Question
Good day,

I have been experiencing horrific back pain for several years.  It started in 1993 when I was struck by an automobile and then involved in another accident as a passenger a few months later.  Since then, my condition has deteriorated to the point where I was deemed as permanently disabled in 2006.

I recently had MRIs of my lumbar and thoracic done (this month).  The results were actually worse than expected, with 4 discs compressing the spinal nerves in the thoracic (t7-t8, t8-t9 [indicated as the worst one according to the report], t10-t11, t11-t12).  The impression on the report stated: "There are disc herniations at multiple levels in the mid and lower thoracic spine as above.  Cord flattening is most pronounced at t8-t9.

My lumbar has three problems (l3-l4, l4-l5, l5-s1).  L4-l5 states "shows disc desiccation.  Left paracentral disc herniation causing moderate flattening of the right l5 root, increased from previous (this was compared to an MRI I had done in 2011).  Subtle flattening of right l5 root and mild central stenosis.  Each neural foramen is mildly narrowed."

The lumbar issues have not really changed since the first study done in 2004.  At that time, the bottom thoracic spine was noted as possibly an issue, but this moth's MRI was the first study of the thoracic done.

Now that I have bored you with the details, I would like to know your opinion on whether these issues can possibly cause the severe spasming of my mid and upper back and ribs.  All of the ortho and pain docs I've seen were dismissive of these spasms.  I just want to know for the sake of knowing if they are possibly related.

Thank you in advance for your assistance, and I apologize for this long-winded question.

Answer
Hi Stephen,

To answer your question directly, yes, there can be a relationship between the nerve pinching (radiculopathy) and muscle spasms. I'm sure there is no lack of good will amongst your doctors, however, it is often difficult to assess this, especially if the spasm is purely subjective and they cannot actually see or feel it. A Neurologist would be the best source for determining and correlating the location of the problems noted in the MRI's and the areas of spasm. It is also a difficult condition to treat. I am not sure if any of your doctors have included a Chiropractor, however, it may be prudent to see if careful adjustments would affect the spasms. It is also possible that there is direct damage to the muscles and, over time, this would infiltrate them with scar tissue where adhesions can form. These adhesions can attach to nerves and cause pain and spasms. The best technique in my opinion and experience,  both professional and personal, to evaluate and treat this type of problem, would be a certified active release practitioner and you can see if there is a provider in your area.

So, yes it is quite possible for the nerve problems as indicated on the MRI to cause spasms. It is also possible that, along with this or as a separate entity, there is specific damage in the muscles, tendons or ligaments.

I hope this helps and all the best!

Dr. Steve