I have recently received my lumber spine MRI results and I’m quite shocked. I live in Spain so my results are in Spanish which I have translated the best I can until I can see my GP Friday. It’s says I have chronic fractures with subsidence of the upper end plates from L2 to L5. Slight degenerative disc changes consisting of a decrease in the T 2 signal and height of the disc from L1 to S1. Also small posterior protrusions of the discs LS 1 LS2 to L5/S1. I have osteoporosis and have had 2 previous fractures and 2 slipped discs in 2019.
Can anyone Shed any light on this please. I’m really worried. Thank you
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1ChLoE
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I don't know whether any of us have enough medical knowledge for this. I do know that degenerative disc disease is a form of arthritis that's very common as we age, which can cause pain for some but not others. As far as I know, fractures aren't caused by disc degeneration or slipped discs, as discs fill the space between the bones, rather than the bones themselves. If you haven't had one already, a DEXA scan normally follows on from any diagnosis of fractures. They should also run a number of tests to look for any potential underlying causes of your fractures, including hyperparathyroidism (not the same as hyperthyroidism), low Vitamin D and coeliac disease or other absorbency isssues. For both disc issues and fractures, have you been given advice on safe exercise to support and protect your spine, safe lifting etc?
Hi thank you so much for your reply. I have had 2 dexa scans, I have had lots of blood test and even though I’m in Spain still have low vit D3 . I also have diverticula disease so maybe that is a problem. I’m waiting for a nerve conduction test on my legs. I am also waiting for a physio appointment. Not much advice on safe lifting, but I’m 68 so retired. Thank you so much
I discovered a few years ago that sunbathing for hours daily didn't maintain my Vitamin D level, so I now supplement all year round. I currently take 2000iu daily, but before getting my IBS better controlled had to take more than this. If your Vitamin D is low, have you considered taking a higher dose supplement? It plays a really important role in calcium absorption, so is likely to be one factor contributing to your fractures.
It's definitely worth getting some instruction in safe lifting. We all do lots of lifting in our daily lives - eg picking up heavy bags of shopping - and can protect our backs by knowing how to do this (for example, avoid twisting).
Your lumbar spine sounds very similar to mine. Mine is a very long story but basically I had three MRI scans done back in August.
I had been convinced for a long time that I had fractured my sacrum and it turned out that I had. I started with a lumbar scan then followed that with another two scans, the sacrum and the pelvis.
I also have loss of disc T2 signal at L4/L5 and L5/S1 plus loads of other nasties. I’ve got disc degeneration, well lots of degenerative changes and herniated discs and some of the vertebrae are overlapping by quite a bit. I’ve got a lot of nerve pain and pains that run right down through my buttocks.
Basically I’m doing gentle physio / Pilates exercises with a Pilates teacher who specialises in osteoporosis and is also a physiotherapist so she really knows what she is doing. I’m gradually building up my walking distance. I do three hour long Pilates classes every week and the physio who referred me for the MRI scan ps said ti do exercises on the other days too - I’ve found I I don’t keep moving I end up very stiff and in a lot of pain.
I was told never to twist my spine or to rush anywhere, I don’t carry weights and I’m terribly careful if I’m anywhere muddy or where there are lots of wet slippery leaves and I use Nordic walking poles when I’m out walking.
Do you have osteoporosis and why did you have the MRI scan done? ?
Thank you so much for replying. I have osteoporosis, runs in the family. But I had a back injury in my late thirties and have rheumatoid arthritis taking steroids. Your lumber spine sound so much like mine. I have been having pains in my legs, hips, in various degrees. I can’t walk far at all before I need to stop and sit down, which eases my pain short term. I will definitely look at Pilates, but someone that knows what they are doing. I had my first fractures just leaning forward and twisting forward. Thanks again
Just to say. I’m not putting downwhat Fruitandnut said but I was told not to do Pilates. I had bought a new CD too but have never used it. I was given some excercises by The Osteoporosis Society. I would get advice before doing anything like that. It probably would be fine but I would check.
I was originally told to do Pilates by an NHS physio who had been treating me for a back problem way back in the early 1990s. I was very lucky with her because I’d had lots of physio that wasn’t very good. At the end of the course she told me to find a Pilates teacher, told me what to look for in a teacher, gave me the phone number of a good masseuse and started me off with simple basic exercises to strengthen my core.
I am in what I jokingly I call the remedial class. We all have similar horrible problems and my teacher has also seen all of my MRI scans.
You have to be very careful what teacher you choose, mine is a physiotherapist and she knows all of our bodies and adapts everything to suit our own needs. We are very lucky to have her and Pilates and walking is what keeps me moving.
