Whats the cause of my backpain???

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saskia
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January 13, 2012 at 9:21 am

Post count: 3

#5366

Hello,

I have trouble understanding why my back hurts and how to stop the pain.
I am 22, female and I’ve been having this back pain for 3 weeks now and it’s not getting any better.

The diagnosis of one doctor was thoracic syndrome. She said two of my rips were dislocated. Another doctor said that I have mysclerosis in the big trapezius muscle. My whole musculature in the right back and neck is EXTREMELY tense.
Today I was at physiotherapy. The massage to relax the tense muscles hurt so much that I could hardly bear it. There are two points that hurt the most, I think next to the TH2 vertebrae. One on the right side and one on the left.
I also have a constant pressure on what I would identify as my gullet. It literally feels like someones poking against my gullet from the inside (right). It’s extremely irritating.

Yeah, I don’t know what to do about all of that. I feel like nothing is helping in any way. I tried many different things now and I don’t want this backpain to become chronic.

So is there any way that I can get my muscle to relax?, should I ask for a radiograph or mri?

I’m thankful for any advice on how to deal with this.

Donald Corenman, MD, DC
Moderator

January 13, 2012 at 1:32 pm

Post count: 8660

#5370

You complain of significant neck and trapezius pain (the muscle in the shoulder). 95% of the time, these complaints are due to a disc herniation at the lower two discs in the neck (C5-6 and C6-7). A thorough physical examination will uncover this diagnosis (decreased reflex, sensory deficit or motor weakness). If your pain seems to be worse with bending your head backwards and better with putting your neck on your chest, this is most likely a pinched nerve in the neck.

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.

saskia
Member

January 16, 2012 at 1:16 pm

Post count: 3

#5386

Hello,

actually the pain is worse with putting my neck on my chest, so no pinched nerve.
I do have pain when I put my head on my left shoulder.

A disc herniation is a severe thing, right?
I haven’t noticed any numbness. What do you mean by decreased reflex oder motor weakness?

Should I ask for a mri? I feel so unsure about the diagnosis.

Donald Corenman, MD, DC
Moderator

January 16, 2012 at 9:32 pm

Post count: 8660

#5387

Flexing the head forward and inducing the pain still could be from nerve compression but is more unusual. A disc herniation may or may not be significant. If this compression is causing nerve dysfunction, then it is as significant as the quality of the symptoms.

Decreased reflex and motor weakness would be noted on a physical examination.

At this point, you need more information. A knowledgable physician or chiropractor who can perform a good physical examination is in order. I think X-rays at this point might be helpful.

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.

saskia
Member

January 19, 2012 at 6:23 pm

Post count: 3

#5416

Hello,

So i was at the physicians office and physiotherapy today. Physiotherapy was first. Everything still hurts. The physiotherapist said that i have pain from th2-th6 and still in the trapezius muscle.

I have to say, that i’m not a fan of the physician. I am from
germany. Here the doctors talk to you for 3 minites max, today i feel as if she talked to me for 1 minute. I wanted
xrays of the th and the c vertebrae but nobody really cared about that so only a xray of the th part was made. Which showed no abnormality.

All she said is that i should train the muscles although training hurts.

If i change the physician during one quarter i have to pay an extra fee. and besides i don’t know if that will be better.

Should i search for another physician? Honestly a thorough physical examination has never been made and i don’t feel like she’s listening to what i’ m saying either.

Donald Corenman, MD, DC
Moderator

January 19, 2012 at 10:11 pm

Post count: 8660

#5417

You would think that there are many physicians that have great spine experience as spinal disorders are the second most common reason to visit with a doctor. Unfortunately- there are very few physicians that have great spine knowledge and I assume the problem in Germany is the same as in the States.

Most commonly, upper thoracic pain is caused by the cervical spine but most non-spine physicians look at imaging only of the thoracic spine as “that is where the pain is”. I believe that instead of trying to replace your primary doctor, obtain a referral to a spine specialist. The mainstay of diagnosis is a thorough history and physical examination followed by at least X-rays.

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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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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