New to this forum: Primary Osteoarthritis, C-spine and L-spine

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New Member

Date Joined Aug 2006
Total Posts : 8
   Posted 8/4/2006 6:19 PM (GMT -7)   
Hi, I am new to this forum.
Have had OA for a while now and it's now what my doctor terms "chronic". So I have entered into the chronic pain area. Also have "multiple pain syndrome". My primary and I think fibromyalgia along with the OA. And it has all flared up in the past three months. Been to a rheumatologist he was an idiot (clinical investigator, a 6 page form of medical history for me and all blood relatives, you must be kidding? I have 7 brothers and sisters and cousins everywhere) He ordered blood work like he had stock in the laboratory. My primary care physician could not believe the blood work he ordered, Urine, Hep B, Hep C, Antineutrophil Cytoplasmic (ANCA), Beta-2 Glycoproterin, Anticardiolip Ab, Complement C4, C3, Protein Electro S, Lupus Anticoagulant Reflex and HLA B 27. It's all normal except for Hep B which has high antibodies, I have been vacinated.
My own primary did the Sed Rate, Lyme and so on.
Been to a neurologist and I am just humoring him until he releases me at the next visit because I am sure from my MRI results he is now going to tell me that the neuropathy and other aches and pains are pretty much in my head. Which by the way I now know is not empty and does contain a brain because he ordered an MRI, but it is "unremarkable". I resent that phrase. The lumbar MRI he ordered is as expected, but I now have 3 bulging discs instead of the two original ones from 2 years ago. It's boring sometimes to keep seeing "bulging". Well only L1-2 are normal, the remaining lumber is at varying stages of degeneration, facets, anterolisthesis, foraminal stenosis and so on. The neurologist said take some ibuprofen. He did the EMGs and NCVs, nothing abnormal. Hmm, why do I have numbness and pins and needles, why do my legs go numb when I lay on my back? Starts with my toes and works it's way up to just above my knees. I don't do that anymore at first it was interesting and then it was freaky.
So the C-spine is also a mess with stenosis and facets and so on.
What really made me go this time were the headaches, I couldn't stand the headaches. Every bone and muscle in my body aches. From the tippy top of my head to my toes. All  at once, every joint. But those headaches are a killer. The neurologist says it's migraine and my primary and I are sure it's from the neck. They are occipital, they smolder in the background, most times I wake up with one, as soon as I open my eyes I know it's going to be a stay in bed kind of day. I have been loosing days. I am not sensative to light, I am not sensative to noise and the only reason I get nausea is because I have emptied the contents of my medicine cabinet into my stomach. Anyone else get the headaches. I stopped taking all the stuff out of the medicine cabinet since my primary gave me vicodin for the headaches. I have the migraine stuff but I don't like the adverse events that are listed. I am taking elavil, 25 mg at bedtime to sleep.
I have PT scheduled, what can they do for me? Anybody been for PT? I am afraid that they might snap one of those osteophytes in my neck and I won't walk out on my own. That's why I have avoided chiropracters for this. Fear of a snapped neck or back.
I was using an inversion table regularly but then everything got worse, I have told the doctors about using the table but they don't really say anything. Should I go back to it?

Veteran Member

Date Joined Mar 2005
Total Posts : 1884
   Posted 8/4/2006 9:21 PM (GMT -7)   

Hi Sharmur and welcome.  I, too, cannot stand reading 'unremarkable' - ugh!

It sounds like your rhematologist was getting a full blood panel to help rule out any other infections/issues that may be causing your issues.

I am not familiar enough with some of your issues/questions to give you any answers, but I wanted to welcome you to HW until someone can hopefully give you some better thoughts.

I do want to ask - how long have you been on elavil and did any of these issues start AFTER taking it? Elavil is an interesting drug, but it can do some funky things to you.  You might want to check online to see a more in-depth look at side-effects.  What other meds other than vicodin have you been taking?

Good luck.




