Question
QUESTION: I have chronic thoracic and lumbar pain, more thoracic then lumbar.most of my problems are in my my thoracic area.I have annular disruption in t 6-7 t 7-8 t 8-9 t 9-10. radial tear in t 6-7 . t 7-8 7 8-9 t 9-10 diffuse spread. t 10-11 nuclear contaiment. multilevel discogenic syndrome. spinal stenosis of thoracic and lumbar.t 6-7 herniation. disk degeneration at t 6-7 t 11-12 l 4-5. moist disks.cervical,lumbar and thoracic degenerative disk disease.lumbar,thorasic and cervical facet arthropathy.discogenic disease/myofascial syndrome.arthritis. t 6-7 t 7-8 t 8-9 t 9-10 diffuse opacification. t 10-11 central opacification of the nucleus and disk space.loss of disc signal L 4-5 L 5-s1. loss of disc height L-4-5. bulging disc L 4-5 L 5- S1...... and sooo much more....I have no idea how any of this happened.....i dont know what to do, please help  please email me

ANSWER: There are 3 sections of spinal vertebrae. The 7 vertebrae in the neck are called cervical vertebrae, the 12 vertebrae in the middle section are thoracics to which the 12 pairs of ribs attach, and the 5 bottom vertebrae in the lower back are lumbars. Each section is numbered from top to bottom so C1 attaches to the skull at the top and L5 attaches to the pelvis at the bottom. You have problems in all 3 sections.

A disc separates each vertebra and acts like a cushion, absorbing shock along the spine and allowing motion between each segment. The disc is a cartilage-like material made up of a jelly-like substance in the center known as the nucleus, covered with many strong and fibrous, ligament-like outer layers called the annulus. These type tissues do not have a rich blood supply like most other body tissues to nourish and replenish them; rather, disc tissue depends on a transfer of extracellular fluids to bring in the needed nutrients and oxygen. This transfer of fluid occurs between the bone (vertebral body endplate) above and below the disc and depends on the difference in pressure between the inside of the discs and the surrounding tissues. This is why normal joint motion that results in a pumping action is so essential, and explains why most disc nutrition and regeneration takes place when we lie down - because the pressure inside the disc is reduced and the fluids migrate toward the area of low pressure. This process is not very efficient, and slows down as we age, so that the disc can rather easily be exposed to wear and tear exceeding its ability to heal and regenerate - a process known as degeneration or degenerative disc disease.

Any number of factors in addition to age can cause or contribute to degenerative disc disease. Obesity which creates additional gravitational stress on each joint is another. Not enough exercise results in a gradual weakening of the supporting muscle and ligamentous structures making the disc prone to injury from ordinary everyday activities as we use our backs each day through sitting and standing, bending and lifting. Too little activity during the week followed by too much activity on the weekend can also result in injury. Naturally, falls or accidents can directly injure even a healthy spinal joint, but is made all that much worse if it is in a weakened state to start.  Repeated episodes of even minor injuries can eventually result in muscle tension and/or inflammation limiting the motion, and thusly the pumping action of the disc, which becomes stiffer and drier causing it to lose its shock absorbing properties, and making it more prone to yet another injury. This is the very definition of degeneration where each incident lowers the pain and subsequent injury threshold so that eventually the most ordinary of activities such as walking through the grocery store is too much. Poor health habits including too much soda pop/not enough water, inadequate nutrition, alcohol use, and nicotine use contribute. There may also be an as of yet unidentified genetic factor causing some individuals to be more likely to develop this condition.

Because you have so many levels of involvement  I am suspicious of a systemic problem as the root cause of your difficulties. In other words, if you fell down the stairs last month or last year and injured your back you would, of course, recall the incident and, furthermore, it is unlikely to have resulted in injury to nearly every disc in your spine.  Below is a short list of possible systemic reasons to have multi-level spinal issues and lots of other problems too.

1.  Repeated Injury
2. The toxins of acute Infective Diseases such as diphtheria, shingles, typhoid fever, malaria, scarlet fever, septicemia.
3. Acute or chronic Poisoning most commonly by lead, arsenic, mercury, copper and phosphorus.
4.  Autoimmune Disorders such as Rheumatoid Arthritis, Celiac Disease, Myasthenia Gravis.
5.  Central Nervous System Disorders such as Cerebral Palsy (CP), Parkinson's Disease, Multiple Sclerosis (MS).
6.  Metabolic Disease such as diabetes or alcoholism.
7.  Nutritional deficiency.

Do this:
See your primary care doctor for a thorough history and physical examination and blood study to determine the underlying systemic cause of your issues. See a chiropractor to help with the day to day pain in the meantime. By way of example, if this happened because you fell down the stairs, the chiropractor could help you feel better, and then advise you to hold on tighter to the hand rail next time. If this happened because you have uncontrolled diabetes, the chiropractor could help you feel better, and I would advise you to work closely with a primary care doctor to get the diabetes under control. See what I mean?

AUTHOR BIOGRAPHY

Dr. Michael L. Hall, D.C. practices at Triangle Disc Care in Raleigh, North Carolina specializing in Spinal Decompression for the treatment of acute and chronic neck pain and back pain due to herniated, degenerated discs. This is a conservative procedure for patients suffering with bulging or herniated discs, degenerative disc disease, posterior facet syndrome, sciatica, failed back surgery syndrome, and non-specified mechanical low back or neck pain.

For more information call (919) 571-2515, click on www.triangledisc.com or email [email protected] . Type "Free eBook - 101 Things I Need to Know about my Bad Back" into the subject line.




---------- FOLLOW-UP ----------

QUESTION: Thank you so much,is there any type of surgeries that can be done?

Answer
A surgeon would be better qualified to address the relative risks and rewards of surgery, but in my experience - particularly with multi-level degenerative changes, you would be well advised to try everything else first. Certainly the entire spine cannot be fused. Fusing the level or two or three that is presently causing the most trouble simply transfers mechanical stress to the remaining vertebral levels which then fail in turn necessitating yet another surgery. This is a game that cannot be won. Regardless, surgery does not address the root cause of diabetes or obesity or nutrition or alcoholism or whatever it is that is going on with you that has resulted in the widespread degenerative changes which by definition worsen over time. If you're less than pleased with the state of your health now consider where you will be in 10 years if these issues are not addressed.