[tdouglas]

Hi, everyone. I started a post last year about a severely herniated disc in my lumbar spine. I got some pretty great advice, so I'm back for more!

I ended up getting a microdiscectomy to fix the herniated disc, and that's all well and good. But I was having pain in my thoracic spine, too, so I asked the doc to order up an MRI, just to be sure it wasn't another big issue. Well, after getting the MRI and visiting the doctor again, he told me that everything was fine, and I took him at his word.

Months later, however, the pain in my thoracic spine is still there, so I decided to go get the results and have a look. Here's what I found:

"There is mild disc desiccation in the mid thoracic spine. There is mild multilevel facet osteoarthritis throughout the thoracic spine. No significant central canal stenosis or neuroforaminal stenosis."

My first thought is that I'm glad the word severe doesn't pop up, and my second thought is that I'm glad there is no stenosis. But my third thought is why didn't the doctor tell me about this stuff? Is a mild disc desiccation and mild multilevel facet osteoarthritis not worth mentioning? Should he have said everything is normal when the MRI says otherwise, or am I overreacting? What do these "mild" problems mean for me?

[Jomar]

If it was a surgeon that said that, maybe he meant it as no surgery needed/ required at this time??
Who knows what drs think.

But he could have mentioned these just so you know ..

I'd take the image/report to another independent dr or even a highly skilled chiro, they are trained to understand these reports too.
Many chiros will do a free or low fee evaluation, hoping to get business of course, but you don't have to let them adjust you ..it might be worth trying it and see what they say..


Can you describe the T spine pain?
Is it any specific place , like a vertebra level, or possibly a muscle/trigger point issue?
Sometimes it helps for us to have the symptoms described as well as the report info.

[Hopeless]

Originally Posted by tdouglas

Hi, everyone. I started a post last year about a severely herniated disc in my lumbar spine. I got some pretty great advice, so I'm back for more!

I ended up getting a microdiscectomy to fix the herniated disc, and that's all well and good. But I was having pain in my thoracic spine, too, so I asked the doc to order up an MRI, just to be sure it wasn't another big issue. Well, after getting the MRI and visiting the doctor again, he told me that everything was fine, and I took him at his word.

Months later, however, the pain in my thoracic spine is still there, so I decided to go get the results and have a look. Here's what I found:

"There is mild disc desiccation in the mid thoracic spine. There is mild multilevel facet osteoarthritis throughout the thoracic spine. No significant central canal stenosis or neuroforaminal stenosis."

My first thought is that I'm glad the word severe doesn't pop up, and my second thought is that I'm glad there is no stenosis. But my third thought is why didn't the doctor tell me about this stuff? Is a mild disc desiccation and mild multilevel facet osteoarthritis not worth mentioning? Should he have said everything is normal when the MRI says otherwise, or am I overreacting? What do these "mild" problems mean for me?

Docs do react differently. I had one doc tell me I needed surgery based on my MRI and I did not. (Mild lumbar herniation that healed on its own.) Then years later, I had a doc tell me that my MRI had some abnormalities but nothing that he would not expect for someone of my age and that the abnormalities were nothing of any real concern. He gave me a copy of the MRI results after he had discussed it with me.

Personally, I think the doc should have told you something similar to what my doc told me after MRI, abnormal but insignificant. To not notify you of ANY abnormality is probably because he did not want to have to discuss it with you since he seems to have considered it insignificant.

The question is........ Are you experiencing pain or problems? If you have NO symptoms, he probably thought it of no significance.

I now have moderate thoracic herniations, multi-level facet osteoarthritis, degenerative discs, and a few other things that I can't remember at the moment.

I would ask him to give you a detailed explanation of why he stated your MRI was "normal" or did he mean that it is insignificant.

[tdouglas]

Originally Posted by Jo*mar

If it was a surgeon that said that, maybe he meant it as no surgery needed/ required at this time??
Who knows what drs think.

But he could have mentioned these just so you know ..

I'd take the image/report to another independent dr or even a highly skilled chiro, they are trained to understand these reports too.
Many chiros will do a free or low fee evaluation, hoping to get business of course, but you don't have to let them adjust you ..it might be worth trying it and see what they say..


Can you describe the T spine pain?
Is it any specific place , like a vertebra level, or possibly a muscle/trigger point issue?
Sometimes it helps for us to have the symptoms described as well as the report info.

Yeah, I was thinking about seeing someone else. But what's crazy is that this doctor is one of the best I've ever had, especially at explaining things and relieving my worries, so that's why I'm really surprised he never brought this up.

The pain in my thoracic spine is like a dull, achy pain, right on the spine. Bending my head down (chin to chest) causes tightness and pain, and if I tilt my head left or right from that position, it shoots pain through the opposite shoulder blade.

Originally Posted by Hopeless

Docs do react differently. I had one doc tell me I needed surgery based on my MRI and I did not. (Mild lumbar herniation that healed on its own.) Then years later, I had a doc tell me that my MRI had some abnormalities but nothing that he would not expect for someone of my age and that the abnormalities were nothing of any real concern. He gave me a copy of the MRI results after he had discussed it with me.

Personally, I think the doc should have told you something similar to what my doc told me after MRI, abnormal but insignificant. To not notify you of ANY abnormality is probably because he did not want to have to discuss it with you since he seems to have considered it insignificant.

The question is........ Are you experiencing pain or problems? If you have NO symptoms, he probably thought it of no significance.

I now have moderate thoracic herniations, multi-level facet osteoarthritis, degenerative discs, and a few other things that I can't remember at the moment.

