Viewing 6 posts - 1 through 6 (of 10 total)
  • Author
    Posts
  • BillL
    Participant
    Post count: 18

    Dr Corenman:
    4-6 weeks of intermittent faint heat or burning sensation around left lower posterolateral chest wall area, and at times left upper anterior abdomen. No Acute injury. Mostly absent standing, usually occurs within minutes of sitting in any chair (especially with a back) or car seat. Hx of small left paracentral THORACIC disc herniations 2005 at T4/5, T5/6, T8/9, and T10/11 with a moderate sized T6/7 herniation with superior/inferior extrusion & flattens the left anterior spinal cord. No treatment 2005 when only having crick sensation posterior thoracic which settled over time, and no such abdominal or lateral chest wall Sx. Hx of previous discectomies at right L5/S1, right L4/5, left L2/3 and left L3/4, with these predominantly lateral herniations. Sometimes current slight burning occurs if lying supine a while. No leg or focal neuro Sx.
    Sounds a bit like a diagnostic challenge. Getting abdominal U/S soon to check kidneys, pancreas, spleen, etc. Does this sound like a spinal issue and if so which direction to turn? And the odds of this being a new or worsened thoracic disc issue? What to make of the sitting posture consistently triggering after a few minutes, no pain or symptoms during standing to sitting or vice versa. And if thoracic related, are these responsive to injections or other conservative treatments?
    Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    This could be a spinal issue but you are doing the correct order of investigation to make sure there is no visceral cause of your pain. If this visceral path of inquiry is not fruitful, then the thoracic disc herniations become suspicious. 4-6 weeks is not a substantial amount of time to do a full workup unless there are neurological findings that are worrisome (myelopathy). A round of PT might be helpful initially. If no acceptable results, then a new MRI of the thoracic spine and possible diagnostic/therapeutic injections would be called for.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    BillL
    Participant
    Post count: 18

    Thanks for the response. There was an addendum post after the first to correct that previous MRI was 2015 and not 2005.

    Since the post, abdominal U/S negative other than trace gallbladder sludge, and while pancreas was unremarkable the radiologist stated U/S not optimal for pancreatic Ca sensitivity (gland not obscured by gas per tech). Also oddly a minimal amylase elevation 110 (Normal to 100), and normal lipase at 26, rest of labs including CRP and Sed Rate normal.

    Plan to update thoracic MRI right away. But if stable,no change, or maybe slight worsening how to interpret this scenario or proceed next?
    Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I can’t give you assurances about organ referral pain patterns or the presence/absence of pathology. I rely on other specialists to let me know if there is organic pathology and if the patient is cleared to look for spinal sources of pain.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    BillL
    Participant
    Post count: 18

    Thanks, and I understand your point. Thoracic MRI pending. Can follow up but a bit hard to tell if this could be source of symptoms assuming medical causes not proven and especially if Thoracic MRI is largely unchanged…

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Can be difficult to know if the thoracic spine is involved until all other organ systems are ruled out. If your viscera are given a clean bill of health, then the thoracic spine can be investigated.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
Viewing 6 posts - 1 through 6 (of 10 total)
  • You must be logged in to reply to this topic.