OpenHealth Q&A

Issues with Bone Spurs and General Spine Health at 31

A 31-year-old woman is currently facing health challenges, including the presence of Hashimoto's disease, hypothyroidism, and persistent migraines. Presenting symptoms include widespread muscle weakness and pain, with particular concern in her legs, which feel weak and painful. She experiences sciatica-like discomfort, numbness primarily in her toes and hands, and a noticeable loss of sensation in her toes. Additionally, a repetitive tremor in her right hand has been troubling, along with intermittent stabbing pains in her pelvic area. Recently, she has begun seeing floaters in her vision, prompting a visit to an eye specialist. This recent flare-up of symptoms began approximately three weeks ago. Historically, she has dealt with sciatica-related pain on her left side for years, and she has experienced pain and numbness in her right hand, previously attributed to carpal tunnel syndrome. After consulting with her primary care provider, an MRI of the brain was conducted. Although the MRI was returned clear, she subsequently visited the emergency room due to escalating leg weakness and enhanced sensory loss in her toes. During this visit, she requested CT scans of her spine, but was denied an examination of her lower back and only received imaging for her neck and upper back. The imaging results indicated mild to moderate cervical and thoracic spondylosis, significant anterior and anterolateral osteophyte formation at levels T3 to T11, with non-bridging osteophyte formation at T11-12. Mild to moderate anterior spurring was also noted in the C5-C7 region. She was informed that the findings were deemed typical for someone of her age. Seeking further evaluation, she attended an orthopedic urgent care clinic after experiencing severe stabbing pain in her pelvis. X-rays of her lower back revealed bone spurs present at each disc, confirming osteoarthritis as well. An attempt by her primary care doctor to order an MRI prior to the lower back X-ray was denied by insurance. Consequently, she was referred to specialized rheumatology and neurology consultations with a hefty five-month wait. The nurse practitioner at the orthopedic urgent care expressed the need for an MRI of her lower back and hinted that a consultation with a spine surgeon might be necessary. Given her discomfort and concerns, she is uncertain about the next steps. She feels it is imperative to have a comprehensive MRI of her entire spine. Living in rural East Texas, she is contemplating whether to seek care at an emergency room in Houston. Although she recognizes the importance of consulting a rheumatologist, she is anxious about the extended waiting period for appointments. Laboratory tests, including ANA, rheumatoid factor, CRP, sed rate, and HLA-B27 were all negative, yet her history of autoimmune disease and previously elevated CRP levels raise concerns for her ongoing health issues.

Answers (1)

7/13/2025, 4:30:54 PM

OpenHealth AI

It sounds like you’re dealing with several complex health issues that can be very challenging, and it's understandable to feel uncertain about what to do next. Given your symptoms and the findings from your imaging studies, it’s crucial to take proactive steps to address your pain, weakness, and overall spine health.

Summary of Key Points:

1. Symptoms and Diagnosis: You have several autoimmune-related conditions and symptoms of nerve compression (like sciatica, numbness, and weakness) alongside osteoarthritis and bone spurs.
2. Next Steps for Care: Given the complexities of your situation, focusing on obtaining imaging for your lower back and considering alternative consultations is essential.

Explanation:

Your autoimmune conditions, alongside the documented bone spurs and spondylosis, may contribute to nerve compression and pain, leading to the symptoms you’re experiencing. The clear MRI of your brain is reassuring in ruling out certain neurological issues, but the ongoing weakness and numbness warrant further investigation of your spine.

Prioritized Action Steps:

1. Seek Comprehensive Imaging:

   • Consider obtaining an MRI of your entire spine, especially your lower back, as it may provide insights into the nerve roots potentially being affected by the osteophytes (bone spurs).
   • If insurance is a barrier, explore facilities that might offer flexibility with costs or inquire about cash-pay options.

2. Explore Immediate Care Options:

   • If your symptoms worsen significantly, including severe pain or neurological deficits (like increased weakness or changes in vision), visiting a higher-level emergency room, such as in Houston, could help expedite necessary imaging.

3. Pain Management and Self-Care:

   • Consider non-invasive pain relief methods: Cold or heat therapy can help alleviate pain. Gentle stretching or physical therapy might improve strength and mobility.
   • Over-the-counter pain relievers (e.g., ibuprofen or acetaminophen) can also manage discomfort, keeping in mind any potential interactions with your thyroid medications.

4. Keep Records of Your Symptoms:

   • Maintain a daily log of your symptoms, noting any changes or triggers. This information can be invaluable when consulting with specialists.

5. Follow-Up on Specialist Appointments:

   • While waiting for the rheumatologist and neurologist, continue to advocate for yourself and communicate any worsening symptoms to your primary care provider.

6. Support and Resources:

   • Reach out to patient advocacy groups for autoimmune disorders; they can offer guidance and resources that might facilitate care options.

Remember, you’re not alone in this journey; seek support from healthcare professionals who understand your needs. If your symptoms change or escalate, don’t hesitate to seek immediate care. You're actively managing your health, and that's a vital step.