schmorl's nodes

[xafnndapp]

My sister in Italy is 55, after intense pain at her back for a few days (middle section, with shooting pains also at her rib-cage), she went and had X-rays taken yesterday, and they told her she has Schmorl's nodes at her D-11 vertebre.

No ostheoporosis.



She is quite fit and active, she told me that this pain began after a few days of some extra effort she did carrying something and possibly after an intense session with her chiropractic she has been  seeing regularly for a few years now. She doesn't recall something specific that she did to cause the pain to start.



Her pain is diminished but of course she wants to be reassured that it is not something really problematic.

I did a little research and saw more or less what this is about.



What's the best immediate "therapy" for her?

Rest and chiropratic? Is there something she should be avoiding doing from now on or can she have a normal life?



Thank you very much for your advice.



STEFANO

[star queen]

Schmorl's nodes are not an uncommon finding on spine radiographs. If you look at the picture, it will look much like a bite has been taken out of the bone.  Most of the population has them and doesn't know it. Your sister has probably had these all her life. Schmorl's nodes do not impinge upon the nerves of the spinal cord or cause bulging discs.  There is no treatment for them and they don't change or go away. They are generally painless, so it is doubtful that the pain your sister is having is caused from this finding.  Treatment will not be based upon this finding alone, but on her symptoms, any arthritis found, and general condition of the bone. If your sister is older than 40years of age, I suggest she talk to her MD and see about getting a bone scan (DEXA)to see about any osteoporosis risks.  good luck

[xafnndapp]

Thank you star queen.



Actually she just did a DEXA and she is absolutely fine, no ostheoporosis at all.



She actually is still in pain after one week of the diagnosis and she has to go ahead at pain killers...

[blueyed1980]

I just found out today my husband has Schmorls nodes.  He was in severe pain one day from his eyelashes to his toenails especially in the middle to upper back.  Went to the ER couldnt find out anything, just iflamation of the muscles they said and put him on muscle relaxers, Mobid, and Loracets.  Gradually got worse over next few days could not even get out of bed without help and sever pain, in tears.  He is 44 years old man and in excellent health.  Xrays showed nothing, blood work showed nothing. Finally a MRI came up with the diagnosis. as Schmorls nodes.  Yes he has a also a bulging disc as well but pain was not coming from that.  This pain went on for at least a week with severe pain with help out of bed and then trying to walk and having to stop upper back muscle spasm/pain.  After about 2 months now he is much better but still has a hard time getting enough air in to sneeze, which was impossible at the beginning of this 3-4 month timeframe.  So we are waiting on appointment tomorrow with the doctor on exact extent of this disease.  Pain I assume will return at some point , but no answers to this as of yet.  Thanks.

Debbie

[rpaylor]

This is really interesting. I have just gone through a very similar episode that started about a month and a half ago - gradually increasing pain over a weeks time (from a fall at work) that led to some of the worst pain I've ever had.  Continuous back spasms, couldn't walk or get out of bed without help.  I finally ended up in the ER, where they gave me an x-ray that was inconclusive.  Had to go back to the ER a second time because my legs and feet started going numb.  Finally got an MRI, and guess what - no typical disc herniations and no pressure on the spinal cord, but an acute schmorl's node in L2 with associated edema.  



I started reading up on this, and it seems the medical establishment has recently accepted that even though these are normally asymptomatic, the acute variety can cause severe symptoms.  This partly has to do with the central disc material, which can be highly caustic to blood-fed tissue, coming in direct contact with the blood-rich center of the vertebra.  This causes a lot of inflammation and subsequent acute pain, although this is only part of the picture, I'm sure.  



The good news, from what I understand, is that after the bone heals up properly (which they say can take months), things should be mostly back to normal, although there is a slightly higher risk of back problems in the future.  You need to be careful to NOT go to a chiropractor initially (I made that mistake).  After the bone has healed, then the chiropractor will probably be beneficial, as will some physical therapy to get some strength and flexibility back.

[kwood1]

[kwood1]

A Schmorl's node by defitinition is basically a centralized disk herniation in which the cartilaginous end plate of the vertebral body has sustained fracturing and there was injection of disk material into this fracturing of the end plate. Thus, a Schmorl's node is a form of disk herniation. It is linked to trauma at some point in a person's life. Some people do get them in the teen years when playing sports. Recent research has shown that the material or chemical substances within a disk can cause noxious (painful) stimulus. This is also the case with a typical disk bulge or herniation. You do not have to have direct pressure on nerves to causes pain. Any time the disk loses its integrity and the nucleus shifts to a position outside of its normal confines, it begins to leak chemicals such as substance P, interleukin I, and many other big technical names. These have been found to acutally lead to a dripping of these substances onto the recurrent nerve or spinal nerve itself leading to pain like there was direct pressure on the nerve. This also explains why some people have herniations and Schmorl's nodes that are not painful and others have pain. It is when the disk is actively leaking these substances that it becomes painful. The typical model of thinking is that Schmorl's nodes are not that big of a deal. However, I can tell you by experience, many people have debilitating pain from these. Some helpful treatment notes is that traction and the newer non surgical spinal decompression works relatively good. It will not be a cure all for everyone. Everyone heals differently and there are many cofactors. People with diabetes heal slower for example. use of MSM is a natural anti-inflammatory and has been shown in research to shrink the size of disk herniations. I would also suggest B complex vitamins and use ice at home not heating pads. Disk problems are inflammation. You control inflammation with ice not heat. I have disk herniations and was once basically paralyzed in my left arm due to disk bulging. Disk bulging is seen much like a Schmorl's node. Most physicians see them as being insiginificant because the radiologist says bulge instead of herniation. Junior Bryant of the San Fran 49ers and Chris Depoto of the Colorado Rockies actually had to give up their professional sports careers from "mere" bulging.  I would also recommend Pilates and Yoga based exercises when someone's pain levels begin to decrease for stabilization. Also see a book called Pain Free by Pete Egoscue. I am not selling these products or pushing them. These are recommendations for those in spinal pain and cannot find solutions. I hope this helps.

[bundydi]

Your comments are very interesting. I have had severe low back pain