Question
I have been going to the same doctor for two months now for back pain. He told me that my x-rays were normal (cervical and thoracic) then ordered an MRI of the cervical spine only and this cam back normal as well. I took it upon myself to go get my x-ray and MRI reports, and it turned out that the x-ray report does say (for the thoracic spine):

Coned AP and lateral views show minor multilevel degenerative disc changes and a minimal levoscoliosis centered around the T9 level.  The vertebral bodies are completely formed at each level.  No acute compression fractures are seen.  No osteolytic or blastic lesions are noted.

What does this mean in layman's terms? Could this be the source of my back pain and numbness?  My doctor said there was nothing wrong with me and there was nothing more he could do for me. Thanks!

Answer
Dear Tina,

First of all medical doctors often say that there is nothing wrong on x-rays, because they can't treat any dysfunction there...the best they can offer is medication which will do absolutely nothing to help the source of pain...it does not address degenerative conditions or poor spinal function.  Secondly, the medical radiologist only reports on what he/she see's on the films concerning pathological conditions...such as degeneration, tumors, bone spurs, fractures, and metabolic processes that may require drug delivery therapy or surgical intervention...  They are rarely if ever concerned with the biomechanical relationships involved as their training does not place any emphasis on the structure of the spine in relation to the normal spinal models.  

I would expect to see that your head is forward of the shoulders, the shoulders may be rounded and that your mid back is rounded concerning your posture.  This presentation is consistent with the pain you have described, your x-ray results, and a common functional problem called Upper Crossed Syndrome, which can be effectively managed by addressing the over tightened muscular structures of the chest, anterior deltoids, anterior neck and strengthening the weak muscular structures of the rear deltoids, rhomboids, trapezius, and posterior neck muscles.  

X-RAYS...In layman's terms: your discs are losing their hydration content, drying out and degenerating. The report does not indicate whether or not you have lipping or spurring (arthritic changes) around the discs at those levels, but this is common with disc degeneration.  This may result in achy sore pain levels in the upper back, and referred pain from the degenerative disc, and fascial and ligamentous structures.  This pain is again often overlooked in general medical practice because it does not follow a dermatomal (nerve root) distribution.  The levo-scoliosis means that the spine has a lateral curve to the left, but I can not ascertain the magnitude of this scoliosis because the angulation of the curve has not been reported.  Since the radiologist describes it as minimal, I would opine that it is less than 10 degrees.

The fact that you have generalized degenerative changes in the disc indicates that you have longstanding postural distortions and spinal joint dysfunction.  Degeneration takes place over time due to abnormal compression and movement of the spine.  This needs to be addressed with postural exercises, spinal manipulation and improved postural muscle control...ergonomics of your work space should be considered as well.  

I would suggest that you have all of this evaluated by a musculoskeletal specialist such as a chiropractic physician.  Chiropractors are exquisitely trained in the diagnosis and management of musculoskeletal pain syndromes and have high effectiveness in improving posture, ergonomics, pain reduction and increased function.  Even research published in medical journals has proven the effectiveness of chiropractic care placing it as the best treatment for back pain over accupuncture, physical therapy, and medical care. Patient satisfaction rates are also the highest in health care.  

Your complaints and clinical presentation are very common and I see cases like yours in my office on a weekly basis with good results.  I would expect from what you have written that you would see improvements in as little as the first 4-6 visits in two weeks time.  To fix the dysfunction may take months of resistive exercise protocols and postural exercises, but often this can be effectively taught and completed at home...it depends on the case.  Now you have to realize though that the degenerative disc disease will persist as nothing can change the degeneration you already have.  The key is to stop it from getting worse now.

Please have this checked out by a good local chiropractic physician.  Ask your family, friends and co-workers for a referral to a doctor they trust, and then do your own research either through their respective websites or with a consultation with the doctor...make sure you take the x-rays for them to visualize and the MRI report.  Hope this helps Tina.  Best wishes.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net