Have you ever had lower back pain that caused numbness and tingling sensations to radiate down your leg? Were the MRI results of your lumbar spine normal? When you have lower back pain and your spinal structure looks normal, ask your physician to take another look! Sometimes, it is tissue that is the source of pain.
When I worked in pain management, I often treated patients with lower back pain caused by a synovial cyst forming in the narrow space of the foramen. These tiny cysts lightly touch the nerve root of the spinal cord and cause numbness and tingling sensations either on the side of the leg(s) or directly down the back of the leg(s). If the patient’s pain was unbearable, I scheduled the patient for a steroid injection in the area of the cyst(s). When the injections became no longer effective, then I would schedule the patient for a consultation with a neurosurgeon to discuss the removal of the cysts(s). Read the information below to learn more about synovial cysts.
What are synovial cysts?
● Intraspinal facet cysts (synovial cysts) are fluid-filled round structures with a smooth border that develop on the facet joints of the spine.
Causes
● Synovial cysts develop because of articular tissue protruding due to facet joint arthritic changes and spinal instability.
● On MRIs and CT scans, synovial cysts are seen next to degenerative facet joints on the back side (dorsal).
● Cysts can also develop on the front (ventral) side of the spine and protrude into the intervertebral foramen, lateral recess, or lateral spinal canal.
o This formation leads to compressions of an existing nerve root in the foramen or descending nerve root in the lateral recess causing severe neuropathic and radicular pain.
Treatment
● Treatment for this type of spinal pain is the use of NSAIDs.
● If pain continues to progressively get worse, a consultation with a neurosurgeon is necessary for surgical removal.
References
Pedersen, D. (2016). Spine surgery provides relief for professor with back and leg pain. https://uihc.org/patient-stories/spine-surgery- provides-relief-professor-back-and-leg-pain
Prostock-studio. (2021). [Photo]. People, Healthcare and Treatment. Closeup of sick young African American woman suffering from acute side back pain, sitting on bed at home, touching area with red highlight. Black And White. https://www.shutterstock.com/image-photo/people-healthcare-treatment-closeup-sick-young-1962299
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