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Schmorl’s Node Treatment With Advanced Clinical Methods In Malaysia

This article covers Schmorl’s Nodes as well as how it is diagnosed and what you should do.

What Is Schmorl’s Node?

By definition, a Schmorl’s Node (also known as Schmorl’s nodules) is either a downward or upward notching or protrusions (pushing) of the spinal disc cartilaginous structures, and bony surfaces of spinal bones called vertebrae. Schmorl’s Node is a common occurrence of degenerative changes with aging, detected in routine spine x-rays. However, we may also find it in young adults and even teenagers.

Schmorl’s Nodes or Schmorl’s Nodules (spine nodules) in young adults and teenagers are often hereditary predisposition results. 70% of those diagnosed with Schmorl’s nodes are said to have a genetic predisposition. In essence, Schmorl’s Nodes is a vertical herniation of the spinal disc. This herniation often results when there is a weakness in the vertebral end-plates. Although most cases are asymptomatic, they are clinically significant.

A clinical research study of 400 back pain patients reported Schmorl’s nodes in about 20% of the participants. As such, it becomes a point of clinical significance, especially when the discovery of Schmorl’s Nodes is in teenagers and younger adults. Therefore, you should take steps to avoid the complications of additional spinal disorders as you age if you have Schmorl’s Nodules.

How A Schmorl’s Node Diagnose?

Spine MRI showing schmorl's nodes

The most common diagnosis of Schmorl’s Nodes is through spinal x-rays. But, CT-scan and MRI assessments offer a much greater detail of the vertical disc herniation. X-rays, CT Scans, or MRI tests will show a notch or a bump seen pushing into the vertebrae. This little notch is called a Schmorl’s Node. As mentioned earlier, the diagnosis of Schmorl’s Nodes in young adults is a point of concern. Although most of these cases are genetically linked, some develop it due to excessive load-bearing activities.

Are Spinal Nodes Painful?

A Schmorl’s node is not always painful; however, in some, it can be a direct source of pain when the nodes are large or if they induce an inflammatory reaction at the vertebral endplate or vertebral body (spinal bone) that the end-pate attache. In most, the pain of Schmorl’s nodes is often the result of co-conditions such as degenerative disc disease, facet hypertrophy, or spinal disc bulges.

Spinal discs require an uninterrupted flow of nutrients (water, oxygen, amino acids, and glucose) to remain healthy. The problem with the spinal disc is that they don’t have a direct blood flow to provide them with the needed nutrient. And as such, the required nutrients must defuse from the vertebral body (spinal bone) across the vertebral endplates to reach the hungry cells on the spinal disc.

The spinal disc’s nutritional needs are met through the process of diffusion known as “imbibition,” where the spinal disc soaks up nutrients through the vertebral end-palate from the vertebrae above and below. Schmorl’s nodes damage the vertebral endplate preventing them from soaking up the nutrients and problems in transferring the soaked-up nutrients into the spinal disc.

Without sufficient amounts of the needed nutrient, your spinal disc becomes weak, wearing, slipping, and tearing prematurely. So, while a Schmorl’s Node may not be the only source of cause pain, it can lead to other conditions that do cause pain.

Degenerative Disc Disease, Schorl’s Nodes & Pain

Schomrl’s nodes cause premature degenerative changes in vertebral discs and spinal joints that can become quite painful. It becomes weak and susceptible to tears and slippage (spinal disc bulges or disc herniation). Moreover, spinal disc degeneration results in loss of disc height. And the loss of disc height puts excessive stress on spinal joints, causing them to wear out and become degenerative and arthritic (facet hypertrophy). Therefore, Schmorl’s nodes that were not painful during early life can become painful or, at the very least, a source of pain due to the interruptions they cause in the inflow of nutrients from the vertebral body that crosses the endplates before entering the disc.

What Is The Clinical Significance Of These Nodules?

illustration of Schmorl's nodules in thoracic

In short, if you have it, it means that there is a weakness in your end-pates. The endplates are the caps situated at the top and bottom of every spinal disc. These are anchors used to connect the spinal disc to the spinal bone. Also, the vertebral endplate is the structure needed to transmit the required nutrients to the spinal disc. Therefore, any weakness in the spinal end-pate will directly impact the health of the spinal discs. As such, those diagnosed with q Schmorl’s Node will develop spinal disc disorders (slipped discs). Therefore, precise preventive plans and even lifestyle changes for the young adults diagnosed are critical regardless of your age at the time of diagnosis.

