Expert: Dr. J. Shawn Leatherman - 9/28/2006

Question
Thank you for your response, I will add the EPA & DHA to my diet. I am only 47 about a year or so ago I was hurting all over and was referred to a Neurologist she ordered a bone scan. From that they found arthritis in every major joint. Recently I had a xray of my hip and they found severe arthritis. My rheumetologist says I am looking at total hip relacements in the future and is surprised at the fast progression of my arthritis. By adding these supplements do you beleive I will be able to have a more active life style for longer?
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Followup To

Question -
I recently had a MRI of my back and I do not know who to read the report, I was hoping you could help. The report reads: There is evidence for marked hemangioma formation along the lower lumbar spine at the L4,L5 and S1 vertebrae. This is a benign finding. The remainder of the marrow signal also has a benign appearance. I do not see compression fracture. The alighnment of the lumbar spine appears grossly preserved. Mild facet dgeneration changes are present, L1-2: patent, L2-3: patent, L3-4: patent, L4-5: moderate facet degenerative changes and a mild disc bulge create mild bilateral neuroforaminal narrowing, L5-S1: again a posterior disc bulge and moderate facet changes result in mild bilateral neuroforaminal narrowing. Impression: Degenerative lumbar spondylosis without significant central canal narrowing or significant neuroforaminal narrowing identified on this exam.

Answer -
Dear Rosemary,

Hemangioma is a one slow growing benign (non-cancerous) tumor of bone.  The composition of the tumor is newly formed small blood vessels called capillaries and somewhat larger vessels called caverns.  Hemangioma is considered a primary bone tumor which means it did not originate in any other place in the body.  The cavernous form is the most common benign bone tumor in the spine, but affects only 1% of the population.  These types of tumors are usually asymptomatic.  They only cause problems if they grow large enough to push on the spinal cord (approx:  10-15%).  Expansion of the vertebral body is rare though.  Treatment is only utilzed if the tumor is expansile and compresses on the cord.  Surgical decompression of the bone would be the most appropriate course of action at that time.  Sometimes radiation may be used, but not often.  

Mild facet degeneration means that the actall joints of the spine which are called the "facets" have the beginning of osteoarthritis and the body has laid down some extra bone (degeneration) at the facet which will show up on the MRI.  Moderate means that the bony changes are more significant.  This condition is also one in which there really will be no specific treatment.  Staying mobile and active will decrease the amount of continual arthritic changes.  You can also take supplements to help such as chondroitin sulfate 1500mg/day, glucosamine sulfate 1500mg/day and MSM (methylsulfonylmethane)750mg/day.  You should also see reduction of pain within 2-4 weeks on these supplements and you should continue to take them as a daily regime.  You will not be able to actually change the degeneration you have, but you can reduce and sometimes stop the progression.

The word "patent"  means "open"...the holes in which the nerves travel out of the spine are open.  The mild bilateral neuroforaminal narrowing at the last level in the spine, L5/S1 means that the holes in which the nerves exit the spine are somewhat made smaller by the arthritic changes as well as the mild disk bulge.  This can create irritation to the nerve roots and can cause pain in the low back as well as the buttock and down the leg.  Again it is stated on the report though that it is mild and insignificant at this time which is good news for you.  

Another supplement that will help the inflammation you may have as well as any pain levels would be Omega III fatty acids.  Specifically EPA (eicosapentanoic acid) and DHA (docosahexanoic acid).  4000 mg/day is a good dosage to reduce pain and inflammation as well as have therapeutic effects in other areas of the body.  Make sure you purchase a product that is MOLLECULARLY DISTILLED, do not take a supplement that is not.

Concerning the disk bulge, this is a common finding in the population, and is commonly found on people without pain of dysfunction.  Therefore a mild disk bulge has no diagnostic value in itself. Disk bulges can be reduced with exercises, chiropractic adjustments, and decompression therapy.

Rosemary, your MRI findings are fairly normal (common) and mild in nature.  If you are having pain and that is what prompted the study, I would urge you to seek out a local chiropractic physician for care...make sure to show them the MRI results.  These types of issues are treated very effectively with conservative care such as chiropractic, exercise, stretching, and nutrition.  If you have any further questions feel free to write back.

Respectfully,
Dr. J. Shawn Leatherman

Answer
Dear Rosemary,

I do believe that adding the supplements to the diet will prolong your independance from further degeneration and surgery, although they will not likely stop the progression.  

When adding supplementation to your daily dietary regime, you are effectively combating oxidation of the bodies tissues, supplying the body with tools for repair and maintenace, and specifically with omega III fatty acids you are reducing system wide inflammation.  Therefore, the supplementation will provide therapeutic value.  It has been long known and proven that dietary changes bring about health or the lack of health.  The glucosamine/chondroitin/MSM will help to repair the joint space (bone/cartilage interfaces), and reduce the friction creating further degeneration, but again it will not reverse the current damage.

The arthritic changes you presently have are for the most part permanent.  Studies have shown conclusively that any reversal in arthritic changes to the bone are minimal at best, but prevention of further degeneration can be attained as long as the joint mechanics are not severely deranged/ biomechanically improper.  There are also many different types of arthritis. Some are due to improper metabolic and digestive processes such as gouty arthritis, some are purely mechanical derangements such as osteo-arthritis, many are related to auto-immune function and genetics, but all cause inflammation.  So anything that decreases inflammation in the body will concurrently help to alleviate further progression.  Keep in mind that supplements will not alter genetic predisposition.

In addition increasing your daily intake of brightly colored fruits and vegetables is the best way to slow down oxidative damage (aging/degeneration)in the cells, including bone tissue.  You should be consuming 10 servings a day for maximum protection...keep in mind any increase in your dietary intake will be a bonus. Remember many foods actually cause inflammation in the body:  fried foods, hydrogenated oils, red meat, simple carbs such as bread and pasta, so use these types of foods sparingly to decrease the attack on your cells.  Below are some reference books you may want to read.

The Omega RX Zone - Dr. Barry Sears
Pain Free - Dr. Luke Bucci
Clinical Nutrition for Pain, Inflammation, and Tissue Healing - Dr. David Seaman
The Antioxidant Miracle - Dr. Lester Packer

Respectfully, Dr. J. Shawn Leatherman
Know Your Fats - Dr. Mary Enig

Respectfully,
Dr. J. Shawn Leatherman