SarahjaneParticipantApril 15, 2013 at 2:19 amPost count: 3
Dear Dr Corenman,
Out of the blue I deveoped muscle spasms in my neck a year ago.I had an MRI of my thoracic spine and I had degeneration throughout and disc protrusions .I was told I had Scheuermann’s kyphosis in my teens.I had PT and the pain improved to some extent.
Six months ago after a prolonged period of standing my left shoulder and then my neck went into a severe spasm.I also experienced numbness in my left hand which was associted with the ulnar nerve.I was sent for a cervial MRI and the only finding was a prominent cervial lordosis.
I had meds and then have had months of PT and while the hand numbness and shoulder pain have improved the neck spasms have not.They occur across the region of the vertebrae my therapist calls the cervico-thoracic junction.They are extremely tight or else feel as though they have been badly strained.
It takes very little to irritate the muscles. I also feel as though I have pain in the joints going right up to my skull base.I also have degeneration and disc dessication in my lumbar spine.
Will I ever be free of this pain?.Sometimes it feels as though I am struggling to hold up my head.Also every non orthopaedic doctor I have seen comments on my poor posture but any orthopaedic doctor never mentions it.It is possible to improve it any further?.Many thanks,Sarahjane,32Donald Corenman, MD, DCModeratorApril 15, 2013 at 8:25 pmPost count: 8459
Scheuermann’s disorder is an interesting problem as it produces changes at more than just the area it is affecting. The increased kyphosis of the thoracic spine has to be balanced by changes in the lumbar and cervical spines or you would not be able to stand upright.
The increased kyphosis in the thoracic spine causes increased lordosis (see sagittal balance in the anatomy section and Scheuermann’s disorder in the conditions section) of both the cervical and lumbar spines. This increased lordosis causes two problems.
One is increased load of the facets. This increased load can cause facet inflammation and pain (see degenerative facet disease in the cervical section). The other is increased muscle contraction to hold the head in the proper balanced position. Muscle overload pain then occurs (lactic acidosis).
Facet pain is treated with manipulation, medications and injections. Muscle overload pain is treated with strengthening and muscle relaxors.
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