Sounds like Pilates was just not the correct exercise for you Mavary - I remember being desperate to do Tai Chi because I’d heard it was good for people with back problems. You know what it’s like when you would try anything to deal with the pain. I tried an introductory class for a few weeks and yet by the time I had ‘Parted the Wild Horses Mane ‘ each week. I ended up barely able to move the next day - yet it is recommended for joints and back problems as is yoga which is supposed to be good for backs but doesn’t suit me either. I’ve just struck it lucky that Pilates is perfect for my body.
I’d say you have to be very careful doing any sort of exercise - unless and until you have spoken to someone with knowledge of your body which 1CLoE is going to be doing - and you have to choose any teacher you have very carefully. You need a tiny class and a very good teacher - in my case with a teacher who really understands osteoporosis.
I always understood Pilates was good for your back and like you say I would definitely get advice before doing it. But that’s why I bought the CD because I thought it was good. But for me I was told no don’t do it. I think you are very lucky to have found someone that understands the breaks you have. I just wish I could find someone like that. My Consultant wanted to get an exercise group up but then we had covid and now she’s left so I don’t expect we will get it now. I can walk but not too far but my Husband and I moved into an apartment fifteen years ago where we haven’t got any room for white goods. Therefore I have to wash up by hand which kills me. I’ve thought about it for a long time and I’m going to get a tabletop dishwasher after Christmas. Maybe try and hang on till the January sales. My back is telling me. No!!! Go and get it this minute. I don’t want to ever wash up again. 🤣. But my head says wait for the sales. We will have to wait and see which wins. I’ve got osteoporosis very badly and that may be why I was told not to do Pilates. I’ve had seven fractures.
I’ve just been thinking of your Pilate class and was wondering how I could get into doing something like that as I feel ignored by my Consultants since lockdown. It would certainly do me good to move more.
Well my Pilates class is good. I would look for someone who is a qualified physiotherapist, someone who understands osteoporosis and someone who enjoys working with people who have osteoporosis who are often older people.
There are so many different levels within Pilates - what we do in our group is very relaxes and is basically mobilising and stretching our bodies, strengthening our cores which helps support our backs and masses of work on balance - to prevent falls.
We’re definitely not aiming for six packs and muscles like Popeye. I’d say we work hard but at our level, no one is throwing themselves about and it’s not like aerobics, it’s a very slow moving gentle class and we all leave feeling really good.
So if you can find a teacher (my teacher teaches STOTT Pilates) ask them how they operate and try a session with them, they might want to see you by yourself to start with. You’ll know if they are the right person for you when you speak to them. You also want a very small group so that you can have lots of individual attention.
I’ve come across a couple of awful classes when I didn’t do enough research although I didn’t do back to either of them, one where the hall was packed full of people all throwing their legs around and grunting and a teacher who didn’t ask you anything about yourself and another one who told a girl who said she didn’t want to do something because it hurt, just to do it!
Your teacher should be able to tailor everything you do in class to suit your own particular needs. Even both sides of your body feel different so what suits your body will possibly not suit the person next to you. You want (and need) to move but you definitely don’t want to do any damage.
I believe there are different kinds of pilates. Have never done it myself so don't know details. However if one avoids twisting while upright that should help. My physio exercises for my back do include one where I twist, but I'm lying down, plus I don't have any fractures.
It’s interesting what you say about twisting HNS because the physio who sent me for the scans told me to avoid twisting at all costs and although like you we also do an exercise which is a sort of twisting but we are also lying down. I have read that playing golf is very bad if you have osteoporosis because you are twisting and putting tremendous force on your spine which is interesting because my elderly aunt who had osteoporosis had been a very keen golfer all of her life and another elderly lady along the road from me who is of a very similar size and shape to my aunt and who was a dedicated golfer was complaining to me in the summer about finally having to give up golf because of osteoporosis.
I think it would be interesting to know the lifetime hobbies of people who are now living with osteoporosis - although I know there are lots of other contributing factors involved.
I was under the impression that seated trunk rotations are ok. (as demonstrated by a physio in this video, for example. it's the second exercise.) I wonder about side bends. I've read they should be avoided if you've fractured, but wonder if they're ok if you haven't.
Those look good. All sound stuff. You don’t need to be able to get your legs round the back of your neck to benefit your body. We don’t do the second one possibly because most of what we do is either standing up or lying on the floor although thinking about it we sometimes do diagonal stretching with opposite arms and legs - arm forward, opposite leg back sort of thing which I suppose is rotating through the trunk - but the other exercises are all things we do. We do a lot of chest opening / back strengthening exercises - it’s never ceases to amaze how many variations a physiotherapist can find to do similar things, even something as simple as palms up or palms down can change an exercise. The last exercise is a classic Pilates exercise sometimes known as the the ‘dumb waiter’.
