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I'm new....have thoracic disc annular tear. Anyone else out there w/thoracic dx?

OMGthisHurtsOOMGthisHurts Posts: 10
edited 06/11/2012 - 8:44 AM in Upper Back Pain, Thoracic
I had a freak accident at work (I'm a nurse). The patient I was helping (he was lying flat in bed) grabbed my stethoscope which was draped around my neck. He got both ends, so had me in a pretty tight hold. I was bent over his bed getting ready to help move him up in bed with the CNA on the other side of bed.

Once he got ahold of me, he began thrashing my neck & upper body in all different directions very violently. He was also trying to strike me in the head with his free hand. I was off balance from the thrashing in random directions and was worried I would fall and "hang" myself. The CNA, the patients wife, and myself were all trying to pry his fingers off the stethoscope at the same time. And I was still trying to maintain my balance. Episode lasted 45-60 seconds. Finally got loose; my stethoscope (metal part) was bent at a 45 degree angle from the force of his grip. I immediately felt lightheaded, mildly nauseated, and assured the patients wife (who was horrified) that I was fine, then left the room.

Had a slight headache for part of the day, and also some sharp thoracic pain and right leg weakness/clumsiness. Very strange feeling!! I reported incident and filled out all paperwork.

It has taken over 6 years to discover that I have an anterior annular tear of my T67 disk which is also the cause of my on-going pain in right ribs, right leg clear down to my big toe. At times, the leg weakness is prominent and I feel very clumsy and off balance. 2 months ago, my right ankle gave out on me and I fractured the ankle. Feel like I'm falling apart.

I know that thoracic injuries (acute ones) are not as common as lumbar and cervical. And my physiatrist has told me about some of the treatments for this which sound very risky. I am 56 years old now (injury happened age 49). I have not been able to return to hospital nursing and have had some luck with finding nursing jobs that don't require lifting. But even sitting or walking will exacerbate the symptoms for days at a time.....

Anyway, my questions to you all are:

Anyone else out there with a traumatic thoracic injury?
How long did it take to diagnose it?
What kind of doctor did you see?
How much is it affecting your ability to do your usual activities?
Did it ever get better?
Did you have surgery?
If not, are you considering surgery? What kind and why?
Any other ideas, suggestions?

Thanks so much for reading my ramblings.


  • Welcome to the club no one wants to belong to. Thoracic is very rare and often overlooked.

    Mine was from a car accident last April. I initailly went to my orthopedist who diagnosed a rotator cuff tear. He did surgery but found very little damage (MRI looked worse than it was).

    It took 3 months of PT and not getting better to find out that there was another MRI that showed a herniation at T1/T2.

    I went to a orthosurgeon who blew me off saying that my pain didn't match my MRI so it wasn't real. he did telll me it would look good for my lawsuit...what an ass.

    I then went to a neurologist who did an EMG and lots of PT. He listened but since he didn't have that last MRI either he just prescribed meds and PT.

    After another 2-3 months I went back to my orthopedist looking for other ideas. I was floored when he said "why won't they take care of your herniation" See up until November I didn't have that last report either.

    I went to two neurosurgeons. One looked at all the films carefully and figured out a way to get in from the back without upsetting everything. The other didn't even bother looking. She said my pain wasn't bad enough to warrant surgery and walked out. I guess she wasn't very creative.

    So for me it took 8 months, 5 MRIs, 1 CT, 1 surgery and months of meds and PT to get to the problem. I was functioning during that time but on meds and still in pain. Because my pain is neuro activity didn't affect it much. Now the muscle spasms post-op are a real killer.

    Unfortunately the path the surgeon took resulted in a bruised nerve which affects one eye and a fractured vertebra. I'm told these will heal on their own. At 4 months post-op I'm also seeing a return of symptoms plus those lovely muscle spasms.

    Today I'm going back to my neurologist for a follow-up and re-eval. They did another CT last week at another facility so I can't wait to see what it says. My guess is that I re-herniated because of the fracture.

