COPD

[ken_barbara]

I was diagnosed with COPD some 20 years ago and recently diagnosed with it again. I've also developed a marked curvature in my upper spine and a bit of a barrel chest. I've read that development of a barrel shaped chest is common in COPD but can't find any reference to COPD patients having upper spinal deformation. I would very much like to hear from anyone who has information, resources, or experience with this particular set of problems. Thank You. Ken Johnson ([moderator note: e-mail address has been removed])

[Davy9]

COPD is a collective term that encompasses several diseases defined by the characteristic of impeding gas flow during exhalation (obstruction). Scoliosis is a deformity of the spine where the vertebral column has a double curve laterally like the letter 'S'. It can be minor or severe. Scoliosis can be present at all ages and presents the lungs with more of a restrictive disease component at it can limit the excursion of the chest wall.

COPD results in a barrel chest because the lungs lose their springy elasticity and the rib cage uniformly lifts and expands as the ribs naturally pull up and outward. COPD does not precipitate scoliosis but can be present along with scoliosis.

Your description makes it sound as though you have developed scoliosis only recently. Are your certain it is scoliosis and not kyphosis? Kyphosis is a deformity of the spine in the chest area expressed as a hunching forward, appearing like a hunchback. COPD does not necessarily cause kyphosis either but kyphosis is not unusual later in life as part of the aging process or as a consequence of degenerative spine type diseases. Kyphosis also has degrees of severity.

[ken_barbara]

Thank you Davy9 - you are correct - my wife found research on the internet just last night that suggests what I have is Kyphoscoliosis secondary to COPD. Of course they may be independent of one another, but she found 2 articles suggesting that Kyphoscoliosis may be a consequence of COPD. Thank you for responding to me. After 20 years of severe acid reflux, I developed several chronic conditions related to the acid reflux, including COPD from long-term aspiration of stomach acid. The hunch-back look has developed since that time.

[Davy9]

The barrel chest seen with COPD can make kyphosis appear to be more exaggerated. Be advised also that the long term use of oral steroids can result in bone loss and osteoporosis. That can lead to loss of bone integrity and kyphosis (and other bone weakness problems as well).

[ken_barbara]

That is interesting. I have taken Prednisone several times for a variety of reasons and used, and use to this day, steroidal nasal and lung sprays to help keep down swelling and congestion. Many years ago I was encouraged to take low dose Prednisone continuously but I refused after reading about possible side effects. I have been careful to take everything possible supplementally for good bone health, but the hunch in my upper back is really obvious - quite possibly exaggerated due to the barrel chest look - good observation. You sound like you are very knowledgeable in this arena. Is that self-taught, or are you a professional in this area? Do you have any idea if chiropractic treatment could help stop the progression of Kyphosis? The VA is referring me to a chiropractor for treatment. Thanks, Ken

[Davy9]

I am a retired Respiratory Care Practitioner.

It is the oral steroids that will have the greatest potential side effects. Considering that the condition exists I do not know what can be done to reverse it. I do not know that a chiropractor will make much of a difference, if any. You need to define what your treatment expectations are and whether they will be met or even addressed. Write them down and be clear to your providers. At this juncture I think your best goals would be to keep the kyphosis from progressing and to try and revitalize your bone structure.

Ask you doctor(s) about osteoporosis and its relationship to chronic steroid treatment. Ask them for a treatment plan to recuperate bone density.