[Thoracic]

#11050

I have been diagnosed with stenosis in the T1 – T3 region. My general symptoms have been severe pain in that region along with pain in the shoulder blade and front chest just about right nipple. I also have some tingling in these areas and triceps at times. Symptoms are worst in the morning, but last most of the day. I am on pain relievers with only a slight effect. I am having issue with any prequalification for a procedure because I do not exhibit any lower leg weakness (noticeably) and/or any bowel and bladder dysfunction. Are these symptoms common with upper thoracic stenosis? All material I find states cervical and lumbar stenosis is more common, and I would think lumbar stenosis affects the lower body. Any insight would be helpful! This it affecting my daily life with no resolve.

[Donald Corenman, MD, DC]

#11060

It is highly unusual to have central canal stenosis at T1-3 without some significant preexisting problems here like a previous fracture or injury.

Not having leg weakness or bowel/bladder dysfunction is a plus. The physical examination would demonstrate long tract signs if the cord was involved. These include lower extremity clonus, hyperreflexia and incoordination of gait (triangle test and gait analysis). You would notice problems with leg coordination with walking.

You might not have cord symptoms but you might have nerve root symptoms. The nerve roots in this area do go to the hand, the scapula and the front of the chest wall right below the nipple.

To prove these nerve are irritated, you can consider SNRBs (selective nerve root blocks-see website) and the use of a pain diary (see website).

A good spine surgeon should be able to ferret out the cause of your symptoms.

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.

[Thoracic]

#11063

Thank you Dr Corenman.
I have had surgery two times in the area – C7 and T1, for discectomies. Since I do not have some of these lower body symptoms, I would agree that this is affecting just the nerve and not the spinal cord. I will look into the nerve block solutions. Is this something that can be also be treated with Physical Therapy, Chiropractic adjustments or is surgery about the only way to correct this pain otherwise?

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