Melody,

First I want to say thanks to Glenn...he did an excellent job of explaining. I am just sorry I butted in.

Secondly, I am laughing about Alan and the car seat. Please know I am laughing WITH you...I have the same problem! The only difference is my car seat does not tilt to the left and, not to be rude or anything, but I am not overweight. I think what happens is that of course I am using my right foot to drive so I probably LEAN to the left a little more and even when I use my coccyx cushion.

Okay, I would simply ask the Ortho doc about the MRI you had posted and MENTION the L5/S1 (lumbar/sacrum). It would be up to the doc of course if he wanted to proceed with this. The reason my spinal PM did all 3 is because during an injection of the L5/S1 I guess he could see my tailbone. He asked me when I had broken it. I was like...WHAT???!! And he showed me right there on the flouroscopy machine the two places where it had been fractured. Long story but I am totally clueless as to how that happened. In the interim I was having pelvic pain and of course my feet burned and hurt like the devil. I also had a feeling of a cell phone vibrating in my feet and my left leg. So, you just have to know that everything from the waist down has gone kaput! Anyway, he wanted to see where all the OA was PLUS if there was any nerve issues further down...as Glenn is speaking of and there is. My coccyx too.

Anyway, don't let the doc dismiss it away. Based on the MRI you posted for Alan there are issues. Maybe the doc is just saying it isn't bad enough for surgery I don't know. But I wanted to ask...is this ortho doc a spine specialist? There are OS's and then there are OSS's. And don't let the Neurologists dismiss it either. This is one reason I stick with my SPINAL pain management doctor. As he says, the neurologists know the nerves but they do not really know the spinal nerves. Honestly, I am finding that to be somewhat true. Boy, that didn't sound very nice. What I mean is...my own Neurologist is good but honestly she is kind of clueless when speaking to her about the spinal issues I have. So, I would just print off what Glenn had to say because, speaking strictly for myself, those facets are just killers. All summer long I was in agony with burning and bad pain my feet. But I should add I also had sinus tarsitis in my left foot. And a shot of cortisone took care of that problem fairly quick.

It is just odd to me that bi-lateral facet injections and an subsequent RF did and does the trick....but it does come back when the medial branch nerves regenerate.

Okay, back to Alan and the nerves. I don't know if it would ever go away. I think it depends on what the problem is at whatever level. That's why these injections are DIAGNOSTIC as well as therapeutic. Sometimes they work great and provide great relief and for others they just don't help.

So, the best advice I could give is just to ask the doc again and tell him what we have said here. I know when I asked my PM recently if there was anything else we could do about my own facets. He basically said no....it would be a fusion which is what he is trying to keep me from for the time being. On the other hand, there's my husband with a huge herniation but it has the potential to dry up and go away with time; taking the pressure off of the nerve roots. But that's not true of the facets which is why I keep getting the medial branch nerves ablated. And, well, as I sit here and type there is no back pain and definitely no burning, tingling or pain in my feet.

Well, I rambled enough, I think what Glenn and I are saying...is just don't rule out those sacral nerves. Oh, and oops, another question. Does Alan ever have the feeling of walking on marbles or something similar. I had that too and it was driving me crazy. It didn't hurt it was just annoying like I had marbles in my shoes. But that feeling is gone now too.