Doctor says David Wright's prognosis isn't necessarily negative
The reports on David Wright's ailing back came in fast and furious . . . and somewhat ominous. The Mets' captain has lumbar spinal stenosis, the team said, a version of the ailment that ended the careers of former Met Lenny Dykstra and former Giants running back David Wilson.
That was the bad news.
The good news, said Dr. Jeffrey Goldstein, director of spine service at NYU Langone Medical Center, is that his fate doesn't necessarily have to be the same.
"He has to rest," he said, adding that depending on the severity, reducing the pain could take a number of weeks. "It's not a no-pain, no-gain-type scenario. He's going to have to rest it to heal and it really depends. Some patients, it could take a few weeks, and they do very well."
Lumbar spinal stenosis generally is defined as a narrowing of the spinal canal, Goldstein said. (Stenosis is the Greek word for "choking" or "narrowing.'') This leads to compressed or pinched nerves toward the lower back, Goldstein said, and can manifest in back and leg pain and sciatica.
Most sufferers are older -- the result of degenerative wear on the back -- but younger patients generally tend to be born with a congenitally narrow space around the spinal cord. Many can live with this with little problem, Goldstein said, but the issue is exacerbated if the area is injured -- for instance, a herniated disc.
"It crowds an already crowded space," Goldstein said, and leads to pain.
Goldstein, whom NYU lists as one of the leading spinal surgeons in the nation, said he has treated athletes who suffer from the problem. The rule of thumb, he said, is to begin with conservative treatment and move your way up.
"I do take care of a lot of athletes," he said. "It really depends on the patient, [whether] it's mild back pain or debilitating back pain . . . We do an exercise program and potentially epidural steroid injections and they can get back to what they're doing, and some have it never bother them."
Not having treated Wright, Goldstein said he had to withhold judgment on the third baseman's future.
For patients with severe cases, surgery can be the way to go. In that case, many surgeons opt for spinal decompression, which is minimally invasive and very effective, he said.
This method, called a laminectomy, essentially removes bone, bone spurs and ligaments that are putting pressure on the nerves, according to the American Academy of Orthopedic Surgeons. Some patients can go home the same day, it said.
It doesn't mean that Wright's career is safe, but it does lead to some optimism.
"The symptoms can wax and wane," Goldstein said. "The surgery is the last thing to consider. If we can treat the symptoms and we can get rid of the symptoms with physical therapy and anti-inflammatories, then surgery [is not the answer].''