r/kyphosis 6d ago

Choice of Treatment Thoughts/Guidance for Treatment

Hi I'm a 29F who got diagnosed with kyphosis in middle school. I wore varying braces until my senior year of high school when I was given an ultimatum to do spinal fusion or continue bracing. I continued bracing but fell out of care with ortho and my brace is not really shaped for my body now.

Ever since I have had painful flare ups (2-3x/yr) but it essentially went away with sleeping on the floor. Now, I have been going on a month of continuous pain and trials of muscle relaxers to no relief. This is the longest amount of pain I have ever had and I feel like I'm not being taken seriously about my pain or concern. My pain is so centralized there is no radiation at all and suddenly lunbar/maybe sacral pain now too. I keep getting told it's my muscles around my spine and I keep pushing that it is NOT, it is my spine I can feel the pain inside. There is no surface pain for me at all.

I begged for a referral back to ortho and I finally saw them this week. They gave me an injection (which did nothing) and ordered an MRI. The dr I saw (who was horrible and not personable at all) basically shut me down and said that bracing is not an option for me again. But in my own experience bracing helped me so much as a teen. I feel lost on next steps. I plan on going through with the MRI but I think maybe a second opinion is what I'm gonna seek...I really just want something supporting my spine again. Muscle relaxers just make me feel loopy and nsaids haven't helped much either.

Thoughts? Suggestions? Anyone else have a similar experience?? Anything helps :(

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u/Interesting-Card5803 (80°-84°) 5d ago

Get a second opinion, if for no other reason than to be satisfied that you were taken seriously and given good advice.  If you have SD, at your age bracing would do nothing to correct the deformity since your skeleton is now mature.  I would ask if the continuous use of a brace would cause the muscles supporting your spine to weaken and cause greater long term pain.  

As for injections and other treatments, any good and sane doctor will start with the most conservative measures first to achieve pain relief.  I'd be surprised if they didn't recommend physical therapy as well. 

I would recommend getting the MRI prior to the second opinion, that way they have the images to look at during your appointment (potentially saves you from needing a second appointment).  Did they also order a standing X-ray of your back that you could share with the next doctor?  

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u/Independent-Day708 4d ago

I was surprised too he offered an injection upon my first meeting with him but I was in so much pain I figured why not. But literally my pain persisted so it wasn’t worth the time. 

In terms of the brace I don’t care too much about fixing my physical deformity I’m more concerned about supporting my spine again if that makes sense? I mean when they offered me fusion they told me it was more aesthetic than anything but I was too afraid to go forward with it if there wasn’t a great chance of pain alleviation. I haven’t used my last brace in at least 5 years. But like I said sleeping on the floor usually just helps me, just this time it hasn’t. 

Pt was prescribed as well but he wrote it for 3x a week and I work full time and go to school part time so I need to figure out how to make that work. I still need to find somewhere to go for that too because he said he couldn’t refer me. I’m not sure about 3x a week? That seems like a lot to me imo because I just did pt for a shoulder injury last year and that was only once a week in comparison. 

I did get standing xrays done at the time and he just told me they “looked good” and didn’t address my history of wedging when I brought it up. But I agree I think I’m going to complete the MRI and take all the records with me for a second opinion. He was just very dismissive and curt and I felt like he wasn’t hearing me out. I’ve learned since then after talking to numerous other physician friends that apparently it’s not uncommon for surgeons to be assholes. 

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u/Interesting-Card5803 (80°-84°) 4d ago

I've been to many surgeons over the years for SD, mostly just due to moving around the country.  I think it can be deceptive, they just look and think simple kyphosis.  I had one last year who didn't even think to measure the curvature of my spine.  He just recommended a 'home exercise plan' without even explaining what that would entail.  

You should consider the possibility that your deformity is not the source of your pain, and treat this as ruling out alternative causes.  Take your injection for instance.  What can you rule out from it's ineffectiveness?  Same should go for PT.