Regular Member

Date Joined Oct 2005
Total Posts : 315
   Posted 8/5/2006 7:49 AM (GMT -7)   
Hi Shar,
I have OA in my spine as well as DDD and severe lumbar stenosis in 4 levels. I also had herniated discs where I was not able to lay on my back at all & felt the same sensations with my feet & legs getting pins & needles and going numb. Luckily the epidural steroid injections I had did help with the sciatica and I don't get much pins & needles anymore. I can lay on my back for a few minutes now but pain from stenosis prevents it any longer than that.
When my sciatica started is when I had an MRI done (before this I had no clue what was going on in my spine except that I had lower back pain & occassional swelling on and off for 3 yrs). I was actually kind of happy in a way to know that something WAS wrong in my spine as I've had other problems with tests that usually showed all was "normal". It's a catch-22 - it was horrible to hear what I had & that it will be pretty progressive but elating to get a black & white diagnosis. I had tried all the OTC meds myself and told my rheumy nothign at least he worked with me to try different prescription meds to see if anything worked. THe only one that worked slightly for me was vicoprofen, but I had to stop taking it due to the fact that I developed extensive, severe bruising all over myself. So now...i am taking nothing for pain. I just feel like I have to live with it somehow b/c nothing seems to work anyway.
I had also been on Elavil for over 3 yrs. I started this while I was having minor backpains, plus I have lupus and fibromyalgia. So I was given Elavil  to take one 10mg pill every evening to help with pain & sleep. It didnt seem to do much for pain but it completely regulated my sleep and zonked me out every night. I would fall asleep like clock-work every night (even if I was in moderate pain) and wake up same time each morning feeling totally refreshed.
I also started Physical Therapy this past March. I started this before I got my epidurals. My PT told me if any excersices hurt too much, not to do them. Of course everything seemed to hurt at first but I just bore through it all. I went under their care for 6 weeks & that also seemed to help a little with lessening my pins & needles. I actually still go to PT 3 times a week for an hour on my own. I am no longer under their care, I just go there to do my excersises and pay a very small fee. I personally feel it has helped me somewhat...especially with my abdominal muscles which are imperative to support the mid-section and back. At least when I lean forward to walk, my abs don't hurt anymore <lol> ..but I still feel a bit more stronger and I think will help in my recovery when I have surgery.

New Member

Date Joined Aug 2006
Total Posts : 8
   Posted 8/9/2006 11:28 AM (GMT -7)   
Well, my symptoms started before the elavil although elavil can cause neuropathy this is not the case with me. And now the elavil is not quite working as it was, 25 mg not putting me to sleep even though I am taking it earlier and earlier each night. You do need to increase dosage on many medications from time to time.

PT started on Monday worked on posture first then yesterday some minimal exercises to see if I could do them, laying on stomache and pushing upper body up with arms can only do 10 reps with some ease, next 10 cannot quite do. More posture orientated, sitting straight in the chair and pushing head back a little. Did that with relative ease but woke this morning with an awful headache, had to call off work. Go back for more PT tomorrow have to ask if this could have initiated the headache. Headache is devastatingly painful but no migraine symptoms, light, noise, nausea. Spending all night and a half day in bed is just no good for my back. Woke at noon to very painful right backside side and hip.

I am lucky that insurance will pay for 60 sessions a year so I can squeeze a bunch into the remainder of this year, it will be a good start. 3 times a week should be ample until the end of the year.

Funny that I have had the MRI results since last Friday and the neurologist that ordered the tests has yet to phone me with the results. Hmm, what is that all about? Unless he is angry that I sent a letter basically demanding the MRI place send them to me under HIPAA ruling.

MRI C-spine as follows done 10 July 2006
DX: Multi-level spondylosis most marked at C4-C5 with right formainal stenosis by osteophytes.
There is advanced spondylitic narrowing of the C4-C5 interspace with anterior and posterior spurring. There is right foraminal encroachment by osteophytes which cause stenosis at this level. There is mild spondylitic narrowing of the C5-C6 and C6-C7 interspaces with mild spurring but no stenosis or area to indicate herniated disk disease is present. The ostiorphyte on the right at C4-C5 attenuates the ventral aspect of the thecal sac but causes no mass-effect upon the cord. The remaining interspaces and vertebral body heights are well-maintained. There is no fracture, mal alignment or bone destruction.

MRI L-Spine as follows This was done 01 August 2006 (this one ordered by neurologist)
There is minor (Grade I, 5%) anterolisthesis of L4 on L5 due to severely degenerated facet joints. There is otherwise normal vertebral body height and alignment on supine non weight-bearing study. Marrow changes at L2-L3 refelct degenerative disc change present with normal marrow signal elsewhere. The conus medullaris is normal.
At T12-L1 there are mild degenerative disc changes with disc bulge without stenosis.
The L1-L2 level is normal.
At L2-L3 there are moderate degenerative disc and facet changes with disc bulge without stenosis.
The L3-L4 disc level is normal with mild facet degenrative changes.
At L4-L5 there are mild to moderate degenerative disc and moderate degenerative facet changes with left sided disc bulge. There is mild left lateral recess and left more than right foraminal stenosis. (Does this mean that the right also has foraminal stenosis but not as much as the left? And does this expain why both legs go numg when I lay on my back?)
The L-5-S1 dic level is normal with mild to moderate facet degenerative changes.

