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

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.

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Comments

  • 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.

  • 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

  • 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.
  • 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!
  • 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
  • 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.
  • 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 image
  • 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.
  • 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.

  • 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.

  • 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.  

  • 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!

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

  • 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 !!

  • 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.

  • 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 image  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 image

  • Hi live just outside the city to the north direction.  image 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.image But can preempt surgeon saying if its better when you don't run then don't run.image

  • 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.image

     

  • 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

  • Hi Emma and Andrea for your response.  Both of your situations sound really bad and my heart goes out to you both.  My appointment on 25 jun is looming closer but don't expect too much!  Have either of you thought about steroid injection at facet joint? My pain and symptoms vary daily but pretty bad considering my age.  Did your consultants know why your cysts occurred in the first place?  

    I am swimming, cycling, yoga and stretching and cross training and have a personal trainer writing me up core exercises with back issues in mind.  A physio in the local area who specialises in back and sport problems did not know about cysts and is trying to find out more.  

    Hope things improve cannot believe how much my life has changed so quickly - an accident would have had same response!

    I want to get over this without surgery and will have to learn to be patient and listen to my body and keep up daily with core, stretching exercises and try and get rid of the weight which has crept up over the last 2 years (not fat but definetely have excess to lose!).

     

     

  • Hi update

    The appointment in June was completed - consultant was running 2 hours late and he had a bad cold.  Upshot is no treatment for me as not running improved symptoms.  I told him I wanted to be able to run again. He said to me my running days are over.  He just Said it is your facet joints.  I asked him what level of degeneration and he said mild to moderate.  Told me to take up cycling 

    Have not ran now for 6 months.  I am going to gym, cycling and swimming along with strength work and yoga stretching.

    Still have not come to terms with it - still feel like a runner!

  • Hi Not sure if this thread is still being looked at, but I also have just being diagnosed with the same problem, although I have been told I can still run short distances on flat surface. I think my marathon days are over and It must be depressing if you are told not to run any more, but I would recommend that if you are OK to run short distances and you can get into Cycling and swimming, then do the short triathlons, otherwise known as Sprint distance.  i.e. 16 lengths of pool, 15 mile bike (approx), and 3 mile run.  If you can do this, it may satisfy you competitive types as at least you are still entering races and getting the added benefit of cross training, but obviously only if you are able or allowed to do the 3 mile run bit.  Good luck everyone. Don't lose hope.

  • Hi Good for Age. Nice to get another response after so long! What is your diagnosis? I never know what they class as a short run.



    As for me I have not ran now for 3 years. My back is feeling okay now and I still maintain core, strength and flexibility training. Bought myself a bike and cycle now. However still would like to sometimes run again. Seen a physio recently and advised I could try short distances but build up slowly walk jog etc. Had tried for 2 weeks but felt stiffness in my back next day so did not progress further. Worried I would damage my back - who knows? ???
  • Hi, still waiting to see the consultant but MRI shows synovial cyst and 2 slightly bulging discs.  Had symptoms now of tingling, pins and needles in leg and foot for 4 months, but strangely no pain.  Osteo said increase runs gradually, I have got up to 6m but had a go at 10 on Sunday and back ached for next 2 days but OK now. Suppose it's bound to ache if you haven't run 10 miles for several months. Have got Edinburgh Marathon end of May but won't be doing that now.  I am tempted just to run to the 9mile point as it is very close to the finish.  Organisers won't let you drop from the Marathon to the half Marathon which is a bit tight and I am sure others will be tempted to just do part of it.  I have had it booked for nearly a year. BTW - I think a short run is anything up to 4 miles. 

    I guess if you hadn't run for 3 years then it must be a bit like starting to run from scratch again.  Guess if you take it easy and work up to it slowly you may be OK. Advice from my Osteo is stop if it hurts and put ice pack on afterwards whether it's aching or not.  It's good that you're still cycling, I've been told not to as its too much leaning forward.  Oh, will need to change my name as no longer good for age!

  • Hi your  MRI does not sound too bad.  Clearly issues are related to spinal stenosis hopefully with some rest it will settle.  Mine did and I no longer suffer pins and needles etc.  My back used to be okay when running but produced pain and stiffness the next day.  Reading about facet joint degeneration (my diagnosis as well as cyst) this is a common symptom.  Also sitting and being inactive is just as painful.  Recommend some form of exercise and stretching everyday as well as strength and core training.   I have ridden on a road bike for 2.5 hours and had no problems afterwards.

    i did a little 20 minute walk/jog last night on dirt track (pavement ban) and no pain today.  Will see how it goes, but intend only to jog to supplement my cycling.  Have only one back and I intend to look after it. The physiotherapist gave me a training programme and it is right back to the beginning again!

    Good for you if you run part of the marathon - get enjoyment from it, that's the main thing!