Teenagers and young adults need urgent preventive measures that help avoid progression. The same applies to older adults, as Schmorl’s Nodules can progress and cause spinal bone collapse, leading to significant pain and disability. CSC’s chiropractic and physiotherapy center offers holistic therapy options that fix and repairs the cause of your pain. Get in touch with us and discover how our methods of combined care are best for you.

What Are The Treatment Options For Patients With Spine Nodules?

To recover from the aches and pains, you feel with schmorl’s nodes, you need focused therapy measures that address damaged discs, joints, and inflammatory processes that result from Schmorl’s nodes or its associated co-conditions.

Many have told us that the therapy they received didn’t help. Our advice is to get the proper treatment. Get specialized care from people who know what they are doing, not just the general or basic physical therapy or physiotherapy treatments that most centers or hospitals provide.

Although there is no specific treatment for Schmorl’s Nodes, there are things that one diagnosed with such a condition can do to prevent other more spinal severe diseases such as degenerative disc disease, herniated disc (slip-disc or slipped disc), or fragmented disc. Prevention is better than cure, and for those with Schmorl’s Nodes, they need to heed the warning. In short, if you have Schmorl’s Nodes, it would be best for you to partake in a preventive program to avoid the nasty pitfalls of a slipped disc.

Prevention should not just be through care or therapy programs but also changes in lifestyles. It is best to avoid heavy lifting or contact sports at a young age. It is best not to do the heavy lifting with a young spine.

If you have spinal disc problems and Schmorl’s Nodes are involved, don’t worry because, at the Chiropractic Specialty Center®, we use unique and cutting-edge technology to repair your injured spinal disc. Our expert chiropractic treatment plus our clinical physiotherapy is an unmatched collaborative method of care.

Targeted Chiropractic & Physiotherapy For Painful Schmorl’s Nodes

CSC has many outlets in the Klang Valley area, near Kuala Lumpur. Visit one of our chiropractic & Physiotherapy centers today; chose a center near you:

CSC’s Three great locations in Kuala Lumpur:

  1.  Damansara Heights (Bukit Damansara) center near Mont Kiara offers combined care from physiotherapists & chiropractors. Contact our KL center for the best chiropractic treatment in Kuala Lumpur today.
  2. Sri Petaling center near Taman Desa & Bukit Jalil area providing physiotherapy & chiropractic
  3. Best physiotherapy with chiropractic in Bandar Sri Damansara for residents of Kepong, Desa ParkCity & Sri Damansara.

CSC’s Five locations in Selangor:

  1. Chiropractic & physiotherapy in Petaling Jaya at CSC’s center in Ara Damansara
  2. CSC’s center in Kota Kemuning (serving Shah Alam & Klang) providing combined care by physios & chiro
  3. Best chiropractic center in Bandar Sri Damansara for residents of Sri Damansara, Desa ParkCity, Sungai Buloh & Kepong
  4. CSC chiropractic & physiotherapy center in Bangi
  5. CSC’s physiotherapy and chiropractic center in Setia Alam (serving Shah Alam and Klang residents)

We can provide results not available anywhere else. If you have pain from muscles, ligaments, joints, or spinal disc, call our center today. We are Malaysia’s premier center for neck pain, back pain, slipped disc (slip-disc), and sports injuries. If diagnosed with Schmorl’s Node, call us today for targeted therapy and an effective preventive and management program.

This Post Has 16 Comments

  1. William nevo

    I have t11 and t12 l3,l4 damage. I also have schmorl’s nodes. I am 59. Should I avoid heavy or moderate weight lifting exercises? I currently do mostly abdominal and light back and leg exercises.

