Can PMR weakened muscle cause curvature of the spine?

[Omanain]

I finally saw a doctor at the pain clinic today.

Since being diagnosed with PMR in 2018 I have lost 15cm in height.

In 2020, just before lockdown, I was moving a pkt of mushrooms across my body from the table to the counter, when I felt something 'go' in the middle of my back. An hour or so later the pain set in and it was terrible, even worse than PMR before pred! I was virtually helpless for a couple of months.

As I could not get hold of a doctor let alone have a scan or x-ray I did my best with Google. I found the Guy’s and St Thomas’ website and the description of Vertebral Compression fractures seemed to fit my symptoms exactly.

As I had already suffered an insufficiency fracture in my hip, my rheumatologist, during a telephone appointment, accepted my diagnosis and persuaded me to have a series of Zoledronic acid infusions even though my bone density scans were fairly normal.

The doctor I saw today does not think I have compression fractures but a problem with the muscles in my back. He has arranged for an MRI scan to rule out anything sinister.

Can anyone help me to understand this?

I understand how a compression fracture could cause sudden pain and height loss, but how can a muscle in my upper back suddenly let go?! It caused a bit wedge of muscle below my breast and I have to dig in really deep to find my sternum!

I will no doubt get a full explanation at the pain clinic when I go back after the MRI scan, but it could be many months before I get an appointment.

[PMRpro Ambassador]

ncbi.nlm.nih.gov/pmc/articl....

Given the symptoms you report I find it very difficult to imagine it isn't osteoporosis and disc degeneration that is causing your loss in height.

nynjcmd.com/shrink-age-combat/

However, loss of muscle tone weakening your ability to stand upright will also contribute to loss of height. But in all the things I have read about that it is a less considered and very secondary cause that is mentioned - in fact, not even secondary, more like quaternary!!!!

Do tell us what they decide. 2020 was NOT a good year ...

[Omanain in reply to PMRpro]

Thanks for this Pro.

Funnily enough the Doctor asked me what I hoped for from this appointment, I told him I wanted to understand of what had happened to me! I am now more confused than ever! Hopefully the MRI will clarify things.

[PMRpro Ambassador in reply to Omanain]

IMHO - what a stupid question! I know it is a common question for them to ask but if you go to the doctor with a specific complaint surelyyou are expecting to know what is going on and the GP is the gateway to that happening. You were failed badly 4 years ago - but no-one seems to have caught up on that. And for goodness sake - if you are 6 inches shorter than you were, SOMETHING is happening!

[Omanain in reply to PMRpro]

I received an appointment for an MRI Scan in the next day's post, it is for 23rd April, so something must have caused the sudden speed!

Thank you for the information on The Aging Back, I was especially interested in the suggestion that DEXA scans are not always reliable. Maybe I have osteoporosis in my spine after all?

Best wait for the scan results before I start speculating I suppose.

[PMRpro Ambassador in reply to Omanain]

They are very dependent on the operator and exact positioning of the patient which can alter the angle of the beam.

Look forward to hearing their opinion.

[Sophiestree in reply to Omanain]

This question is a counselling technique and it sends me round the bend. When I was a Childline counsellor you had to ask the children that. What child knows what they're hoping for when they've finally got the courage to ring in the first place.

bonkers

[PMRpro Ambassador in reply to Sophiestree]

Absolutely!

[Numptybrain]

I’ve definitely lost height, my daughters tell me I’ve shrunk. I’ve got osteoporosis, had it for 3 years now, rheumi has just done an X-ray of my spine laying down then in a curve so I’m assuming he’s looking for fractures too, as I get terrible pain at night when I lay down.

Good luck

Wendy xx

[PMRpro Ambassador in reply to Numptybrain]

Hope they did a standing one too? The UK only ever did lying ones on me and you don't see the problem. Even I can see it on a standing one!!

[Numptybrain in reply to PMRpro]

No and he didn’t tell me what he is looking for

[AtopicGuy in reply to Numptybrain]

Well done for filling in your Profile! Many users don't! You're clearly not such a "Numptybrain" after all, Numptybrain!

In your Profile you wrote that you are on "Painkillers for several spine conditions which result from surgery years ago. Currently two thoracic spine fractures from February 2020 still causing a lot of pain." As others have said, it is very unlikely that PMR is at the root of your spinal curvature problems.

[Numptybrain in reply to AtopicGuy]

I think rheumi is looking at PMR for pleural/ pericardial effusion and maybe ankylosing spondylitis also, I think but not sure as I’m still having issues with spine now

Thank for replying

Wendy x

[Omanain in reply to PMRpro]

Exactly! I just have to stand sideways by a mirror to see I have a curve in my back. The doctor took one on his spine models and showed me how a spine should look, then he bent it forward and said this was how mine looked. Oh really?

But will this show on a lying down scan?