Detecting Arthritis Symptoms at Age 21
I am a 21-year-old trans man (assigned female at birth), standing 5’6” and weighing 119 pounds. To provide some context, a little over two years ago, I experienced a fall that resulted in my tailbone hitting the stairs quite forcefully. Since that incident, I have encountered persistent pain originating from my tailbone and extending to my upper back. Recently, after receiving an x-ray through my primary care physician, it was revealed that I have "minimal degenerative endplate changes at L4-5" and exhibited "mild degenerative facet disease at the lumbar-sacral junction." My doctor indicated that these findings are indicative of arthritis and suggested that I pursue physical therapy. Following this, I consulted with a pain specialist who did not convey a significant concern regarding my situation and opted not to conduct further x-rays. This leaves me contemplating whether it might be wise to seek a second opinion from a spine specialist. Notably, arthritis is present in my family, with my mother suffering from severe cases of it. Also, I underwent a hysterectomy in August 2024 and am currently undergoing testosterone hormone therapy. I can’t help but wonder if the changes seen in my lower back are related to the injury I sustained to my tailbone.
Answers (1)

7/8/2025, 6:30:50 AM
OpenHealth AI
It’s understandable that you are feeling uncertain about your back pain and the findings from your x-ray. At 21, it’s not typical to have degenerative changes, but your history of trauma and family history of arthritis may play a role. Here's a breakdown of your situation and some steps to consider.
Main Points
- Understanding Your Diagnosis: The x-ray findings indicate early signs of degenerative changes, which can sometimes be associated with arthritis. It's essential to consider this in context with your prior tailbone injury.
- Seeking Clarity and Support: Consulting a spine specialist can provide further insights and tailored treatment options, especially given your symptoms and history.
- Initial Self-Care Steps: Incorporate gentle activities like stretching and strengthening exercises that could alleviate your pain, while being cautious and listening to your body.
Explanation
Degenerative endplate changes and mild degenerative facet disease typically suggest wear and tear in the spine, which can cause pain. Sometimes, trauma (like your fall) can accelerate these changes. The use of testosterone can affect bone health, but it's more relevant to monitor overall well-being and timely symptom management.
Since your pain has persisted and you've encountered differing opinions from healthcare providers, seeking a second opinion from a spine specialist who can evaluate both your x-ray findings and your symptoms comprehensively could be very beneficial. This specialist can clarify whether your pain is mainly due to the degenerative change or if it is related to your past injury.
Next Steps
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Consider a Second Opinion: Reach out to a spine specialist for a thorough consultation. Ask about the relationship between your injury, current pain, and the degenerative changes observed.
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Engage in Physical Activity: Start with low-impact activities like walking, swimming, or yoga. Focus on routines that can strengthen your back and core while maintaining flexibility. If you can, consult a physical therapist to guide you in a tailored exercise program that fits your needs.
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Monitor Your Symptoms: Keep track of your pain (when it occurs, intensity, and triggers) over the next few weeks. This information could be helpful for your next appointment and to understand your personal patterns better.
It's important that you feel supported in addressing your health concerns, so please continue to advocate for yourself and seek out the care that feels right for you. If you have any further questions or need clarification on self-care tips, feel free to ask.
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