    1. Yama Zafer, D.C.

      Dear William,

      Thanks for posting a question. We apologize for the late reply. Spinal damage often occurs at joints and spinal discs. Spinal disc damage results in slipped discs, nerve impingement, and significant pain. Joint damage leads to joint degenerations, bone spurs, and arthritis. Exercise is an excellent means of keeping healthy. However, if the damage to your spine has progressed, you will need to be careful when exercising. Free weights, deadlifts, and leg presses are best to avoid. Abdominal exercises are good. But, avoid sit-ups as much as possible. Situps place excessive stress on spinal joints and spinal discs. A healthy joint and disc can bear these stresses when situps are correctly done. Also, avoid any twisting or bending motions, as these lead to further joint and disc damage.

      If you experience pain or stiffness, we recommend that you set up an appointment for a comprehensive assessment of your spine. We can address any spinal issues through the combined efforts of our chiropractors and physiotherapists.

      We hope this helped. Please contact our office on 03 2093 1000 should you need further assistance.

  2. Myrna

    Thank you so much for the information here. I am 45 yrs old and; have schmorl’s nodes, scoliosis, herniated discs, Si joint dysfunction, and scoliosis. I knew I had scoliosis since a child, but I recently became aware of other things due to pain and MRI scans. I have worked with children since I was a teen and; was working as a Child Development worker FT for the past 5 yrs, but have been on leave for several months due to my chronic pain. I see a physiotherapist, chiropractor, and massage therapist, but things are not getting a lot better; my work asks when I will be coming back. I don’t know what to say. Do you recommend that I not go back to that line of work? Lifting children, & bending were regular tasks.

    1. Dr. Yama Zafer, D.C.

      Dear Myrna,
      Thank you for posting an important question. Schmorl’s nodes by themselves are not painful. The same applies to scoliosis unless the curve is over 40-degrees. However, patients with scoliosis, schmorl’s nodes, and herniated discs can expect back pain and radicular pain (pain that shots down the arms and legs). Based on what you have mentioned, you may also have facet hypertrophy, hypertrophy of ligamentum flavum, and Modic end-pate changes, causing the spinal discs and joints to degenerate faster.

      Chiropractic and physiotherapy (physical therapy) is your best option. You will need to visit a center that combines both approaches for you. You will need to be careful about the type of chiropractic and physiotherapy you get. It would help if you avoided the Gonstead and Diversified chiropractic techniques. The Gonstead technique and the Diversified technique are both rotatory methods of chiropractic adjustments. Patients with scoliosis, disc herniation, and bulging discs should not be treated through rotatory methods (twisting) as it will worsen their condition or prevent it from full recovery. The best and most researched form of chiropractic treatment is the Activator Method.

      As far as your physical therapy is concerned, it would help if you avoided the Mckenzie exercises, twisting the spine, hot packs, and straight leg stretches. These will cause aggravations of the spinal disc herniations and spinal nerves, leading to inflammatory reactions and increased pain. Your therapists should focus more on passive therapies through equipment at the initial phase. The most effective are spinal decompression therapy, shockwave therapy, and high-intensity laser therapy. Homecare should include icing the spine at the affected segments for 15 minutes every two-three hours and exercises such as the Kegel exercises and wall-assisted squats. Additional exercises can be considered only when you can return to a normal function or when your pain reduces by 50%.

      Getting over the pain of spinal disc herniation, scoliosis in the spine, schmorl’s nodes, nerve pain or sciatica treatment is easy. To do so, the care you receive must be focused and condition-specific. If you don’t improve, chances are the care you are getting is inadequate or improper. If you live in Malaysia, I will encourage you to visit one of our centers. Our chiropractic doctors and clinical physiotherapists have treated thousands of patients just like you successfully. The key to success is our precision. We provide focused treatments through the combined efforts of chiropractors, physical therapists, spine specific rehabilitation enriched by advanced methodology and technology. You may contact us on 03 2093 1000. We have seven centers throughout the Klang Valley.

      I hope this helped.

  3. Hijab

    Hi! I was 17 years old(2017) when I was diagnosed with multilevel schmorl’s node formation in the lumbar region, and it caused a lot of pain. Sometimes the pain was unbearable. After continuous medications for one year, the pain disappeared. But after five years, the pain came back again. This time it is even more severe than before! Although I was taking all necessary precautions during these years. What should I do now?

