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Help! Running out of options....

rollergirlrrollergirl Posts: 23
edited 06/11/2012 - 9:00 AM in Upper Back Pain, Thoracic
I am a 31 yr. old female and have had sharp pain in my upper back for over four years and cannot get any relief or answers. I have tried chiropractic treatments, massage, accupuncture, physical therapy, biomechanical therapy, anti-inflammatories and even narcotics (percocet) and nothing has given me any relief at all, or even taken the edge off. I went to a neurologist and he said he could not help me because the pain did not seem to have a "focal point" or something. (Although, I had a massage a few days ago and she pushed something that almost sent me through the roof.) I went to a thoracic surgeon and he told me I needed to exercise more, which infuriated and frustrated me at the same time and left me in tears. The pain is between my shoulder blades just to the left of my spine. It is literally next to the spine. It hurts when look up and to the right, breathing deep, and any movement of my left arm, especially across the body in the front. I can sit comfortably and pain free in some positions, but pain is always same intensity when moving or lying certain ways. I have had MRI, the result was:
1. mild degenerative changes within the entervertebral discs at multiple levels with mild disc space narrowing and disc dessication, most notable at T3-T4. Mild ventral bulging and osteophyte at multiple levels in thoracic spine. No herniation, stenosis or impingement. No mass, fracture or infection.
2. degenerative changes at multiple level with preservation of disc space height, lordotic alignment of the cervical vertebra and an upper thoracic curve to the left.
3. Mild diffuse cervical spondylosis with mild facet arthropathy at on the right at C7-T1 and on the left at C3- 4. At C4-5, C3-4, and C2-3, mild dorsal annular bulging.

I have tried looking up each of these things individually and just cannot make sense of any of it. This is starting to make me crazy though. Please if anyone has any ideas of what to do or where to go now, I would appreciate any suggestions available!

Thanks for your time!


  • dilaurodilauro ConnecticutPosts: 9,875
    The best source for that is with your doctor. No one here is trained on how to properly read MRI, X-Ray, EMG or any other diagnostic reports.

    Providing such information is a forum violation. We have also stressed to all members not to ask another member to interpret a report.

    Keeping that in mind, its easier to make general observations. When ever I read a report, I look for three key words:

    Mild Most of the time, patients can reduce discomfort through approved exercises, Physical Therapy and over the counter medications.

    Medium There are some areas of concern. A doctor may prescribe different medications to help you. Additional conservative treatments may be considered, such as Spinal Injections, TENS units, Aroma and Music Therapy, etc. Patients may also be on a detailed physical therapy treatments.

    Severe When you see these words, then you probably already know the action plan.

    I forget about any mention of Degenerative Disc Disease, only because this is such a common condition. Most people have a degree of this by the time they reach 25. DDD is the aging of our spine.

    For more details, just click on the Conditions and
    Treatment tabs on the main menu.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hello Ron, thank you for your response.

    I guess maybe I should clarify. I am not asking for an interpretation of my MRI. I have had that by a number of doctors.

    What I was looking for is where to go next, as I have exhausted a number of options and have not been able to get any relief. Was hoping that maybe someone had something even sort of similar and maybe had some advice.

    I only included that information because it seems from all the other posts I have read, people included the areas of the spine they have issues with and what the issues were. They just were able to do it in a more concise manner than I obviously was able to do. I am just getting familiar with a lot of the language and I read somewhere we are supposed to be as specific as we could and since I am not familiar with some of the terms, I didn't know how else to explain except put the conclusions from my MRI.

    I apologize. Just am tired of hurting and seeking any advice available, as doctors have not been able to do anything to give me any relief.
  • Rollergirl, It sounds like you are in serious pain and that it is getting you down.

    I don't know what would be causing your specific problem, but I do know that when I had severe stabbing/burning pain to the left of my spine, it was associated with my cervical spine issues. I could not move my left arm without the pain increasing, nor turn my head. Looking down was especially troublesome.

    Now I am not saying you're c-spine is your problem. But I would continue pursuing an answer. How long has it been since the MRI? Have you had a CT scan? Flexion/extension x-rays?

    Only you know the severity of your pain. If you know in your heart that there is something wrong, you owe it to yourself to keep pushing for help. Perhaps a standup MRI would be more beneficial, or an mri using better equipment. I know that my surgeon threw out the MRI I had at one center and ordered another one at a facility that uses better equipment. Also, does your doctor review the films, or just read the radiologist report? You said the thoracic surgeon just told you to exercise more. What did he say about the curve in your upper thoracic? Can you get a copy of his notes from that appointment for further clarification and what his diagnosis is? Did he say to come back? One thing important to note is that usually physical therapy and exercising is ordered before a doctor will consider going the surgical route. They often order 6 weeks of therapy or so, maybe some shots, and then have you come back to discuss what is next.

