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Cervical Stenosis, Spondylosis, Annular Tear and Scoliosis in Thoracic Spine
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MedHelp Member's Question

Cervical Stenosis, Spondylosis, Annular Tear and Scoliosis in Thoracic Spine

by INGRASS, Sep 30, 2006 12:00AM
Hello again Doctor.



Thanks again for the information you provided in response to my first post on 09/01/06.



I have posted the pictures from the 2005 MRI on the net.  You can view them, if you wish, at:

http://new.photos.yahoo.com/kwujek1/albums



When you double-click the individual pictures, a larger version comes up and the viewer can add comments.  



Since I posted the first time, I have seen both my primary care doctor and a local neurologist.  I had appointments with both

of them the same week.



Before I saw them, I remembered that I had had a consultation with a chiropractor back in 2002 during which he took standing

x-rays of the entire spine. In addition to this, I had also been to a large county fair on September 11th of this year at

which a couple of chiropractors were set up with scale like equipment that measures how straight you are.



One of the chiropractors at the fair did some measurements and handed me a paper with a diagram on it that shows that my left

hip is 2 1/2 inches higher than my right hip, the left shoulder is 7/8" higher and the head curves downward to the left.  The

screening showed that I am putting 12 lbs more weight on my right leg as opposed to my left.  



I picked up my films from the chiropractor that I saw in 2002 and brought both them and the recent diagram to my primary care

doctor with complaints of reoccuring significant left hip pain which he had previously diagnosed as trochanteric bursitis and

given me an injection for about three months prior to this most recent visit. (Con't below)
Doctor's Answer

by CCF-Neuro-M.D.-SH, Oct 08, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.

   I am only able to see half of your post and I am unclear on what your question is.  As far a chiropractors are concerned with the multiple measurements that suggest musculo-skeletal misalignment, are sometimes helpful to some people, but the results inbetween different practioners are inconsistent and they routinely engage in potentially dangerous practices such as "cracking the neck" (could potentially lead to artery dissections and strokes).  Many patients are in need of physical therapy and the services of this type by chiropractors, physical therapist and rehab doctors is very valuable and should not be overlooked.  However, due to the rare potential of unsafe practice and inconsistent practice, then I would suggest seeing a registered physical therapist instead.  I will post more if I can see the rest of your post after this is submitted.
Member Comments (21)

by INGRASS, Sep 30, 2006 12:00AM
To: CCF DOC
I also complained about the back pain that I

spoke of in my first post to you.



I asked him if the back pain could be caused by the annular tear in the thoracic spine and his answer was "Who said you have any problem in the thoracic spine, I thought your problems were with your neck".  This was a little upsetting because when I first saw him, shortly after my initial diagnosis last year from an out-of-state clinic,  I brought a cd containing all of

the pictures from the 2005 MRI and he would not look at it because he didn't want to wait for it to load onto his laptop that he carries around with him.  He started to load it, but then stopped, telling me that it really wouldn't show well enough on his computer. Also, I gave him copies of all the reports that went along with the 2005 visit to the out-of-state facility.  The information regarding the tear is clearly stated in one of these reports and he has had them for nearly a year. We had also previously discussed it.  



Since I did not get a straight answer from him regarding the tear, I figured that I would ask the local neurologist when I

saw her in a few days. I then proceeded to ask him about the recent chest x-ray that had been done at his facility.  

Specifically, I asked about the incidental finding of "mild left convex thoracic scoliosis" and if any additional testing

needed to be done.  At the time, I did not know that the scoliosis, hip pain and bursitis could be related.  He relunctantly looked at the x-ray films from 2002 and then had me bend foward.  He said he could not see it and proceeded to offer me narcotics (the second time he has done so). I told him that I "did not wish to go down that road" at which time he prescribed Relafin, 1000 mg to be taken every morning.



Just to clarify, I am located 90 miles southwest of Chicago and my initial MRI from which the diagnosis stems was done at an

out-of-state clinic.  At the time of the initial MRI and diagnosis, it was stronly recommended that I find a local

neurologist to monitor me for any early signs of myelopathy.  So, I am dealing with both local doctors and out-of-state

doctors.  