    In my case I can't afford to wait. Because of the accident I have 3 years of coverage for medical care and lost wages. So with less than 2 years left I need to know what is happening. If there was no clock I would probably be a bit more conservative.

    However I am not happy with this constant blur of pain that defines my life. Funtioning pain is probably the worst. If you met me on the street you would never know anything was wrong. But on the inside....
  • Hey Kris,

    Thanks for your reply. I totally understand your experiences with the different doctors and their varying opinions. I've been through 3 IME's and they all just chuckle when they see that I have a thoracic disc disruption. They just don't believe it can happen, and even if it does, that it is not supposed to be painful. Well, I hope someday, they experience this kind of pain and then see what they think....No actually, I wouldn't wish this on anybody.

    I am so worried about surgery because of my age. You didn't mention how old you are? I'm 56. I would probably need that surgery where they have to go in through the side (punctured lung, etc.) since my injury is at T67. There's a gal on here who did have that done and she's documented her "journey" very well from pre to post-op and beyond. It gave me hope (although it is scary), but she is in her 20's. I don't know if I would be a good candidate for this very intense surgery at my age even though I am really healthy. And like you said, if someone saw me walking down the street, they'd have NO idea how much pain I was in.

    It really sucks, doesn't it??

    I wish you good luck and good TREATMENT at your up-coming neuro appointment. Let me know what happens.

  • Hi there, OMG! Another nurse here... and I feel your pain (or something kinda similar). I too have thoracic problems, from mild scoliosis, to a couple of discs with stenosis, to herniations both front and back and on multiple levels. The unfortunate thing for me is that I have serious problems at all three levels. I had cervical spine surgery in late 2006 and will have lumbar surgery in the next few weeks. That doesn't leave very much spine to work on, and there's no way I would want fusions all the way up and down my spine - nor would an ethical surgeon do such a thing unless a traumatic injury were involved.

    I can tell you this about thoracic surgery: In some instances it is easier than it was in the past. If the disk has herniated posteriorly or laterally, there may be a good chance they could perform the operation from the back. If any of the disk material has calcified, however, that person would not be a good candidate for this procedure. (I'm in that group too.)

    If the herniation is to the front of the disc, it's impossible to reach it from the back because the ribs are in the way. If the surgeon thinks surgery is warranted, the old anterior approach would be used. Yes, it is more traumatic. A general surgeon usually will open the chest cavity, deflate the lung, and move any organs or vessels aside. The neuro or ortho surgeon would then proceed, and the general surgeon would be called back to close the chest.

    I know it hurts, I know it can make you crazy. At this point, my surgeon and I have discussed using a neurostimulator to cover my cervical and thoracic pain, since I have so much going on at so many levels that surgery could never address them.

    I hope you have what you need to help you cope with your pain. If there's anything I can offer in terms of support, just let me know!

    Take care!
  • Wow, you have quite a dilemma going on in your spine!! I'm curious, did all or any of these conditions result from work injury as a nurse? There's some very interesting research out there about the old "proper body mechanics" trainings we had to attend every year. The fact is, they don't do any good in really protecting nurses backs (or anyone in the healthcare field who lifts or transports patients). The real facts are that we are constantly incurring micro-tears along our spine every time we do a lift or an assist. Then there's those times when you are on your own with NO help and you simply have to over extend to help someone to prevent them from falling. The cumulative effect of years of these micro-injuries usually leads one day to the BIG ONE. We think it was just that one doozy episode of lifting or twisting, or in my case, being assaulted and shaken by a confused patient, that caused an injury. Maybe that is true in some cases....but mostly it is due to years of abuse of our backs even as we thought we were doing proper "body mechanics". Some experts now call 'body mechanics' a joke!

    So I would be curious if you - or any other health care workers - have their injury due to working with patients (not their fault) and are now struggling to continue in your profession??

    Thanks for your reply! Keep in touch and let me know what you decide on that electric stimulator thing. I have a smaller version for my one thoracic area and it's great...when I have it on. It doesn't fix the cause, but does treat some of the effects (PAIN). Have a great day.

