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  • Jackie Specht
    Member
    Post count: 2

    Hello Dr. Corenman,

    Two years ago, I was injured in an auto accident. Throughout the first two years of treatment, I suffered from sciatic pain in my legs and had a stiff lower back.

    I’ve tried traditional therapies for the past two years. Then under went spinal injections, but nothing seemed to help. We later discovered a herniated thoracic disc. The more I read about herniated thoracic discs, it is very consistent with my pain. I have sharp shooting pain in my stomach, back below my arms pits, electric pain that moves up my spine occasionally and pain in my buttocks and legs, pins and needles.

    QUESTION: I need to understand if the cause for the pain I am experiencing is related to the Thoracic Disc herniation?

    After seeing several doctors, I am getting mixed opinions. It seems clear to me. But 2 surgeons I’ve talked with, don’t think I’m a candidate for a surgery at this time. I am reaching a level where the pain isn’t tolerable. Doctors are suggesting medial blocks with radio frequency treatment.

    QUESTION: If I proceed with the radio frequency treatment, will it jeopardize my recovery down the line if I decide to have a corrective surgery later on? I understand this procedure leads to muscle atrophy.

    QUESTION: If I tried all traditional therapy, is there a chance this pain will ever go away without surgery?

    QUESTION: Should I also get a CT scan?

    I appreciate your advice.

    Kind Regards,
    Jackie

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Thoracic disc herniations can cause local thoracic spine pain, radiating pain around the chest (or abdomen if it is a lower disc) and paresthesias (pins and needles) with occasional bowel and bladder changes and difficulty with walking from imbalance. It is not common for a thoracic disc hernation to cause actual leg pain.

    Medial branch radio-frequency ablation works for facet pain but not for disc pain or nerve compression. Of course, if some of the pain is facet induced, facet blocks will indicate how much pain is generated.

    If you want to have more information regarding the symptoms caused by cord compression, nerve compression or discal pain, an epidural injection would be the diagnostic test of choice (see website).

    There is a chance that the pain can diminish without surgery but after two years, that percentage is lower.

    Unless there is obvious bony anatomy changes, a CT scan will probably not be helpful.

    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.
    Jackie Specht
    Member
    Post count: 2

    Hello Dr. Corenman,

    Thank you for your feedback.

    I have had the following injections so far:

    Bilateral Transforaminal Epidural L5 R&L
    Bilateral Transforaminal Epidural L5 R&L
    R L45, R L5S1 Facet
    L L45, L L5S1 Facet
    Bilateral Transforaminal Epidural L5 R&L

    -What other diagnostics would you recommend to isolate that the pain is coming from the Thoracic Herniated Disk?

    -My MRIs show the herniation. I have all the pain symptoms described in our thread.

    I will be getting a referral to see you. Please note that I am in the Denver area.

    Kind Regards,
    Jackie

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    The work-up so far has focused on the lumbar spine for the origin of your leg pain. This makes sense as the thoracic spine herniation only very rarely causes leg pain. The thoracic symptoms you allude to “I have sharp shooting pain in my stomach, back below my arms pits, electric pain that moves up my spine occasionally” could be from this thoracic disc herniation.

    A thoracic diagnostic epidural would help to discover if the thoracic symptoms originated from the herniation.

    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.
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