I must look for more things by this person she looks good and I’m always looking for things to do on the four days I don’t do my hour long sessions. 😊
When I woke up at 0430 this morning and my mind roamed free (!) I realised we do sometimes do something similar to exercise 2 - we stand up straight, feet hip width apart maybe slightly more to be comfortable, then we cross our arms over our chests - bit like when you see illustrations of the genie in Aladdin stories and standing up straight we rotate gently from the waist - hips stay facing the front - which is pretty similar to 2.
I went to an OP workshop at our local hospital in 2016, and I'm sure one of the things they emphasized in the physio segment was to avoid twisting, although this was in the context of learning how to pick thing up off the floor, or put them down, or unpack shopping, etc. My physiotherapist has given me exercises for my back, in addition to some I've been doing for many years, and the only one which involves twisting is done lying on the floor. She is aware of my diagnosis of "low bone mass." I'm sure that as individuals there are some things we can do and others can't and vice versa. I would not do new exercises without some experienced guidance. Certainly I've been encouraged to do Tai chi, which although it involves the knees a lot and was hard for me for some months, doesn't really have the spine twisting in any significant way, the torso is actually kept quite straight, even though the body moves around a lot. I've just done a few of the movements to check and the turning motions are done by the feet, thus protecting the spine.
Thanks, HeronNS. Yes, everyone appears to agree that the main thing to avoid is combining flexion and rotation (bending and twisting), both in exercise (e.g., alternating toe touches) and in daily activities (how we lift things, etc.). But it's important to maintain thoracic mobility, so it's good to find safe ways to move the back. As you say, exercise should be specific for an individual's concerns. Right now I find it difficult to lie on my back, so I'm doing seated trunk rotations (given to me by a physio).
I took a little Tai Chi/Qi Gong a few years ago and keep thinking I must get back to it. I know what you mean about the torso staying straight as you move. I think I read about one movement that should be modified, but I don't remember which one. Dr. Paul Lam has done videos on Tai Chi for Osteoporosis (and arthritis) but I haven't done them.
Might be worth trying good quality Nordic poles - mine are by LEKI, they’re not cheap but they’re good and mine have quick release wrist straps which have c9me in really handy. I’ve not met or heard of a physiotherapist yet whose eyes don’t light up when I say I use them. They take a lot of weight off your hips and knees and help with balance and let you move at a fairly normal pace.
I’m like you I can sit down for a rest - some people can’t which must be dreadful. I’m not comfortable standing for long though, so at least we can sit. I’m also like you and Met00, no matter how sunny things are and even when I’ve had three weeks in the south of France I still have to take vitamin D3, I take 3000iu every day.
Like you I have a family history of osteoporosis and inflammatory arthritis, I caused damage back in the 1980s when I slipped while wearing roller boots and crashed down on my tailbone. How I feel now is the first time since then I’ve felt so bad. Back then I had two epidural cortisone injections which calmed the herniated disc down. The physio who referred me for the scans said he thinks my current problems date back to damaged caused by that injury.
I would wait until you see your physio before you do any serious exercise though and make sure the physio understands osteoporosis- also don’t do anything that causes pain even if your physio tells you to do it.
My Pilates teacher is always reminding us of that and saying don’t do anything that hurts even if I tell you to do something. We work hard and our muscles can ache but that’s not the same as pain.
Good luck with it all, hope your physio appointment comes soon.
Thank you. I will look into buying some of the poles you mention. I have thought about them, but never got round to getting them. A normal ish walking pace would be a big bonus instead of snails pace. Anything that will help. I’m also looking at buying a mobility scooter. Something I hoped I would never need. I’m quite concerned about seeing physio, but I will make sure they are aware of my problems. It so good to know how other people cope. Thank you again.
If it’s any consolation I was absolutely sure I would end up needing a mobility scooter way back when I was at my worst - I could barely walk and when I did I was so slow, people used to stand aside because of covid and wait for me to pass them and I’d have to tell them to go first because they couldn’t wait as long as I was going to take and I felt so wobbly and I had to go upstairs on my hands and knees. The only way forward I could see was a mobility scooter but I’m hopeful it w8nt be for a while yet and hopefully never.
Luckily we moved in to an apartment 3 years ago which has made life so much easier. I always said I wanted to move before I needed to and I we managed to move about 9 month before my first fractures. Sounds like there is lots of useful information on the ROS website. Lots of reading to do. It’s also good that people here understand as I find lots of people just think it’s a bad back 😥. I try to stay positive and do as much as I am able. Just try to make the best of every day. Thank you
I have used Nordic poles quite a bit. A friend of mine, much older, was bent double with OP, but after learning to use Nordic poles can stand upright again, with the poles to support her. She was about 80 at the time and the instructor considered her a star pupil, even though they had to adapt the classic Nordic walking a bit for her.