  • Your description of you sitting and squirming about and making noises made me laugh. It is so true. How we try to keep on with what we are doing instead of stopping and lying down!

    Then your description of trying to avoid the bumps in the road and bracing yourself, is so familiar.

    I have had lumbar PLIF a couple of months ago, and those symptoms are much less than they used to be now. I am still getting the spasms and tightening in my thoracic spine though, along with neck and arm pain. I hope that I can continue to try to ignore all that!!

    Hey, less of the how old 56 is! I was told my a surgeon that being in your 50s was relatively young compared with a lot of spinal surgeries that he did!
    You are a youngster! (That makes me sound older, but I'm not) :D

  • I was a nurse and hurt my back my back is all over the neck though S-1. Here is my Tspine :O

    A very minimal conave deformity of the inderior endplate of T7 which ia chronic and benign. There are disc degenerative changes noted at T7-T8 where there is loss of disc space height and disc desiccation observed. Disc degenerative changes anteriorly at T8-T9 with marrow endplate changes are notedas well.A posterior desiccated disc extrusion centrally is noted at T7-T8 with mild dural sac compression and no direct cord impingement. a small left paracentral extrusion is present at T10-T11 without cord impingement. At T11-T12 a right paracentral extrusion is noted. This desiccated extrusion extend slightly above the disc space measuring 2 to 3 mm in size with mild right dural sac compression and mild anterior right cord flattening without canal stenos
  • Connie, I'm not working currently due to major back issues; it's been 8 months without a paycheck, and it scares me terribly (thank heavens my husband is busy at work). I had a rotator cuff repair (right) with acromioplasty a few days before Christmas 2008; I had the left rotatator cuff repaired in November 2009 (work injury moving a patient) and had my right thumb joint reconstructed at the same time. (My thumb pain from bone-on-bone arthritis was some of the worst pain I have had in my entire life, and it was there with me day and night, 24/7, for about 4 years.) You can read all the particulars and stuff on my profile under "medical history."

    My neurosurgeon just told me yesterday I had the crappiest spine he had ever seen (yay!), and we're going to approach things one by one. I'll have 2 level laminectomy/discectomy with stability hardware (no fusion) in 2-3 weeks. I may need posterior stabilization of my cervical spine and foramenotomy, but we'll tackle that later if need be. My thoracic spine is a mess, and surgery would be a cluster headache ;), so I'm hoping that the spinal cord stimulator helps with symptoms and I can avoid surgery.

    I've had degenerative arthritis since I was very young, and the bony changes in my back are scarey to see on MRI. The good thing is that I have always tried to be as active as possible even with the pain. I was a fitness instructor, personal trainer, and massage therapist, along with working another full-time job. When I decided I needed to make a change and got a "real world" job, I worked that while going to nursing school at night and on the weekends.

    This worked/works for me, but may not work for others (mileage may vary, etc. etc.): If it hurts to do nothing, and it hurts to move, then choose to MOVE! So much of our pain is connected to muscle tension, weakness and stiffness, not the spine itself. A good session of stretching does wonders sometimes, and when my mid-back is feeling so heavy and rounded and achey, simple seated back exercises and lying chest stretches help ease the tension.

    And now that I've talked about that -- Having multi-level issues makes it hard, hard, hard to follow my own advice. If I sit up straight and pull my shoulder blades back to easy my T spine, it puts too much arching in my L spine and sets that off. Round my L spine when I feel things slipping around makes my T spine feel like crap. My butt hurts and burns when I sit and when I stand. I can walk with a limp (and a cane) for a bit, but it takes its toll. About the only comfortable position I have is fetal on my right side. My head? Well, it hasn't fallen off yet, so I guess that's a good thing. ;) My arms and hands are half numb and half burning. I love my life. :)

    I don't know that I will ever be able to work as a nurse again, not the job I had and can't think of others I could fit. I've only ever been a surgical nurse, which is extremely physical work (lifting, push/pull, moving heavy equipment and dealing with medicated and sometimes violent patients.) I miss my interactions with my patients terribly, but in this job you need to be 100%, anything less puts you and your patient (and coworkers) in jeopardy. A lot of people fake it and say nothing and hobble along, but I can't and won't do that.

