Brief Answer:
Kyphosis

Detailed Answer:
Oh my.....I just spent the past hour crafting this response with all the details of what is going on and what to do and the system somehow coughed it up and didn't save it when I hit the button.....oh my!

Ok...here is the abbreviated version....maybe that's better anyways? HA! Things happen for a reason....the Gods above didn't want to torture you with reading all that stuff I had.....Ok....right to the bottom line of the case.

Let's do it:

Good evening- My name is Dr. XXXXXXX Saghafi and I'm in the XXXXXXX OH area. Here are my thoughts for your consideration:

After carefully reading your story and putting down every meticulous point I could think of your diagnosis is: KYPHOSIS.

This is simply a term which means flexion deformity of the spinal column which can be due to a number of reasons and causes. Here are the top ones I can think of that you may have suffered from in your lifetime:

1.aging (especially if you have poor posture)
2.muscle weakness in the upper back.
3. Scheuermann's disease (occurs in children and has no known cause)
arthritis or other bone degeneration diseases.
4. osteoporosis (loss of bone strength due to age)
5. injury to the spine/slipped discs.


Any or all of the above may be relevant to your situation. It is sometimes believed that people with this condition (humpback) have no choice and that this is destined to occur. While it's true to a certain extent that our spines are 'programmed" to react in certain ways to environmental stresses and triggers I believe that with proper care and exercise during youth and adulthood that this condition can be staved off at least temporarily. In your case, it's not too late to start doing something about it to either slow its progression down or potentially reverse some of its effects.

You need to get your arms the concept that though you don't have a lot of pain right now with the hump condition; the steps you must follow to restore some normalcy to your spinal curvature will involve some pain. But if you're willing to put up with a little bit of that...and find yourself a really GOOD and DEDICATED PHYSICAL TRAINER who can help you do the necessary stretching to re-instill flexibility into your back ligaments, spine itself, and muscles then, you may be able to make this much more tolerable and with some luck even reverse some of its effects. Cure is a strong word and I can tell you there's no specific pill or pills for that purpose.

I'd like to refer you to the arthritis foundation in the UK for a lot of very worthwhile information especially on one of my favorite approaches to this problem referred to as aqua or hydrotherapy. The water needs to be at least nice and warm...or at most TOLERABLY HOT. This will help with stretching and relaxing the ligaments that need to be eventually remodeled.

http://www.arthritiscare.org.uk/Home

When you're on that web page look up the following: OSTEOARTHRITIS. Read up on that entity because KYPHOSIS comes under that category though they don't specifically mention this entity.

Medication wise there isn't much that I can say works of standard drugs simply because as you can appreciate the problem is one involving the reduced FLEXIBILITY OF THE SKELETAL STRUCTURE. Therefore, it should be intuitively obvious that the BEST TREATMENT for such a condition is EXERCISES and practicing of GOOD POSTURE for walking, sitting, standing....virtually military in nature if you want my opinion.....and that being obsessive on this point MAY IN TIME result in increasing flexibility of the spinal column and its elements.

Some people put a lot of faith in a substance known as glucosamine chondroitis sulfate. I've got patients who take that substance and have nothing come out of it and I have a few who swear by it....I would be cautious with any of those types of alternative medications or homeopathic conconctions. I'm sure that medication wise there's nothing either of a standard prescription type or homeopathic, or OTC type of medication that will substantially work for this problem.

In conclusion, I believe you suffer from KYPHOSIS which is specific type of OSTEOARTHRITIS form and could be due to any one of a number of causes (some are listed above). The true limitation of this disorder is to slowly limit the flexibility of the spinal column, its ligaments, joints, and muscles.

However, with PHYSICAL EXERCISE AND REHABILITATION on a daily and consistent nature focused at reinstilling flexibility by stretches, strengthening exercises of the neck and back, and using hydrotherapy to loosen spinal column up and make it potentially more flexible for REMODELING, I believe you have the potential to at least slow down the progression of your condition if not be able to restore some function and normalcy to the column you had previously.

