Degenerative discs lower spine, thoracic spine, neck: Fix the pain?

@chma265 Hello. I would like to welcome you to Connect. I am a spine surgery patient. I had a fusion of C5/C6 because of a herniated disc and bone spurs that caused spinal cord compression. That happened years after a whiplash. I had a bulging disc for years that didn't cause issues until it ruptured, and then the body responds with inflammation and grows bone spurs to try to stabilize it. As we age, it is normal for discs to dry out a bit and shrink. When a disc is damaged in an accident, there can be small cracks that later open up when it dries with aging that can cause it to rupture. That is what happened to me.

I did ask my surgeon how to prevent needing his services again for spine surgery in the future, and he told me the best thing I can do is maintain my core strength because it supports the spine. Some degree of disc degeneration happens to most people with aging, but it doesn't necessarily cause pain or dysfunction. Posture is really important for the spine because poor slouching posture will just put more pressure on the discs because they have to cushion the spine through all of its motion. Good posture stacks the vertebrae in a way that takes less effort to maintain. Discs can start allowing vertebrae to slip past each other if something goes wrong. Adults can develop scoliosis later in life too.

One suggestion I could make is to work with a physical therapist to build core strength and address any movement or alignment issues that could affect the spine. If you already have a diagnosis from a specialist with imaging, a physical therapist may need to see that. What helps me a lot with core strength is my chores taking care of horses and horse back riding. Mainly, I just ride on trails at a walk, and that is good exercise because my back has to compensate for the walking motion of the horse, and during summer, my back is much stronger because I can ride more often. Physical de-conditioning can lead to fatigue and pain. Pelvic alignment and dysfunction can also mimic a spine problem and is really exhausting if it is out of alignment. I have had my pelvis twist out of alignment which caused extreme leg and back fatigue if I walked very far. Physical therapy resolved that issue.

Here is a link to an article written for physical therapists that explains some of these issues.
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
Have you discussed your physical limitations with your doctor? Typically a doc would send you to physical therapy if pain was limiting your daily activities. Spine surgery can make things worse, so it should be a last resort to correct a structural spine issue. Spine surgeons can't always promise to cure pain; they fix the dysfunction as best they can, but surgery is a compromise between an abnormal situation, and some degree of hoped for improvement with an intervention. In my case, I had spinal cord compression and only surgery could fix that, and the compromise is that I lost motion at one level in my neck because I have one larger fused vertebra instead of 2 smaller normal ones. Other discs can be affected after spine surgery compromises normal movement in what they call adjacent segment disease. I am 5 years out and don't have adjacent segment disease. Adjacent segment disease has been a question of what happens first, multiple discs that were already affected before any surgery, or was it caused by extra strain on discs because part of the spine is immobilized by spine surgery? Some patients go through more motion limiting spine surgeries as time marches on.

Do you have radiology imaging reports that indicate your spine is physically getting worse, or was your comment related to your level of pain? Have you been evaluated by a spine specialist?

lisaschultz327 | @lisaschultz327 | 4 minutes ago
I was diagnosed with degenerative disc disease with arthritis, spinal spondylosis, some kind of a twist in my spine and some other spinal problems with long medical names and have the remains of a lumbar herniated disc from about age 30 which now is called a bulging disc. I’m in a lot of lower back pain pain and am allotted 2 – 7.5 hydrocodone with Tylenol a day. The doctor took an X-ray and I was told the above along with the comment: man, your spine is really messed up. I’m a 73 year old woman. The doctor also ordered a MRI but when I got to the hospital and I told them I had a pacemaker in addition to my right knee replacement, they wouldn’t do the MRI. I live near Key West and apparently there are no hospitals in the Florida Keys that have a MRI machine for people with a pacemaker. I have to drive over 110 miles to get to the mainland of Florida and another 30 or 40 to get to a hospital equipped with the right MRI machine so I’ve been putting that off. Other than being a great swimmer, my exercise was work related. I owned and operated a tree nursery myself which is strenuous. The last big hurricane retired me and the nursery so I haven’t really exercised since 2017 except for occasional swimming.

I have just been given cardiac clearance for light exercise after being diagnosed with Atrial Fibrillation, Atrial Flutter, Coronary Heart Disease, Tachycardia and Bradycardia. My history shows 2 Myocardial Infarcts although I didn’t feel anything. Medical care is limited down here (remember that if you think the Keys is a great place to retire) and I don’t really know what to do. I was hoping for a stem cell transplant for the damaged discs but just found out that’s not FDA approved. I don’t want spinal fusion after reading your letters. Any suggestions?

@lisaschultz327 Hello and welcome to Connect. I'm sorry you are going through all your health issues and being isolated from better medical centers doesn't help. I have a friend who lives in rural Hawaii on the big island and has a similar problem, and getting spine care for her involved a flight to another island. Have you considered moving to be closer to family or better medical care? I'm sure that is not an easy choice. I couldn't find a spine surgeon who would take my case locally, and I drove to Mayo for surgery and followups where I could get good care which is about 250 miles each way, and that was totally worth it.

I am a spine surgery patient and had a cervical fusion 7 years ago. Cervical surgery is an easier recovery than a lumbar surgery because in lumbar, you are bearing most of your body weight at the lower end of the spine. I can understand not wanting to have a lumbar fusion as the recovery can be difficult from what I have heard and it may not cure pain. There may be other procedures like a laminectomy that may help if you have stenosis in the central canal which is not as invasive as fusion and is a faster recovery. My 80 year old cousin had this and was off pain meds in 2 weeks and was up and around and back doing his normal activities in a month.

