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54 yo female. 35 years working as a dental hygienist

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Posted on Wed, 20 Mar 2019
Question: 54 yo female. 35 years working as a dental hygienist - very difficult to keep proper posture. Pain started in 90's and been managed with chiro, physio, massage etc. I get heavy arms, right arm can get cold (occasionally) lots of back pain, sometimes muscular, sometimes bones. Pain comes thru chest at times. Wakes me up at night, not good staying on back. MRI: mild multilevel degenerative disc disease. No compression fracture. Incidental not of several vertebral body hemangioma No significant spinal canal stenosis or neural formaminal narrowing. Mild posterior disc osteophyte complex at T5/T6 causes minor impression on the spinal cord anteriorly.
I also have carpal tunel syndrome
doctor
Answered by Dr. Praveen Tayal (49 minutes later)
Brief Answer:
Due to disc degeneration.

Detailed Answer:

Hello,
Thanks for posting your query.
The symptoms that you are having is likely to be due to multilevel disc degeneration. Physiotherapy like intermittent lumbar/cervical traction , back and cervical exercise reduces pressure of disc bulge for some time & gives relief.

The following measures will help with the pain
• Lie on a hard bed.
• Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( dont repeat a dose before 6 hours) with food.
• Avoid forward bending.
• Correct your posture while sitting
• Avoid prolonged sitting
• Avoid strenuous activity & lifting heavy weights.
• Apply diclofenac gel on the affected area. Warm compresses will also help.
Do consult your orthopedician for proper treatment.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (2 hours later)
Not really good to lie on my back, it hurts most when I press on it too long, deep ache.
What about this: Mild posterior disc osteophyte complex at T5/T6 causes minor impression on the spinal cord anteriorly
would the "impression" be compression on spinal cord not contributing to pain and numbness?
What do you mean by strenuous activities? is pickle ball (like badminton/tennis) ok?
would it be dangerous getting chiro?
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Follow up: Dr. Praveen Tayal (5 hours later)
there was no mention of disc bulge on MRI.
doctor
Answered by Dr. Praveen Tayal (2 hours later)
Brief Answer:
Impression does not cause a nerve compression.

Detailed Answer:
Hello.
Thanks for writing again.
The disc osteophyte complex is an age related degenerative change of the spine. It is just making an impression on the spinal cord - there is no compression but this can cause numbness. You can play badminton or tennis of there is no pain in the shoulder joint area. In case this aggravates the pain then avoid these activities. Going for a physiotherapy is a better option than chiro.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (10 hours later)
Thank you for taking the time to explain this to me. I have spent 35 years in dentistry, bending over patients.
Are these changes common in the thoracic spine?
I do get flare ups where it hurts a lot to move
each night, I wake up on my back in pain and my upper back feels deep pain, better when sleeping on side.
is degenerative disc disease the same as ostheoartritis?
If these changes are normal and minor, how can it cause so much discomfort all of the time?
Would most 50 year old present with these types of changes on MRI?
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Follow up: Dr. Praveen Tayal (2 minutes later)
There was also an incidental note of several vertebral body hemangiomas. Could these cause pain? or numbness?
doctor
Answered by Dr. Praveen Tayal (3 hours later)
Brief Answer:
Details below.

Detailed Answer:
The changes are seen after stress to the spine for years. Bending also adds to the problem. You need to start taking the oral muscle relaxants for relief. Degenerative disc disease is similar to ankylosing spondylosis. Osteoarthritis is seen in hip and knee joints.
The discomfort is related to the stiffness of the spine caused by these changes. Physiotherapy and regular exercise will help in regaining the flexibility.
Hemangiomas do not cause pain or numbness.
These changes are seen after 50 years of age depending on work profile and spine flexibility.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12082 Questions

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54 yo female. 35 years working as a dental hygienist

Brief Answer: Due to disc degeneration. Detailed Answer: Hello, Thanks for posting your query. The symptoms that you are having is likely to be due to multilevel disc degeneration. Physiotherapy like intermittent lumbar/cervical traction , back and cervical exercise reduces pressure of disc bulge for some time & gives relief. The following measures will help with the pain • Lie on a hard bed. • Anti -inflammatory drugs like Tablet Motrin 1 tablet as and when required ( dont repeat a dose before 6 hours) with food. • Avoid forward bending. • Correct your posture while sitting • Avoid prolonged sitting • Avoid strenuous activity & lifting heavy weights. • Apply diclofenac gel on the affected area. Warm compresses will also help. Do consult your orthopedician for proper treatment. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal Wishing you good health. Regards. Dr. Praveen Tayal.