Ok...well, I'm going to stop there for the time being and ask you to consider the following....if I've provided you with useful information would you be so kind as to provide me with written feedback and a STAR RATING? That tells me how close I came to answering your questions.

Also, if you've no more questions for me I'd also appreciate just as much your CLOSING OF THE QUERY on your end which allows the network to file your case.

I wish you the best.

I'd like to also let you know that I may be found specifically on this network by writing questions to my attention: DR. XXXXXXX SAGHAFI as well as another network where we can even do WEBCAM INTERFACES if that may be of interest to you. The network is named HEALTHTAP and you can find them at www.healthtap.com. I am in the state of Ohio and my times on shift are Wed-Sat. from 3a-7a (Eastern Standard- New York City time). Feel free to look me there if you have a webcam if you'd like to show me anything in real time.

This query required 1hr. 31 minutes of physician specific time in order to review, research, and document in final draft format for envoy answers to his questions.

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Brief Answer:
Kyphosis disallows remodeling as time goes on.

Detailed Answer:
Good evening. Unless you are willing to work to reinstill more flexibility into the spinal ligaments by ACTIVE STRETCHING (and this is likely to cause some degree of pain or discomfort) your kyphotic condition will only entrench the present hypercurvature and become virtually impossible to change in the future. I leave it to the expertise and creativity of the PHYSICAL THERAPIST/TRAINER to come up with a program that would strive to stretch the cervicothoracic ligaments several degrees at a time. Nobody is suggesting that you overstretch "beyond its stiffness" but you must at least take it to its limit in order to begin to stretch beyond. Does that make sense?

As far as what happened so many years ago I'm afraid that's going to be a bit difficult to ferret out at this point some 40 years later. One of my possible mechanisms from my previous message for the development of a kyphosis is spinal injury or slipped/herniated discs.

Unless, you have X-rays from when you suffered a POP/injury then, I'm afraid anything we want to say happened would be mere speculation. Kyphosis is as easily programmed genetically as it could be acquired due to a remote spinal column or disc injury. I don't know exactly what you mean when you say, "it went hot on the night..." If you are referring to some type of temperature change then, I would have to say that there is no relationship I know of between ambient heat and injury of the spinal column or its discs.

If you haven't received either a CT or MRI of the cervicothoracic spine then, I believe getting one performed will help to understand the current status of the spinal column in the area of the kyphosis.

Surgery is also an option to consider for kyphosis but it should be after everything else is negative in terms of outcome.

In conclusion, don't be afraid of being aggressive with the concept of stretching your spinal ligaments for the purpose of remodeling the skeletal structure. You'll need some help with a good trainer or physical rehabilitation specialist experienced in stretching rehab exercises and knowing where the current limits are of your spine so you will be able to little by little stretch the ligaments out and gain degrees of flexibility.

While a CT or MRI could detect disc abnormalities in the cervicothoracic spine it will be nearly impossible at this point in time to be able and tell what if anything happened when you say that something happened below your 7th vertebrae. In order to go back to decide on any cause and effect you would've had to have gotten some baseline films of your spine when this occurred.

If you feel this information was of benefit to you then, I'd appreciate your written feedback and a STAR RATING of our conversations to this point. If there are no further questions then, I'd also appreciate your CLOSING THE QUERY on your end so as to signal to the network that we have completed our discussion and that we are ready to archive the case for future reference.

I'd also like to let you know that if you'd like to attempt a real time webcam conference with me I also serve as one of the founding physician members of the service known as HealthTap found at www.HealthTap.com. I am on shift Wed-Sat. from 3a-7a (Eastern Time; New York City Time Zone) and I'd be happy to further discuss this situation which we can look at using the camera technology.

All the best to you in the mean time. I wish you well.

This query required 39 minutes of physician specific review, research, and final draft documentation for envoy.

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