I have just read an interesting ariticle that focuses on the differences in explaining the results of diagnostic tests with respect to the spine findings among physician's description of the findings. If you notice they cannot even decide if they are called disks or discs. I am also curious as to the differences between mild, moderate and severe especially when stating that "there is mild to moderate". What is the scale? If "L4 on L5 due to severely degenerated facet joints" in one statement and then later in the test interpretation it is stated "At L4-L5 there are mild to moderate degenerative disc and moderate degenerative facet changes" In one statement it is severely degenerated facet joints and then again mild to moderate at the same level, which is it? Severe or Mild to Moderate? I am confused. Well, my follow up appointments will be coming up soon so I will have to remember to ask them the difference is.

I have also read an article that basically says that even MRI cannot acurately predict all of the soft tissue damage that may be occuring due to the displacement of the spinal anatomy through the degenerative process.
DX: Osteoarthritis, C-spine; multi-level spondylosis, foraminal stenosis by osteophytes C4-C5. L-spine; The only good part is L1-2 which are normal. "Multiple Pain Syndrome". Quickly lost respect for most doctors when they did not respect me. My primary care physician is a saint.

Veteran Member

Date Joined Jan 2005
Total Posts : 763
   Posted 8/9/2006 2:08 PM (GMT -7)   
ok dummy here . What is OA?
Syringomyelia T4-T10
Chiari Malformation
Decompression Surgery 1999
We are normal people, trying to live normal lives,
with bodies that have forgotten what normal is
"Remember I'm pullin' for ya, we're all in this together" Red Green

New Member

Date Joined Aug 2006
Total Posts : 8
   Posted 8/9/2006 2:37 PM (GMT -7)   
There are many definitions which have change over time with research and knowlegde:

(os·teo·ar·thri·tis) (os²te-o-ahr-thri¢tis) [osteo- + arthr- + -itis] a noninflammatory degenerative joint disease seen mainly in older persons, characterized by degeneration of the articular cartilage, hypertrophy of bone at the margins, and changes in the synovial membrane. It is accompanied by pain, usually after prolonged activity, and stiffness, particularly in the morning or with inactivity. Called also degenerative arthritis, hypertrophic arthritis, and degenerative joint disease.

There are many, many definitions which conflict in the description. Some say non-inflamatory as this definition does and others state it is inflammatory. There is Primary which has no known cause and there is Secondary which is a result of injury as in broken bone or overuse of a particular joint. I have Primary OA. Our bones and cartilage just start breaking down and replacing the lost cartilage and bone with bone spurs or osteophytes.
I don't have inflammation in my joints, they do not get hot they just hurt and I constantly hear grinding of bone on bone throughout my spine and in many of my joints. I would love to go one day without hearing the grating of bone on bone everytime I move my head. I can hear this throughout my spine from my neck to my low back.

This causes the spine and affected joints to become imobile, extremely painful and can eventually lead to compression of soft tissue structures in close proximity to the arthritic joint such as the nerve roots and the spinal column due to bony outgrowths.

I have what they like to call DDD-Degenerative Disc Disease, which is my primary presentation but I am now experiencing problems with my knees, ankles and fingers. However, my mother has OA and has had a hip replaced. She was dx'd with OA years ago sometime in her 50's, but has not experienced a great deal of pain until the past few years. I on the other hand was dx'd in my late 30's with this and have experienced a great deal of pain from the beginning. My aunt has the primary symptoms in her neck and ankles while my uncle has had the majority of problems in his neck.

There is no test for OA diagnoses is based on symptoms and degenerative changes as viewed by x-ray, mri or ct scan.
DX: Osteoarthritis, C-spine; multi-level spondylosis, foraminal stenosis by osteophytes C4-C5. L-spine; The only good part is L1-2 which are normal. "Multiple Pain Syndrome". Quickly lost respect for most doctors when they did not respect me. My primary care physician is a saint.

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