I am looking into getting Nordic poles, just need to make sure I get the right ones. Just doing research at the moment and trying to find them as I live in Spain. Thank you all this information is very encouraging. At the moment I’m struggling to walk any distance at all without severe pain. But I know I must keep trying to do so. Waiting for a hospital physio appointment still.
Also look out for an introductory course - we signed up for six lessons with an instructor who then ran regular weekly sessions. We don’t go to a group now but it’s a really good way to get to know how to use them and you may be able to buy your poles from them too like we did.
Thanks for the tip, I will definitely get them for my gentle hikes!
HI, The ROS website has 9 factsheets written for people with spinal fractures. Included in this information is how to lift and move safely. They spent 2 years checking out 100 pieces of research, then wrote a census statement for Health Care professionals, then produced these factsheets. theros.org.uk
It’s well worth joining the ROS too, you get a lot of really helpful information from them. I found the dietary factsheets really useful for topping up on my calcium and vitamin D rich foods. There are so many things on the list that you wouldn’t think of as being good sources of calcium. You don’t need to join the ROS to access them but it’s a good cause.
Hi 1ChLoeI’m not good at reading those sort of results but I do know the discs T12 and below are the worst ones for pain and mobility.
I’ve had seven back fractures in all. My T12 one was the worst putting me in hospital for 12 days. Ooh! I’ve just noticed the first ones to go we’re three years exactly today. The last four were up higher and they happened sometime in June of this year.
You are probably in quite a bit of pain. I hope they’ve given you something for it.
Thank you for your reply. I am taking slow release morphine at the moment twice a day, which does help with the pain thank goodness. My diverticula disease is not good at the moment, having a further colonoscopy in January. Osteoporosis is a terrible disease. I’m going to be very careful with any exercise I do. Hopefully tomorrow I will get a clearer picture after seeing my GP. I’m going to as for an earlier appointment with my rheumatologist. Thanks
Oh poor you. You’ve really got a lot to put up with haven’t you. Nobody knows what awful pain you can get when you get diverticulitis. I don’t get the pain from it any more but I’ve still got it. They removed the blockage I had caused by it. I’ve still got pockets though. I’m hoping it never flares again. And your back as well. My back is very bad . I can’t do much with it but I muggle along. I couldn’t be doing with both of it at once. You must be tearing your hair out.
If we have osteoporosis, almost everyone tells us to eat more vitamin D, but for anyone with an inflammatory condition it may be that the body is not processing vitamin D in the normal way. In this situation, the precursor D3 that is generally measured may be very low, yet the 1.25D level (which is what is actually relevant to bone health) may be either fine or too high. Having too much 1.25D is as bad for the bones as not having enough! Measuring 1.25D is much more difficult, expensive and done by only a few labs, but if you have an inflammatory problem it is the only really accurate test of vitamin D status.
Hi Thank you so much for your reply. I didn’t know that inflammatory disease can interfere with Vitamin D absorption. I have checked my blood tests and I haven’t had a 1.25D test done. I will ask my doctor for this test if not I will try to get a private one. I take Deltius 25.000 UI capsules every month, but my Vit D can still be low. I have just noticed that my 24 hour urine test showed my Calcico was 56.3 normal value is 100 - 300. I also take demilos 600 mg daily . Thank you again for your reply
If you can't get a 1.25D test, I would ask for a PTH (parathyroid hormone) test. This will give a very good indication of the 1.25D level, because if the PTH is low then 1.25D will be high and vice versa. Note that by no means all doctors know that inflammation can cause vitamin D dysregulation in the body. It is because vitamin D3 is normally converted to 1.25D by the kidneys in a controlled way, but in certain inflammatory diseases it is also converted in the inflammatory patches. This means that vitamin D3 always looks low whatever one's 1.25D status because it has been converted when it should not have been! If your 1.25D is actually OK, you shouldn't be taking supplements, even if you have osteoporosis.
Wow thank you so much for that information. I have had the PTH test in the past which was ok, but my mum had hypoparathyroidism. I wonder if that changes things. I have made the doctors aware, but maybe they didn’t connect things. I can’t Thank You enough for this information.
Hi I have just been going through my Rheumatologist notes, and I had a PTH test in August which was normal. I see my GP tomorrow again to see how I am managing with the new medication Gabapentin.
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Vertebral fractures
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PROLIA FRACTURES OF THE FEMUR.
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