    My opinion only: No, 56 is certainly not too old to have back surgery. A great number of people don't ever feel their pain until they're your age or older, so don't think that a limiting factor. What DOES affect the ease of surgery and your healing and outcomes: 1) being a smoker - smoke paralzyes the lining of the lungs so you don't filter and move allergens (and anesthesitics) very well. This can be a nightmare for the anesthesiologist, and it increases the risk for post-op infection. 2) obesity - it is harder to position a patient, harder to anesthetize them, can be harder to operate on them, and they often have a tougher recovery because they are so deconditioned. 3) ignoring the rules and sneaking just a piece of gum or just a couple of breath mints before you show up for surgery. It seems silly, but anything you put in your mouth automatically stimulates the stomach to produce fluids that assist in digestion. You don't want ANY stomach contents when you go in for surgery -- the risk of coughing some up and inhaling it into your lungs is greater, and just a bit can lead to pneumonia after surgery. Ask me how many patients I have had show up with McDonald's bags in their hands. Or potato chips spilled on their laps while in pre-op. No, wait a minute, don't ask! I can't count that high! :D

    So no, Connie, I don't think you should avoid surgery just because you're 56. But it helps if beforehand you become as active as possible, stop smoking for at least 2 weeks before surgery (if you smoke), and drop any extra weight you are able to.

    I hope it works out for you! I'll be following your progress.
  • how did they find out about the tear? curious, i feel your discription of pain, but mri says nothing in the t spine, just problems in neck. it has been 3 1/2 years for me - beenn diagnosised with lupus, but i still don't feel like this has addressed the pain from the back to the ribs.

  • Just wondering how I can get my doctor's to okay this type of test for my cervical or thoracic or both. It caught my eye when you mentioned the "down to the big toe" i have that on and off - and it goes numb quite a bit. i mentioned the pain that i had thru my butt and down my right leg each time they did injections into my neck or thoracic - the doctor jsut said it was a different response than any other patients he had had.

    thanks for your response.

  • I had a MRI done very recently because I have been in alot of pain, stiffness, "pins and needles"/tingling, soreness, muscle spasms and the list goes on. It's been over 6 months trying to deal with all that saying its just me being physical. I'm 26 yr male. The docter tells me that I have a tear between my T8 and T9 along with it fluid in my spinal canal. He put me on nuerotin that didnt help and now is putting me on another drung and it seams to not work at all either. I was wondering do tear of the discs heal themselves? or do they just get worse and you have to do pain management? It hard to get any answer from the doc cause he like literlly told me I dont know how to read MRI's but in the notes it says this...really and he was a nuerologist. so anyone out there help me with those answers? please.
  • I just found out that I have three thoracic herniations and one bulged disc. I'm only 21, and I already have lumbar issues =\ Can't figure out how this happened.

    Have any of you considered injections to help relieve your pain? Experiences, if you've had them?

    My pain management doctor thinks that I could benefit from a round of epidural steroid injections, but I'm a little scared because of the area, what with dealing with the spinal cord so near.
  • I have had epidural steroid injectionsand blocks at T11-12 and they have helped, I am getting ready have it done and L4-5 and S1 and my hip
  • Glad to know they helped you :) I'm really hoping they'll help me, then. I've had eight injections already between L4-L5, L5-S1. Sedation and I don't mind them one bit. Actually kind of look forward to them, ha.

    I hear so much about spinal injections, I didn't realize the same type of treatment could be used for the hip. Very good to know.
  • Anyone know how long anyone have to endure this chronic F******* pain for? I would really want my dang life back.

    -Do tears heal?

    -How long does it take?

