem is the cysts can come back. It's worth trying the conservative management approach IMO. Btw, I'd also try and find a chiropractor with a special interest in neurology. They have a different approach to normal chiros. 

Also, I don't believe the cysts are as uncommon as you may have read. Cysts themselves are quite common but they are very undereported.

Edited: 03/03/2013 at 18:21
03/03/2013 at 18:48

Tricky....

If you've failed at good/great conservative treatment including at least a 6-8 week stability program then doesn't matter who or what you see, but you've got a true structural issue which needs dealing with by means of something invasive.

The right approach (jab or op) done by the right person will give a good outcome.

If you've got a functional issue (it's what you do with your back, rather than what is seen on MRI) that's been dealt with poor conservative treatment, then anything invasive is not a good idea.

Cyst are uncommon, but they rarely give rise to symptoms, regardless if they are structurally seen to be doing so on MR - your MRI, for your age is about the norm.

Get the right answers from someone who's standing in front of you BUT make sure they got the correct experience in making the call.

One things for sure, avoid rowing like the plague....  I'm sure you can get running again, maybe not to your current standard but it shouldn't be totally out of the question

03/03/2013 at 20:13
Thanks six physio for the advice re rowing .... Was wondering about that one! I forgot to mention the MRI showed lateral recess stenosis which eas displacing the right L5 nerve root medially. But no signs of significant central canal or exit foramin stenosis. Normal appearance of the conus and cauda equine - hooray!

I hope to be referred to a consultant specialising in spines. Do not have enough confidence in others at moment due to poor call in the past, plus shed loads of money with wrong info.

I do need good conservative treatment advice due to latest report, but feel I will need invasive treatment due to stenosis and nerve displacement.

Any more discussion will be gratefully received.
11/03/2013 at 19:31
Hi had Gp appointment today and I have been referred to the spinal surgeons. Gp said I have had a long time conservative treatment (?quality though). Gp said surgeons won't operate unless need to and will refer to pain team if steroid injection is needed. But Gp feels that injection is unlikely outcome. I was told I will have a 10 week wait for initial appointment. I asked if it was worth my while having physio or chiropractic treatment and was told no!

I am feeling anxious about my future health and worry about future training and my abilities to carry out my job. I was told they would not make my situation any worse.

Has anyone got any words of encouragement? Still don't know what caused cyst to arise in the first place!
12/03/2013 at 17:31
Hi there

I was diagnosed with as symptomatic syrinx which extends T9 - T11 and I am neruoroglogically impaired on my left side and right foot. Despite this I have worked on adaptations that now enable me to jog again - doing Reading Half sun.
A different cyst to yours but I would recommend you listen to your neuro consultant - research a very experienced one in your area. Prior to surgery I was losing sensation in both legs and the surgery freed up space for the spinal fluid to flow better and I got sensation back in my right leg.

I know my situation is different from yours but my spinal pain was overwhelming prior to surgery - good neurosurgeons can really assist. Would be very wary of allowing a chiro s to manipulate too much - you definitely need neuro qualified people to advise you.

My adaptations are really strong now and I still work as PT doing GP
Referral and am Exercise after Stroke specialist instructor so life goes on - my mantra - positive thought gives positive outcome. All the best
12/03/2013 at 20:10
Hi Pat

Thank you so much for your reply and sharing your experience. I suppose I am a bit of a coward when it comes to surgery. Always thought my training kept me fit and healthy so comes a bit of a shock when you have something that goes wrong and the Gp cannot give any advice in the interim.

There is an excellent spinal team where I live so hoping they can help soon.

How long ago did you have your surgery? Was it something that came on suddenly? I am a community nurse so my back is much needed in my line of work.

Wish you luck and all the best for the Reading half on sun.

Thanks will stay positive.
13/03/2013 at 08:12
Had my surgery in 2001 at Oxford. Symptoms first started appearing in 93 but misdiagnosed until 2000. My understanding is people can have cysts without realising it and don't give any problems when asymptomatic but if there is a traumatic episode they can become symptomatic.

I've always trained my body holistically, everything is interlinked - try and incorporate every aspect of training - don't ignore strength and flexibility movements. I drive a lot of my movement from my glutes and hard work in my abs and core hugely assists my balance.

Take care P
13/03/2013 at 11:37
Hi Pat, I understand and can relate to your explanations. I had been really hot on strength and flexibility training up until about a year before my symptoms. I changed jobs and the nature and demand was very different.

In hindsight I too wish I had kept the strength and flexibility up and been more of a pain in the bottom to my Gp!

My training now is no running for now .... With lots of other cardiovascular training at the gym and pool plus strength training and stretching. I am also trying out yoga.

I look forward to the day I can introduce some running again but knowing I have DDD and facet joint degeneration at L4L5 I will be very protective both at work and play.

All the best in your training.
07/05/2013 at 22:24

Hi, I had that exact injury last August.  I had nagging pain on one side or the other for months but not in the gym when I worked with weights.  The pain just became so severe, I ended up in ER and had an MRI.  Mine was treated with Celebrex (Cox 2 inhibitor) and aggressive physio 3 times a week.  I was off work for a week of rest.  The synovial cyst affected my right leg and it was significantly weaker once the pain had gone away. I had no power through the right hip. I also had a trainer, who worked with my physio, to strengthen the surrounding muscle gently.  I did not start working with the trainer til about 4 weeks after the ER visit.  I did pysio for 5 months and even now still find that the muscle in the right leg contracts just a bit slower and is slightly weaker but I don't notice it running anymore.  I noticed my gait had shortened on the right and my trainer had me walk backwards on a treadmill to slowly lengthen it.  We worked a lot on strengthening the right side on universal machines with low weights at first.  I saw a surgeon (a perk to my job) and he did not recommend surgery.  Just time, unfortunately.  I also have a good trainer.

