severe back , neck ,hip ,joint pains. pleaseeee help doctor

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mohsinaliasdf
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May 12, 2012 at 1:31 pm

Post count: 11

#6186

Hi dr dorenman my name is mohsin ali and i am 17 years old and today i want to discuss the several unusual problems that’s im having. i don’t know where to start there’s soo much to say . well ill start off with a little of my medical history six months ago i was a healthy individual ever since then my life has become miserable not to mention. well first i started having chronic joint pain and fevers i wasnt even able to take a step i mean my legs just gave up . After a couple of weeks the pain started going to my shoulder my elbows and basically my entire body . after two months or so i had an episode where i had to be rushed to the E.r where my blood work was done and i was diagnosed with rheumatic fever ( rheumatoid arthritis) i was given an injection of penicillin and other meds . but it really didn’t help from that day on i cant live a normal life anymore , ive gave up on school ,sports, and everything i normally did when i was healthy. my regular pediatrician isnt helping me as he should be , like he referred me to a rhuematologist , an orthopedic, they had my x-rays done for shoulder ,knees and elbows but find no arthritis. now the big thing with my back just started 3 months ago at first it wasn’t that bad like i was able to do a little somewhat like walk normal . then it starting getting really bad i couldn’t even move , my mother had to pick my body out of my bed and i would fall back down. and yeah i was still having fever at that time . the symptoms were gradually increasing day by day . now its all around my back. my lower back , upper back , surrounding spine areas . now every time i breath i can hear cracking notice my my back and neck .it has gotten me really depressed i mean im just waiting for some doctor to diagnose me thoroughly and get treated . at 17 i know how kids do with their life and here i am home all day suffering . so far no mri done. x ray was done but doctor just said don’t worry that’s all. my question is that what is the main possible reason thats causing so much pain and fevers , and causing my bones to shrink . does it sound like something systemetic or is there really something wrong with my back seperately. i would gladly appreciate your help doc i am looking to get back to normal life. please shed some light on me .
thank you so much.

Donald Corenman, MD, DC
Moderator

May 12, 2012 at 11:13 pm

Post count: 8660

#6187

It appears that you have developed an autoimmune arthritis. An autoimmune condition is one where your own body defenses (white blood cells and antibodies) have mistakenly identified some of your own host tissues as “foreign invaders”. In your case, the proteins that appear “foreign” to your immune system are in the joints of your body.

You mention two separate conditions, rheumatic fever and rheumatoid arthritis. These are different problems but can lead to similar symptoms. Rheumatic fever starts with a strep infection in your throat (sore throat) and is found in younger individuals (10-20 years of age normally). In your case, this infecting bacteria has very similar proteins as some of the tissues of your body. Your body has mistakenly confused your own joint proteins as part of this streptococcus bacterial infection. Your body then goes forward attacking these proteins as it thinks that certain cells in your joints are this bacteria. The heart, brain and skin can also be involved. The joint inflammation is not normally destructive.

Rheumatoid arthritis has a similar mode of pathology but is a different disease process.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

mohsinaliasdf
Member

May 13, 2012 at 7:16 am

Post count: 11

#6191

thank you doc for your reply. my doctors did some blood work and it showed an elevated level of antistreptilosi ASO and was only given a pencillin njection, but show no improvement at all. what can i do in this case should i go to the e.r to be admitted for a full medical check up or otherwise ? i still dont understand where my back pain is coming from . can it be a possible herniated bulgin disc. thanks

Donald Corenman, MD, DC
Moderator

May 13, 2012 at 10:30 pm

Post count: 8660

#6193

Back pain that was not present before your rheumatic fever could be residual from inflammation or from a process that originated in your back (degenerative disc disease or such).

A good work-up from a skilled spine specialist should yield a diagnosis.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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