Hi there - first, thank you for the excellent quality of all materials you produce/develop.
My stats:
Age: 36
Height: 5’10"
Weight: 208lbs
Estimated 1RM lifts: 435lbs (squat); 470lbs (deadlift); 245lbs (bench); 185lbs (press)
I was provided the following diagnosis today by my orthopaedic surgeon (in Canada) after he sent my for x-rays: Cervical spine
Anterior disc space narrowing, subchondral sclerosis and osteophyte formation are seen at C3-4, consistent with degenerative disc disease. Disc space height is well preserved at other all other levels. Reversal of the normal cervical lordosis is noted, a normal variant. No cervical ribs are seen.
Thoracic spine
No vertebral compression fracture or paravertebrral hematoma is identified. The disc spaces are normal in width at all levels. The spinous processes and pedicles are unremarkable.
Lumbar spine
Marked disc space narrowing at L5-S1 and moderate disc space narrowing at L4-5 and L3-4 are seen, consistent with degenerative disc disease at these levels. No vertebral compression fracture is seen. The sacroiliac joints are unremarkable. No spondylolysis, spondylolisthesis or facet arthropathy is identified.
Bilateral elbow
Moderate to severe osteoarthritis is seen bilaterally, with prominent medial spurring and subchondral sclerosis along with spurring of each coronoid process. No joint effusion or loose body is identified on either side. The soft tissue outline is unremarkable bilaterally.
Pelvis and bilateral hip
Moderate osteoarthritic changes are seen bilaterally. Bilateral acetabular over coverage and os acetabuli of the left hip are seen, findings which may be associated with pincer type femoroacetabular impingement. The pubic symphysis and sacroiliac joints are unremarkable.
Bilateral knee
Osteophyte formation at the lateral margin of each lateral tibial plateau is seen with no joint space narrowing of either knee, consistent with mild bilateral osteoarthritis, KL grade 2. Spiking of the tibial spines is noted in the left knee. Valbum alignment of the right knee is seen. Anterosuperior spurring of the patella is noted bilaterally, extra-articular, not clinically significant.
Impression
Degenerative disc disease of the cervical and lumbar spine. Moderate to severe osteoarthritis of both elbows commonly associated with abnormal mechanical forces such as occupational stress or previous joint injury, posttraumatic, postsurgical or due to systematic conditions such as CPPD, inflammatory arthritis or hemochromatosis. Moderate osteoarthritis and FAI morphology of both hips. Mild bilateral osteoarthritis of the knees.
My doctor indicated that this is very bad news given my age and that I can expect a very rapid decrease in quality of life from here. I have to follow-up with my family doctor in order to get blood test requisitions to determine whether the underlying cause is RA. The orthopaedic surgeon does not believe it is and is just OA.
The orthopaedic surgeon advised against any form of weightlifting. I am planning on ignoring this particular advice.
My questions to you: 1. Do you provide consultations for the above situation through your “Injury & Rehabilitation Management” consult?
2. I’ve read your (very timely) Basic Guide to OA post; is there any evidence indicating that caffeine (filter brewed coffee or espresso) further aggravates OA/RA?
3. I continue to lift with little to no pain during my lifts (besides crepitus during the movements). Weeks where I don’t lift result in severe pain and loss of mobility. My concern is the crepitus in my hips and sacrum which constantly require some decompression on my part to “pop” and release tension, providing temporary relief but leading to lingering aggravation and mild irritation in the joints. Is this an early indication of loss of hip use/mobility and what can I ask my family doctor with regards to help alleviate this issue and pain, as he too believes this is a result of weightlifting?
Thank you.