Medicine has not advanced enough to be able to do stem cell transplants for damaged spinal discs. Spinal discs loose their connection to blood supply soon after they are formed when they stop growing. They do not have the ability to heal themselves and have low levels of oxygen because of the lack of blood supply. I had hoped for that too when I didn't want spine surgery, but having a cervical fusion gave me back my ability to control my arms and has been a very good thing in my life. Of course every patient is different and age and all the other health conditions a patient has have to be considered in a decision if surgery is a good choice for a patient. There are risks to everything and the benefit has to outweigh the possible risks and complications.

Does swimming help you? It is a great way to exercise as long as you don't over exert because you become weightless in the water. I used to be a lifeguard, although I don't swim much anymore. I did volunteer in a swimming rehab type program and it always helped the participants.

Have your doctors suggested any spine procedures or do they advise pain management instead?

I thought you may be interested in this information about regenerative spine treatments being researched at Mayo in Jacksonville, FL.
https://regenerativemedicineblog.mayoclinic.org/2021/06/17/could-regenerative-medicine-relieve-neck-back-pain/

Hi and thank you for replying. After 40 years, I am moving out of the Keys to a small town 26 miles inland from Naples, FL. Naples does have a number of hospitals and Ft. Meyers is not far either but I do not know of any spinal hospitals yet. I am in considerable pain and don’t walk well but I am mobile. The longer I walk, the more it hurts. My new home will have a swimming pool which I fully intend to use. There is also a big community pool and probably water aerobics will be offered which I will take. Eventually I have to make the trip to Miami for an MRI that can be used by those with pacemakers. I do not want spinal surgery. I know of several people who had laminectomies in the past 20 years and they are not doing well now. They are facing more and more spinal surgery. I have signed up for a study with Disc Genics regarding stem cell transplants starting in 2024. I am also taking Sirolimus, a rapamycin medicine as a Guinea pig. It is approved by the FDA for organ and stem cell transplants and you can get it through studies being done on it. It has been studied with some successful results on rats with ddd issues as well as cardio issues. It was discovered in the 70s but apparently it takes forever in study programs. I’ve been on it for almost 3 months. It hasn’t killed me yet but I haven’t noticed any changes either.

I am 75 years old and have a degenerative disk disease inherited from my mother I've had three lumbar back fusions and two broken vertebrates in the thoracic spine and scoliosis caused by back surgeries and the fusions usually last between three to five years now I'm going to have scoliosis surgery I will have rods and screw's all the up my spine needless to say I'm very nervous about this but so tired of being in pain all the time and can't do much of anything. I live in Houston, Texas, and have plenty of highly-rated doctors here, and feel like I'm in good hands If anyone has had scoliosis surgery I would like to hear about their experience

Hi Lisa. You have a lot going on and I get how disconcerting it all can be. I’m glad you decided to move closer to services as being in a remote area of the Keys makes everything more complicated. There are great medical services in both Naples and Ft. Myers.

Now your spine. I started off much as you describe. The spine surgeon’s first statement when he reviewed my MRI (get yours wherever they have the very latest and best equipment) was, “Your back issues are legit!” My spine was twisted to the right and also angled down. Compressions. Spondy. A mess…I wasn’t actually aware of the misalignment as it developed over a period of decades. I knew I’d lost height but not exactly why…Once I had a clear picture - I went about developing a strategy.

I heard and read lots of stories that scared me to death! The surgery didn’t fix them problem. The surgery created new problems that required additional corrective surgery. The surgery created permanent injury/after effects. Who wants that? But the more I dug the more I came to appreciate two facts: (1) Most “back surgery” message boards are populated by those who have a surgical problem and I was just not reading much about surgeries that went well. (2) Many/most of those posting of surgical difficulties relied on ortho rather than neuro surgeons.

As I sit here now - 3.5 months post significant lumbar surgery (the cervical work I had done 6.5 months ago is so resolved I don’t even think about it) - I’m glad I did it. Yes, the immediate recovery was difficult but allowing my spinal column to become permanently injured due to continued degeneration is a poor option. “Pay me now or pay me later” sort of thing. And the price “now” is lower than the price later…

Yours is a difficult and confusing pathway. Get the best diagnostic pictures interpreted by the best specialists then develop a comprehensive strategy with a neurosurgeon. I wish you the best!

Have you or anyone else heard of Disc Centers of America. They claim to be able to rebuild and heal discs of practically all problemems using their patented spinal decompression machine and special supplements. I passed because it sounded too good to be true.

Hi, I looked up Disc Centers of America and at 1st I got the Decompression & Laser one I think you are talking about. Then Health Grades came up with all different locations than the 1st one I looked at, so I looked up that one, (same name) and they are chiropractors! And they even use coupons! Yes, I will pass too. I couldn't believe it. I wished it would be a good place too.

Yes, I know what you mean. When we are in pain, we will grasp at almost any straw. Looking back, I should have seen all the red flags at once. Good thing I almost always tend to take a day or two to consider what I am about to do. Fortunately, common sense took over. Not sure how places like this manage to stay in business.

I found a place with office locations in Naples, FL and also in Texas that puts a filler of some type in your damaged discs that sounded pretty good but they weren’t covered by Medicare and it was a pricy fix if it worked so I didn’t follow up.