07/05/2013 at 23:28

Hi Snawbaw - very interested in this as I've just been diagnosed with advanced degenerative disc disease at L5/S1 with advanced degenerative changes of posterior facet joints at L4/5 and L5/S1.  Also marked narrowing of disc associated with sclerosis of endplates and osteophytes.  I've been doing pilates for a couple of years and yoga for about a year but to be honest it only helps me for a while and the mornings I feel like an old woman as I peel myself out of bed having done many stretches.  I've been referred to an orthopaedic surgeon and as far as I know there are no cysts.  I have sensations and stiffness in my buttocks - I can't call them pains and they move around.  I've cut down the running but not stopped altogether and I'm doing lots of core strengthening work.  I should hopefully get an appointment withinin the next month but a bit apprehensive as to my options.  It's heartening to hear stories if people in similar circumstances who have had good outcomes.

09/05/2013 at 22:26

Hi sorry for the delay just back from my holidays.  To answer both Andrea and Green Eyes.  I have a spine consultant appointment next wednesday for my initial assessment I hope to find out more about the MRI findings and my options then.  I have not ran for 2 months now and I resorted to buying a book for back rehab including core strength and stretches for back issues,  I have been swimming, cycling and eppillator to keep my pecker up.  I have now started yoga and doing that to in ernest!  I am on 10mg amitryptyline for nerve pain.  Things are slowly improving, I do not get back pain on standing evertime now.  But back pain still present, can feel the cyst!  I have neuropathic claudication in my right upper leg, it feels weak but I am trying to strengthen it with spinning classes.  Some things trigger inflammation some times and not others.  I want to get back to being able to run and do long walks.  Last week did not enjoy a  hilly walk - back in spasm and also right leg - horrible.  Looking back I also had a period where on running had severe spasms in buttocks which stopped me in my track could not run and then when got back to it very short gait - could be the facet joints or could be the cyst.  

09/05/2013 at 22:32

I will let you know what information I receive from the spine consultant next week.  Do not want an operation but I had been having severe pain for 18 months and put on weight as pain stopped me from doing most exerises cause I kept trying to run which kept back inflammed etc.  I want to have more of an improvement.  I did see physios before my mri and did not get quality advice or rehab.  Will probably try another physio following advice from consultant when I have more information to tell physio.  Thanks once again for both of your replies - it seemed like there were not many people out there which had these issues!

10/05/2013 at 17:25

Guess what appointment postponed now - wont be seen until end of Jun! 

11/05/2013 at 15:15

I've just invested in a Swiss Ball - wish I'd got one earlier - only had it a couple of days and already noticing a big difference in my core and my back feels a bit better as a result - a bit bad that you won't be seen till the end of June Snawbaw - try ringing up and getting an earlier one - it can't as it seems a long time to wait !  hope you get it sorted soon - I'm still waiting for my appointment so who knows !!

11/05/2013 at 19:35

Hi green eyes luv Swiss ball cheap as chips and brilliant.  Advise getting good book  re exercising with it as there are good and bad techniques - don't want to irritate back. I was rather stroppie on phone and 25/6 is earliest - wheels turn slowly in Norfolk! I am tempted to try and do a run before then to see reaction of back as things improving nearly after 22 months!  It will also help me decide how far to go with any proposed treatment - would prefer least invasive if can do. I also recommend yoga stretching exercises - what was painful a few weeks ago is less so now.  Let me know when you get your appointment.

11/05/2013 at 20:40

I've been on you tube and found some quite good demonstrations of Swiss Ball technique - it's been quite an amusing few days chez Green Eyes   I've been doing yoga for about a year - and pilates for a couple of years - I'm hoping for my appointment within the next month - I really want to see the x-ray - have just had a report which I kind of understand but to see what's what would be better !!  Whereabouts in Norfolk are you ?  Norfolk is lovely 

12/05/2013 at 21:50

Hi live just outside the city to the north direction.   Like you I have had verbal results of mri but want to see pictures and gradings.  My brotherinlaw who is a surgical consultant advises not to have op on spine unless red flag problems.  I understand the issues of spinal surgery but I have been one of life's highly active types, bordering on obsessesional! Have ran and also did martial arts high competitive level - some people just don't get it.  I don't think sport has been cause particularly as parents had OA in spine. But can preempt surgeon saying if its better when you don't run then don't run.

15/05/2013 at 20:04

Try swimming to keep activity up.  When I first had the injury, I did water aerobics just to stay active.  It turned out to be a little harder than I thought considering the injury.  All in all, just time and strengthening my back/abs...slowly.  I also was on amatrytyline as well as Celebrex.  Also, biked backwards on stationary bike for range of motion.  Still have some pain but I think that is with me now forever.

 

24/05/2013 at 21:51

hi there. I am 33 work as a icu nurse. last year had the same symptoms as you snawbaw. I ha a mri which showed facet joint degenartion  bone spursL5/S1 with spinal stensios and  cysts. I have the most wonderful neurosurgen. He told me that it is very rare for to see cysts in someone my age. A week later i was booked in for decompression surgery and removal of these cysts. As soon as i woke up from my op i no longer had the bum calf foot pain. I felt great the recovery was going well but 2.5 months in i started with terrible back hip cal and foot pain. today 6 months in i am left with back pain foot and calf pain. nerves take a long time to heal so hopefully in 6 months the foot calf pain should be gone but im left with awful lower back pain. there is no more surgical ops for me so i have been refered to chronic pain team. thats my story hope it helps as its hard to find help and support, best wishes

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