    -Lighting your work/physical toll will help?

    -Is there a chance it would get worse or come back?
  • Mine have not and my dr told me that it would not heal but there is ways to go in and like burn them so they do not hurt, I have not had it done yet Iam too chickhen lol
  • hi im new here :)))
    burn them? do you know the name of this proccedure??
  • I would think that would make the problem more of a problem with burning nerve endings OUCHY. lost your mind on doing that. Waiting to get my Epidural Steriod Injection done appartly that does help so we will see.
  • It is called Intradiscal electrothermal annuloplasty you can google it
  • yeah but who will perform this on thoracic...most of doctors do this for lumbar...you have name of dr. for thoracic? you can PM me :) tnx
  • I live in Indy and have one here but I do not know about other places
  • Omg! There are other people like me!!! This year on tues 19th feb I lent over with no effort and stayed stuck as soon as I stood my back started to spasm and as I walked this band/chest pain started to become worse and worse. As I'm a physiotherapist assistant, my work colleague saw me come in after lunch in a hunched state and as soon as I tried to extend I started to spasm. She placed the heat pad on me and ordered me to go home. I thought this is a one off, until....that same week on the Friday I was having dinner sitting down and I started to spasm like I was having a fit! I had to place my arms on the table as I could not let go of them as soon as I did I started to spasm. My partner had to take me home by helping me walk hunched over. Since that Friday I then went to see Drs who diagnosed me with intercostal neuralgia. I was not convinced as no pain killers or anti inflammatories or muscle relaxants were helping me. my triggering factors were standing or walking. My back is very hypersensitive to touch so my bra, tight clothing, sitting back on my back starts to trigger the stabbing pains which evolve to my band pain, coming all the way to the front as if somebody has punched my sternum and I feel winded, I also feel very nauseous when I hav this pain and dizzy. I've been like this for nearly 6 weeks. Been to see a neurosurgeon which sent me to have an MRI. The report came back saying that I have disc protrusions t7-t8 (central) and t8-t9 (para central), not affecting my spinal cord. My dr assumed that I must have ruptured the annulus fibrous. He later saw in one of the images a white spot which he then diagnosed me with an anular tear of t8-t9 which is not on the sides which is the weakest part, I've torn the thickest part of the anular in the middle near the spinal cord. So I'm guessing all the pain in experiencing is because its so close to my spinal cord :/. I'm just so fed up. I can't even have physio as everytime I've been to see my work colleagues I hobble back home in pain and they make it worse. I'm 22 yrs old and I just need some advice please :), I feel like I'm getting weaker everyday
  • I have herninated disc t2,3,5,6,7,8. It has taken a year to find out that was the problem. Have had two epidurals, they did not work. Been to neurosurgeon, after looking at the mri, he stated the only way to do surgery was through the chest. He wants a myelogram done (which I am having next week) and then we will discuss my options. I can't sit stand or walk for more than 10 mins. I was very scared when he talked about the kind of surgery. But I am in so much pain now, on morphine er and ir and 600 mg of neurotin 3 times a day. Just want to be able to get up and move again. Hopefully I will know April 10 the plans. I wish everyone on here well :)
  • MathhewsMMathhews Posts: 9
    edited 03/29/2013 - 4:39 PM
    As far as fusing, I am not sure. The Dr. saw at least 3 on the MRI, will know more after the myelogram is done this coming week and then I see the neurosurgeon to find out what all is going to be involved. Will let you know as soon as I know. Getting nervous right now.
  • I have a 80% wedge crushed thoracic vertabrae T5 and minor crush at T7 through a motorbike accident. My pain doctor thinks it's chronic pain which should have healed by now. I have constant pain even if I lie down and have had it for 7 years as not many doctors want to operate on the thoracic spine. My pain can get so bad I want to jump off a cliff. It can go to level 8 or 9. My wedge is on my right side. As some doctor wrote you should not have pain with a thoracic spine injury I need some other people to say how bad thoracic pain can be so I can show I am not making this up.
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