So, on to the local neurologist whom I had seen previously 6 months ago and who did briefly view the cd on her computer at

that time.  She told me that yes, the pain in the back was coming from the known disk with the annular tear and kept asking me if I wanted to try the injections.  She also viewed the standing x-ray from 2002 and pointed out the scoliosis throught the spine. She viewed the recent chest x-ray too and kept saying "look how straight your neck is". She did a physical exam and found very tender points along the spine and what I think she said was a muscle knot, a "bump".  When I showed her the diagram from the fair, concerned mostly about the 2 1/2" difference in the hips, she stated that she would not doubt that the measurement was correct.  I felt extremely rushed during my visit with her and left with my head spinning to some extent and a prescription for Zanaflax 4mg which I am to take at bedtime.  I have been doing so for about a week with no relief.



To further complicate things, our local YMCA just opened a brand new, absolutely gorgeous aquatic center with 3 seperate

pools.  One of the pools is a therapy pool that has underwater treadmills and bikes. It also has therapy chairs which are

built into the pool with each chair having water jets that target a different part of the spine.  Since I love the water, I was one of their first visitors and have gone 3 or 4 times already.  I think I may have overdone it, however, as I now have yet another new area of pain, in my back, just to the left of the lower spine.  Could I have pulled or strained a muscle? I also aggravated my neck pain by doing the breast stroke. I have been careful about using the chairs with the jets as they are strong and there is no way to adjust their force like there is in my hot tub.  



One of our local hospitals has re-located their physical therapy department adjacent to the aquatic center at the YMCA.  They do not have a spine specialist or physiatrist, however, and there are none in our area.  The most the local therapy

department has is a therapist with additional training in the McKenzie method.  I spoke with the director of the department

and told him of my diagnosis.  He had nothing to offer except a membership in their wellness program which is not covered by

insurance but is very affordable.  He sent a form to the local neurologist a couple of days ago to get clearance.  Hopefully,

this will help me attain my goals of trying to correct my posture, losing a little weight, and building my spinal muscles.



I apologize for the length of this post.  Writing is therapy, you know.  Anyway, you are probably wondering where this is all

leading.  



I have some more questions which I hope that you can answer.  



1. Does it stand to reason that the hip pain and back pain, since they both began about the same time, may both be

attributable to the scoliosis and the back pain that I originally wrote to you about is not coming from the tear? I

have actually had the hip pain, to some extent, off and on for 5 years. I only sought the injection when it became totally unbearable, although I always told my local doctors about it.



2.      I have been told that there is nothing I can do to stop the progression of the compression in the cervical spine.  Is

this also true for the scoliosis or can this be helped?



3. Will the loss of lordosis in my neck eventually lead to kyphosis?



4. What help is available for the hip pain?  I am not ready to wear orthopedic shoes and don't think I will ever be, but are there shoe inserts that might help?  Is it an orthopedist that I would see for this and the scoliosis?  What

tests should be run for evaluating the current state of the scoliosis?  Is the MRI that I am going to have in Mid November sufficient to evaluate this?  What physical exams or tests should be done. I am concerned about the scoliosis because after doing some reading, I looked at myself in a full length mirror and the right hand hangs to my side about 2 inches lower than the left.  Its pretty freaky looking and I probably won't look again for quite some time.  I am afraid of what else I might see if I look too close.  



5. I have been reading about minimally invasive surgery to remove bone spurs.  There is a doctor in Chicago who is at

the forefront of these procedures.  Would it be worth my time and effort to see him?  Are minimally invasive procedures a possibility for any of my other known problems?



6. Am I putting myself in any danger by waiting until November to have the follow-up MRI?



7 I have suffered from a rather severe viral infection for a little over two weeks.  The constant draining from the

nose into the throat is now mostly gone but I cannot seem to get rid of the coughing.  I have frequent coughing spells that are uncontrollable and have had to leave the room in social settings several times because of them.  This cold and the last one have been particulary severe.  Is this something to worry about? I try to control the coughing with Day Quill and it works to some extent.  



8. Is progression of spinal canal narrowing, without myelopathy, usually an indication for surgery?  I could have taken this the wrong way, but my out-of-state neurologist, whom I really like, told me last year that he suspects that if I

came back this year with progression, the surgeon might recommend surgery. He made sure that I knew that I was "not

off the hook"



9. Do you have any additional suggestions for me as far as what I can do to help myself or what questions I should ask

about my future?  I will be seeing the out-of-state neurologist just before he orders the MRI.  There is already a spot open for it, but I believe it is only open for a cervical MRI, not entire spine again.  



10. I have not yet started the Relafen as I did not want to start two different medications at the same time.  Is the

Relafen right for me given the fact that 2 years ago I was diagnosed with a very tiny diaphramatic hernia?



11. For the last 6 months I have had intermittent problems with my ears.  Most annoying is a strange whoosing sound in my

ears