    1. Dr. Yama Zafer, D.C.

      Dear Hijab,
      Schmorl’s nodes are malformation of the vertebral endplate linked to hereditary issues. It occurs when the nucleus of the spinal disc protrudes through the vertebral endplate. Most experience no pain. However, some will have periodic pains of varying degrees. The pain in Schmorl’snodes is the result of an acute attack caused by inflammatory changes. Acutely painful Schmorl’s nodes are treatable. And we can help.

      Patients with painful schmorl’s nodes need to be carefully assessed. Most patients with Schmorl’s nodes will also have co-condition. Herniated spinal disc, spinal disc degeneration, facet hypertrophy, hypertrophy of ligamentum flavum, nerve compression, and spinal instabilities are examples of the possible co-condition. I encourage you to visit our chiropractor in Kuala Lumpur. Let one of our clinical team members assess you. If you have x-rays or MRIs of the spine, please do bring them with you.

      Once we have assessed you thoroughly, we can formulate a treatment plan that reduces pain and prevents or at least minimize acutely painful episodes. Several therapeutic options do exist. Medication will not help avoid attacks but can reduce pain. However, depending on meds alone is dangerous due to their side effects.

  4. Amy Safko

    Can a Schmorl’s node along the superior endplate of L2 lead to spondylodiscitis? Having a hard time figuring out who to see after two visits to the ER found infection in my blood work with a fever and severe pain in stomach and back, and all the CT scans showed in the findings was the node. However, while the fever is gone, my lower back keeps having spasms and pain, so I see if there could be a correlation.

    1. Dr. Yama Zafer, D.C.

      Great question, and thanks for posting again. Discitis is a swelling of spinal discs. In discitis, the swelling is often due to an infection. I don’t believe you had discitis due to an infectious process. I base this on the fact that CT only showed a schmorl’s node. Also, your fever is gone. The fever was not due to a spinal infection; the back pain is still there while the fever is gone. I would suggest getting an MRI done. I suspect that you have slipped a disc (herniated or bulging disc).

      I hope this helped.

  5. Priyam

    I’m 24, and I have been diagnosed with superior endplate collapse/chronic stress fracture with Schmorl’s node and Modic Type-II Changes in the D11 Vertebral body. Should I be worried about any consequences later in my life? Can I do weight training and regular jogging? Is there any way I can make everything back to normal?

    1. Dr. Yama Zafer, D.C.

      Dear Priyam,
      The stress fractures you have are possibly the results of your weight training program. More than likely, you are doing lots of free weights. You may be doing some or lots of dead-lifts. Free weights and dead-lifts are great workouts. They build muscles faster. But, it comes with a cost! I jokingly tell my patients to do dead-lift training only if they get paid! I say this because it will damage your spine eventually.

      You will need an expert to treat your spine. Basic physiotherapy or rehabilitation programs are not enough. If you live in Malaysia, I encourage you to visit one of our centers. If you live in a nearby country, I advise you to visit us once the pandemic is over. I am not aware of other centers that offer the same level of comprehensive treatment for the spine. Normal life is possible. The first thing you will need to do is to stop free-weights and dead-lifts exercise programs. Secondly, get conservative treatments that target the spinal discs and vertebral end-palates. And lastly, do a follow-up MRI 6 months after you have finished your conservative management to monitor the healing. I hope this helped.

  6. Camilla Corderthomas

    I have scattered Schmorl nodes L1-L5+L5-S1. I have mild desiccation with disc herniation with bulging discs. It’s not supposed to be painful, but mine is extremely painful. We started with physical therapy, but that worsened my condition, so we will try Aquatic therapy. If all fails, I strongly believe that I should have surgery because if left untreated and it really gets bad, one could become paralyzed. Do you have any suggestions for me? I’ve basically been bedridden for 6 weeks and haven’t been doing anything because it hurts so bad. Though I’m not complaining about my doctor, he wants to monitor me. Do you have any suggestions for me because I surely don’t want to become paralyzed?
    Thank you for your consideration.

    1. Dr. Yama Zafer, D.C.

      Dear Camilla,
      Thanks for posting. Schmorl’s nodes are not painful. However, they can be exacerbating your herniated or bulging discs. FOr example, small cuts at the tip of your finger are not painful or symptomatic, but salt or acidic liquids such as lemon juice or vinegar make the small cut really symptomatic.

