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  • barca
    Member
    Post count: 5

    Hi,
    off and on for years I have struggled with pain in the middle of my back (between shoulder blades) but within the past year my pain has gone from a nuisance to really affecting daily life badly. For instance I cannot handwash dishes without bad pain, cut vegetables, cook, I cannot carry my kids, etc…work has been affected as I cannot sit for more than 30 minutes without the back screaming at me.

    I also have been experiencing some strange neurological issues like constant muscle twitching in calfs, some sharp needle like pains in calfs and feet, feet fall asleep very easily driving the car or sitting at my desk, and many nights I wake up and my hands are numb and some bizzare numb pain predominately in my ring fingers, but affecting all of them. I know arm nerve issues should not be caused by T-spine but I am at a loss for an explanation. Neurologist ruled out some of the scary diseases but didn’t have a diagnosis for me.

    sorry for the long background story but I did have a complete spine MRI done and some of the major findings were in my T-spine…the report says:

    There is straightening of the normal thoracic hyphosis. The marrow signal is normal. There are no compression fractures. The thoracic cord is intrinsically normal. There is no abnormal enhancement whithin the thoracic spine or thracic cord at any level.

    At T6-7 there is a small superiorly migrated right-sided protrusion effacing the right ventral aspect of the thecal sac and mildly impinging upon the right ventral surface of the cord without central canal spinal stenosis or neural foraminal stenosis.

    At T7-8 there is a moderate-sized right sided inferiorly migrated extruded disc measuring 4mm in AP dimension and extending inferiorly almost to the level of the T8-9 disc level effacing the right ventral aspect of the thecal sac and resulting in mild to moderate right-sided cord impingement and mild canal spinal stenosis without neural foraminal stenosis.

    At T11-12 there is a small 3mm left-sided slightly superiorly migrated extruded discc and annular tear effacing the left ventral-lateral thecal sac without cord compression or central canal spinal stenosis or neural foraminal stenosis.

    I consulted with one spine doctor and was told to take aleve and try to live with it, since I don’t have bladder issues or paralysis they won’t do surgery. He didn’t even recommend phyiscal therapy as he did not believe it would help in my situation….i felt hopeless leaving his office. I did see a chiropractor a few times but after three adjustments I felt as if things were being made worse. I have done about 8 weeks of physical therapy with very little if any effect positive or negative. NSAIDs barely help. I have a few questions that weigh on my mind:

    – If this extruded disc herniated quite some time ago and calcified is this a situation that can be fixed or at least substantially improved by conservative treatments?
    – would ES Injection help someone in my situation? i have sharp specific back painaching…no pain wrapping around rib cage
    – is spinal cord impingement the same as compression?
    – would the MRI have shown myelopathy or is a CT scan needed to show that?

    I feel rather hopeless and afraid as the doctor I saw gave me the impression that there wasn’t anything that can be done and I basically am in a no-win bad luck situation with the T-spine. I’m 36 and feel like i need to adjust my lifestyle to that of a 70 year old man. Any advice is appreciated.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8468

    Your thoracic spine displays degenerative changes associated with disc herniations at multiple levels. What is somewhat surprising is that you have a reduced kyphosis as most patients with this condition generally have an increased kyphosis from degenerative disc disease or Scheuermann’s disorder (see website).

    In general, your spine surgeon is correct in that you should try every therapeutic method before you should consider surgery. I think that epidural steroid injections can be quite helpful for these disorders. Extension strengthening exercises are important (rowing type exercises) to reduce the load on the discs and get the cord away from the herniations.

    Medications like NSAIDs, muscle relaxants and membrane stabilizers (Lyrica and Neurontin) should be tried.

    If extension (bending backwards) feels worse than flexion, you might also have facet syndrome. Facets blocks can diagnose a facet disorder if extension yields no relief.

    I will assume that you do not have long tract signs in your legs (imbalance, hyperreflexia and clonus) as your cord is working well.

    Dr. Corenman

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