    Let us know what your consultant advises - how long is the wait to see him/her?

  • P.S  You probably are still good for age - lol.image

  • Hi your  MRI does not sound too bad.  Clearly issues are related to spinal stenosis hopefully with some rest it will settle.  Mine did and I no longer suffer pins and needles etc.  My back used to be okay when running but produced pain and stiffness the next day.  Reading about facet joint degeneration (my diagnosis as well as cyst) this is a common symptom.  Also sitting and being inactive is just as painful.  Recommend some form of exercise and stretching everyday as well as strength and core training.   I have ridden on a road bike for 2.5 hours and had no problems afterwards.

    i did a little 20 minute walk/jog last night on dirt track (pavement ban) and no pain today.  Will see how it goes, but intend only to jog to supplement my cycling.  Have only one back and I intend to look after it. The physiotherapist gave me a training programme and it is right back to the beginning again!

    Good for you if you run part of the marathon - get enjoyment from it, that's the main thing!

    Let us know what your consultant advises - how long is the wait to see him/her?

  • Hello belatedly from Australia. I read this thread with a huge amount of interest as I have, after 3 years, finally got the same diagnosis as you Snawbaw.  I have had buttock/leg pain for over 5 years but have put up with it and found Voltaren (diclofenac) to be my drug of choice.  However, there is a limit to how many drugs you can take.  Having done 32 half Ironmans and 10 full Ironmans plus 12 half marathons, 10 full marathons and over 150 shorter triathlons, I should have expected something to give!!  In Australia, the medical profession has access to so much pathology that you get to hear every possible diagnosis....!  I have seen 2 GP's, 2 Sports Doctors, 4 Specialists, 2 Radiologists, 1 spine surgeon and 1 anaesthetist.  I have had 2 blood tests, 7 CT guided steroid jabs in Hamstrings, piriformas muscle, facet joints, spine, sacroiliac joint and groin.  I have had 5 MRI's of various parts of my lower back.  All this in the last 18 months with no real diagnosis just more, "Lets see if this works"  What is it with Doctors?  Finally, the last Doctor I visited, following a lumber MRI, spotted an 8mm sinovial cyst at L4/5.  My L4/5 facet joints are in very bad condition, hence the fluid and the cyst.  I am due to have rhizotomy on some of the associated nerves and the cyst aspirated at the same time.  My lovely lady anaesthetist has performed three of these procedures in the last month and is giving me confidence that I should experience some positive effect.  I have battled on all this time and sustained my training and events through keeping fit and strong and a regime of flexibility exercises plus the diclofenac.  Bending forward has never been an issue as should be expected with this ailment.  It's spine extension, standing, walking, pushing off after a tumble turn swimming and running down hills that cause real pain.  I can cycle all day no problems and sitting is fine but standing etc has not been fun.  I feel this is a much under diagnosed issue which is evidenced by the time, money and effort that I have put into pursuing a diagnosis, which, at last I have.  Best of luck with your recovery and...it's only pain!

  • Hi Steve brown4. Your right when you say your medical staff do more in the way of diagnostic tests! Why did it take them so long to find it? I have had a further mri recently and have been informed that the cyst has spontaneously resolved. However my l4/l5 has mild degenerative changes and the l5/s1 has mild to moderate changes. I have been offered steroid injection if need for pain and agree that NSAIDS have to be taken with caution - longterm effects not good. I will try and persevere but aim to keep healthy and fit now - don't consider myself a runner anymore sadly. Hope all goes well with you. Good luck.
  • Hi again Snawbaw, I had a wonderful day last friday 11th December.  Attended the Hollywood Hospital here in Perth for the cyst aspiration and facet joint rhizotomy on L4/5, L5/S1.  This was done under local anaesthetic and and IV sedation.  I felt no pain through the whole process and was basically asleep for about 1.5 hours and woke up fine.  I walked out of the hospital after 2 hours totally pain free.  It's now day 3 and still pain free...maybe on a scale of 1 to 10 a .5.  I cannot believe the absolutely immediate difference.  After 5 years of this getting worse and worse it is now much much improved.  All folks of my age (67 next birthday) have spine degeneration and arthropathy, it's just part of getting older.  However, as I have always stayed very fit and flexible my only issue has been pain.  The procedures I had have seemingly stopped the pain, so now I feel fantastic.  My view?  Stay away from physios and chiros and naturopaths and get in touch with an anaesthetist/pain specialist.  My lady Doctor has been an absolute star after all the so called experts that I have seen to date.  Just keep plugging away at learning and getting at the best person for the job.  Like any profession there are good and bad doctors...find a good one!  I talked to nurses in the hospitals as they have first hand knowledge of who are good and who are not so good.  All the best.  I am so happy at the moment and wish the same for you.  Stay as fit as you can it really, really helps.

     

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