My Crohn's and Colitis Blog » Bronchial Asthma Treatment » degenerative arthritis and physical therapy
degenerative arthritis and physical therapy
Question:
I was recently diagnosed as having degenerative arthritis of the spine (cervical 4-7) by a Physical and Rehabilitation specialist who has recommended physical therapy. I am scheduled to start PT in a few days but am having serious doubts about its possible effectiveness. (For over ten years I was on mega doses of bursts of prednisone for COPD/bronchial asthma and it is highly possible that this contributed to the DA.) Has anyone had improvement of their degenerative arthritis after having physical therapy? The diagnosis of DA seems to be so nonspecific — I have not had much success trying to find information. My pulmonologist who referred me to the Physical and Rehabilitation doctor suggested I try to search for "cervical radiculophy" but this hasn’t yielded any real information. If anyone has any thoughts about or experience with DA I would welcome hearing from you. Thanks. Maris
Response:
Maris – I think you have two separate and real concerns as follows: 1. Degenerative arthritis or osteoarthritis or cervical radiculopathy of the neck at cervical vertebrae 4 through 7. The spine and neck are composed of vertebrae which are bony and the discs in between which are made of fibrous tissue around a more gelatinlike center. As we age, the discs dry out. They can deteriorate or be injured traumatically as when they herniate. In addition to aging damage to the disc, one can have aging changes of osteoarthritis of the vertebral bones with extra bone (osteophyte) formation. Finally the nerves to the arms leave the vertebrae through little holes called foramina. Osteoarthritis with osteophytes can impinge on the foramina causing pressure on the nerve which you feel as numbness, tingling and pain down the arm in the distribution of the nerve. Physical therapy is helpful for improving range of motion by decreasing muscle spasm, controlling pain etcl. If poor posture is an issue, exercise may help. Traction may relieve pressure on a nerve root. 2. The issue of the large doses of steroids. Steroids cause osteoporosis, not osteoarthritis or degenerative disc disease. You don’t say how old you are but anyone on long term steroids loses calcium from bone. If you are younger, you have more calcium to spare. If you are a man, generally you have more calcium to lose. If you are a postmenopausal woman not on estrogen, you are in negative calcium balance anyway and will lose more on steroids. While taking steroids, one needs to take in 1500 mg of calcium a day and 400 to 60 international units of vitamin D to remain in calcium balance. A glass of milk has 250 mg of calcium and I know very few adults who drink 6 eight oz glasses of milk daily. If you lose enough bone, the bone on the x-ray will look thin but by the time the bone is thin on x-ray, you have lost significant amounts. If you are concerned about this, I would see my doc and ask to have a bone densitometry or DXA SCAN. I hope this helps. You should go back to your doc and make sure you understand what he/she is saying. If possible, ask him or her to go over your c-rays with you. Whenever possible, I go over xrays with my patients so that they can see with their own eyes what the problem is. Best wishes. Susan Hoch, M.D. On 5 – Hide quoted text — Show quoted text – I was recently diagnosed as having degenerative arthritis of the spine (cervical 4-7) by a Physical and Rehabilitation specialist who has recommended physical therapy. I am scheduled to start PT in a few days but am having serious doubts about its possible effectiveness. (For over ten years I was on mega doses of bursts of prednisone for COPD/bronchial asthma and it is highly possible that this contributed to the DA.) Has anyone had improvement of their degenerative arthritis after having physical therapy? The diagnosis of DA seems to be so nonspecific — I have not had much success trying to find information. My pulmonologist who referred me to the Physical and Rehabilitation doctor suggested I try to search for "cervical radiculophy" but this hasn’t yielded any real information. If anyone has any thoughts about or experience with DA I would welcome hearing from you. Thanks. Maris Maris: I’m not a physician so I may be wrong but I believe "degenerative arthritis" may be the same as or similar to Osteoarthritis (OA) or Degenerative Joint Disease (DJD) which many older people develop and others, like me, get at an earlier age. Cervical radiculophy is a manifestation of OA and DJD; it means that the nerves are affected by the disease. This could result from disk herniations which impinge on the nerves or, more commonly and especially in the neck, a narrowing of the foramina which results in pressure on the nerves which run from the spinal cord via openings (foramina) in the neck joints to other parts of the body. I would suggest searching under the more general subjects of Osteoarthritis or DJD. With regard to physical therapy, exercises and sometimes traction can help reduce pain but you should really have a more thorough evaluation of you neck by a rheumatologist or an orthopedic physician. X-rays will indicate if your disks have deteriorated and an MRI will help determine the amount of radiculophy or nerve involvement. I am not aware of any relationship between long term prednisone therapy and DJD but one of the physicians who monitor this group could probably answer this question. Bob Engelbardt Kailua, Hawaii http://home1.gte.net/bobengel/
Susan Hoch
Response:
Related Posts
Categories: Bronchial Asthma Treatment | 
No Comments »