I would ask him to give you a detailed explanation of why he stated your MRI was "normal" or did he mean that it is insignificant.

I've had the pain steadily for over a year, so the pain is there. My next visit isn't for another six months, however.

[Hopeless]

I am too impatient to wait for answers. Can you see the doc or call about his comments on your MRI before your next appt. in 6 months?

Chronic pain has made me impatient, irritable, and someone different than my former self. I have difficulty forming my sentences lately. Things do not come out on paper like I intend.

I hope someone will give you the straight scoop on your MRI.

[Dr. Smith]

Originally Posted by Hopeless

I had a doc tell me that my MRI had some abnormalities but nothing that he would not expect for someone of my age and that the abnormalities were nothing of any real concern. He gave me a copy of the MRI results after he had discussed it with me.

Personally, I think the doc should have told you something similar to what my doc told me after MRI, abnormal but insignificant.

I agree with this. A lot of these... (I hesitate to call them 'abnormalities' because many of them are normal as we age) ...'peculiarities' are part of the price we pay for walking upright and living longer.

Originally Posted by tdouglas

Is a mild disc desiccation and mild multilevel facet osteoarthritis not worth mentioning?

Some of these guys see hundreds/thousands of these things, so they get used to the common stuff, and perhaps in his opinion it was just that--not worth mentioning (or he had an off day, or something else on his mind?), but there's no law that says you can't ask him about it. If the guy is good at explaining things, I don't see any reason why he wouldn't be candid about this. I would just do it in a matter-of-fact manner rather than confrontationally.

The issue (as I see it) is not this incident, but that you're in pain. If it were me (and I don't know that you're not already doing this) I'd call his office and ask to be put on a cancellation list for an earlier appointment, and spend some time in the interim looking for possibilities (from a symptom perspective) to ask about/discuss. YMMV.

Doc

[Dr. Smith]

Originally Posted by Hopeless

Chronic pain has made me impatient, irritable, and someone different than my former self. I have difficulty forming my sentences lately. Things do not come out on paper like I intend.

A-MEN!

Doc

[tdouglas]

@Hopeless

I will definitely call him before then. I'm pretty sure he's going to say it's nothing, but it's worth checking out.

@Dr. Smith

I totally understand that as one ages, their body starts to break down. But I'm only 23 and I've already had one back surgery. I'm not supposed to age this fast! It just adds up to me -- pain in the area the results talk about. Plus, having studied a ton of information about reading and interpreting MRI's, I can see some disc abnormalities in the exact spot of my pain. Of course, I'm not at all qualified to make that call, but it all adds up.

I appreciate you guys taking your time to talk to me about this. Normally, I'd be Googling up a storm, but I can't find much about facet osteoarthritis. It's frustrating!

[waves]

TDouglas,

Since you've said this doctor has been good in the past, I'd give him the benefit of the doubt and go back to talk to him. Emphasize the fact that you are having pain and that it has been worsening over the course of a year. You can say you were looking over your last exam and ask questions about the multilevel facet osteoarthritis. Depending what he says, you can ask directly if it couldn't be related to your symptoms or whether it might have gotten worse since that exam.

If you aren't satisfied, definitely see another doctor. Since you are having symptoms, someone needs to be working with you to address them. If this exam does not explain the symptoms, fine, but in that case, the doctor should try to find what the cause of your symptoms is, and not stop at stating what it isn't.

-----------------------------

Your report basically indicates that you have osteoarthritis. It is mild. The "multilevel facet" part is referring to the type of joint and the fact that multiple levels affected. This page talks about osteoarthritis in facet joints, and the implications of multilevel involvement:

http://www.spine-health.com/conditio...osteoarthritis

Here is the Wikipedia page on osteoarthritis:

http://en.wikipedia.org/wiki/Osteoarthritis

Even young people can have osteoarthritis. It is thought to have a genetic component, and other statistical risk factors have also been identified, but no exact cause has been determined.

Mild osteoarthritis might not be expected to give symptoms. Symptoms show up gradually as cartilage continues to degenerate. The rate of degeneration can vary immensely from one person to another. Also, some may experience symptoms early, while others may have few or no symptoms until quite late. Symptoms can also come and go ... there tend to be "flare-ups".

waves

[Dr. Smith]

Originally Posted by tdouglas

@Dr. Smith

I totally understand that as one ages, their body starts to break down. But I'm only 23 and I've already had one back surgery. I'm not supposed to age this fast!

That's amost exactly what I said when, at 45, my surgeon told me I have the spine of a man in his 90s, and what I really needed was a spine replacement, which he couldn't give me.

Though generally the result of the natural aging process, the initial cause of arthritis, or facet syndrome, may be an injury or overuse in youth.
https://www.treatingpain.com/conditions/facet-syndrome

Some of this terminology can be/get confusing. See: facet syndrome, spondylosis
There may be other reasons for early onset as well, e.g genetics, nutritional deficiency, etc.

Pain in the area... maybe yes—maybe no. With all the research you do, I'll assume you know about referred pain. I don't know that your pain is/isn't—just throwin' it out there, cuz I've had it vis-à-vis myofascial pain syndrome.

Of course, I'm not at all qualified to make that call, but it all adds up.

We're not at all qualified to make that call either.
Whether it all adds up... You'd know better than (the collective) us (we? ) So many variables—medical history, genetics, stuff we don't even know that we don't know...

What is it about facet joint osteoarthritis that you can't find? See also: facet syndrome causes

Doc