      I am confident that the pain you are feeling is a direct result of your spinal disc herniations and bulges. You also mentioned having PT (physical therapy). Physical therapy (physiotherapy) is good when targeted, focused, and specific for disc herniation and bulges. I suspect that the physical therapist started you out on stretches and exercise programs too early. Herniated and bulging disc patients need to start passive physiotherapy or physical therapy. Passive physical therapy treatments are provided through therapeutic devices.

      For your specific condition, I would have recommended spinal decompression therapy, High-Intensity Laser Therapy, myofascial release, and electrotherpy. Exercises and strengthening (active physical therapy) should start once the pain has subsided or when the stretches or exercises that you do are not aggravating your back. I think you will need to change your therapy center. It would be best to find a chiropractic center that offers spinal decompression therapy, physical therapy, laser therapy, and other forms of passive therapies in the initial stages or until your spine stabilizes.

      You also mentioned aquatic therapy. Aquatic therapy is not going to fix your slipped disc (herniated or buying discs). It will help if you put all your efforts into finding a center that offers spinal decompression therapy. You can start the aquatic therapy once the pain has subsided. In the meantime, try to ice your back for 15 minutes every two hours. Make sure to wrap the ice pack in a towel and never ice longer than 15-minutes. Also, avoid hot packs. Hot packs may feel nice, but they will increase inflammation. To recover, you will need effective treatment and avoidance of aggravating factors. Here is what you should avoid:

      1). Avoid prolonged sitting or sitting with a forward-leaning posture
      2). Avoid twisting and bending at the waist
      3). Don’t use a heat pack at all; ice instead

      I hope this helps.

  7. Camilla Corderthomas

    I’ve never done any weight lifting in my life, and I’ve never had trauma or accident.

    1. Dr. Yama Zafer, D.C.

      Schmolr’s nodes are congenital issues with defects in vertebral end-pates. Most have no issues with them. But, for some, they can lead to other spine-related conditions which cause. Spinal discs attach to vertebral endplates. Also, the vertebral endplates are the source of nutrients that a spinal disc needs for maintenance and repair. In schmorl’s nodes, the endplates are damaged which may interrupt the flow of nutrients, causing the discs to desiccate (degenerate, bulge, and herniated). It is critical for patients with schmorl’s nodes to avoid prolonged sitting or sitting in forward-leaning postures as they lead to greater loss of nutrients and faster degeneration of spinal discs. So, even though you have never lifted any weights, you might be sitting too long or sitting in a poor posture. You will need to be mindful of your posture even more than the average person.

  8. Melissa

    I have a question; I’m 55 and have been to three different doctors for my back. The first one told me I had metastatic cancer, so I went through all the testing and pet scan and was told I didn’t have cancer. The second doctor told me I had a fracture. At my last appointment with him, I was told I had an infection in the fracture, and It went away with no antibiotics. I felt for a while I might be getting better, or at least I was hoping. I started having a lot of pain again and went to a third doctor, and he told me I have Schmorl’s nodes. I tried water therapy and was given a tens unit to help with the pain. My back seems to go back and forth from appearing like it might be feeling a little better to terrible pain, especially nerve pain. I’m at my wit’s end, and I don’t know what to do. I’ve never taken pain medication and don’t want to.

    1. Dr. Yama Zafer, D.C.

      Dear Melissa,
      Thanks for posting a question. Back pain caused and exacerbated by schmorl’s nodes can be challenging for patients and clinicians. If you live in Malaysia, please visit our center for a thorough assessment. Schmorl’s modes are not always painful, and however, larger ones can be painful. Also, they often present with co-conditions such as facet hypertrophy, ligamentum flavum thickening, spinal disc damage (disc degenerations, disc bulges, and disc herniation). To recover, you will need holistic therapies and strengthened programs specific to your conditions. Unfortunately, there are no therapies or treatments specific for schmorl’s nodes. However, treatment of pateints with schmorl’s nodes as the leading cause of the pain needs concentration of spinal stability through strengthening programs that target the core and pelvic floor muscles. I hope this helped.

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