With hypertropic facet sclerosis, l4-5, l5-s1, should i look to ortho or neuro surgeon to fix? other speciality?tired of injections, don't want opiates

Either: Neuro/ortho spine surgeons can both treat facet arthritis surgically. However, great caution should be taken, as methods to reliably identify patients who will do well with surgery for facet arthritis has not been established by scientific evidence. Outcomes for facet pain surgery are difficult to predict. Some patients are made better, while others can end up worse.

Rhizotomy may help: Lumbar zygopophyseal joint arthropathy "may" cause "facet " pain. It can diagnosed with injections, however the best treatment option is typically a medial branch rhizotomy which is performed by intervetional pain medicine physicians. See a board certified pain medicine physician for discussion on this low risk procedure. Pain mayimprove for 12-18 months.

Consider: Stem Cell Therapy or Platelet procedures to help with healing and strengthen ligaments. While it will not cure facet disease it can help decrease pain and strengthen ligaments in the surrounding muscles and facet joints. Check out Regenexx.Com for more info.