    You sound very frustrated, and I wanted to just give you some encouragement. You can keep going, so don't give up.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • One thing I might add, and I dont have MRI with me to be 100%, but for two years what was an osteocyte ended up being a herniation with a better MRI machine. I had massive knifing pain between shoulder blades but got good releif with ESI, but you need to know source first. And trust me radiologists all read reports different, I actually had radiologist re-read mine after something missing from previous MRI and sure enough he called back and said yep still there I just missed it, so you really are you best reasource cause everyone makes mistakes, doctors are not created equal, technology is not created equal. Reasearch there is signifigant differece in T 1.5 and T 3 MRI machine.
    When I went to chicago doctor threw out MRI cause it was blurry and actually requested a bunch of additional pictures of my T67 level, which seemed like common sense but it was first time in 8 yrs that had been done. It was a bunch of different views not done on standard MRI. But he was evaluating me for surgury so maybe that was reason why extra views ordered.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • Sorry to hear you are in so much pain, your frustration and exhaustion really comes through in your post.

    Have you seen a spine or pain specialist? I've been to a lot of different doctors, and some just seem to have different specialties. A neurosurgeon (specialized in spine issues) I saw once, really just for a second opinion, said "yep, that's what it is, it happens, nothing you can do, keep seeing your pain doc". Especially in the thoracic areas, surgeons don't want to go there unless it's life threatening. Whereas a pain management doctor can do injections and could possibly provide some level of relief. There are so many "spine centers" these days. In my opinion, and experience from having tried a few different ones, you might have better luck at one.
  • Many people here also express having exhausted all options, the only difficulty is that only a limited number of options are available, it is understandable to surmise nothing is working, as Ron said, we then have the need to have a second attempt and look more critically at each option we may have deemed inconclusive at the first try, your idea is that one solution is attainable just for the looking.

    We are all given advice that can be upsetting and have to take it on the chin, if we decide to ignore the advice of a surgeon that is our prerogative.
    Any potential solution takes time, effort and persistence, every long term chronic pain patient has tried non-invasive incremental treatments and it is frustrating in every way. We know it is hard not to focus on every nuanced diagnosis that in itself does not make any remedy easier.

    Those with ongoing chronic pain have a diagnostic as lengthy as the Magna Carta; it has not made finding a cure any simpler or effective.

    We are not here to minimise the impact of your debilitating pain, we are trying to be helpful supportive and encouraging, what do you think your options are, did you ask the surgeon, we wish we did have the solution to give you but we do not, it is a question of trial and error and staying positive for the duration.

    Take care, pain is pain and we can all relate to that. John
  • Cindy,

    Wow, you are an inspiration. You have been through a horrifying ordeal. Makes me feel wimpy for even complaining. You have incredible strength. Thank you so much for taking the time to read my post and respond. You sound very busy and I very much appreciate you taking the time to do this.

    As for your questions, my MRI was done in June of 2009 after 6 months of twice a week chiropractor visits and short massages that just seemed to make it worse. When I went to see the spine surgeon and neurologist last year, I expressed concern that the MRI maybe needed to be repeated as much of my pain comes with movement and certain positions, so i did not feel the MRI accurately portrayed what I was feeling as I was laying in a position that was not painful. Also, my pain started on the right side four years ago and migrated to the left. Same exact place next to spine at same level, just on the opposite side. So, I knew MRI was not showing that. They both told me it was not necessary to get any further testing done.

    As for what the spine surgeon said.....I brought in the copy of the films, along with the report that was included with them. He was not concerned about the curve in my spine. Said it was mild and unrelated to my pain. He concluded that the pain I was having appeared to be "mechanical type pain" and recommended an overall fitness program, including core strengthening and aerobic capacity. He stated in report "there is no intrinsic pathology appreciated on the cervical and thoracic MRIs." I asked him why if it was mechanical/muscular in nature I did not get any relief from anti-inflammatory medications or narcotics. He did not really seem to have an answer for that. I could accept this more I guess if I had not already done physical therapy and biomechanical therapy prior to seeing him.

    I am currently looking for a new doctor to see and plan to request a new MRI (hopefully a standing one or one that has you in multiple positions) and maybe a disco... (whatever the other test is that people have talked about on here.) I have never had a CT scan or the flexion/extension xrays. (I had never even heard of them prior to your post.) I definately feel more confident and hopeful about further pursuing answers about this after reading posts on here.

    It is funny that you mention that the initial pain you had, that sounds incredibly similar to mine, was in your cervical spine. I have asked both chiropractors I have seen and asked the spine surgeon I saw as well if what I am feeling could be some sort of referred pain. No one seems to really know and keep referring to the MRI, stating it does not show anything remarkable. (grrrr...) Since the start though, I have always said that it feels like something just needs to move and it would stop hurting. Feels like it is knicking a nerve or something because is just so sharp.

    Thank you so much for your encouragement and your time. I appreciate you! You are in my prayers.\


  • anelsen15, thank you for your response. I am currently looking for a new doctor to request a new MRI (hopefully standing) or in multiple positions. I am still learning about these and don't even know where they do them here, but am hoping to figure it out soon. I am thinking the discography thing may be helpful too or maybe instead.

    Did you get relief from your surgery? What did you have done? Did your tears show up on your MRI? Just curious.

    Thank you for taking the time to read and respond, I appreciate it!

  • I do not think I have seen a pain specialist. I went to a pain clinic to do my biomechanical therapy, but was seeing a biomechanical therapist there, and not a pain specialist. I did go to a neurologist, but he did not feel he could do anything. I convinced myself I had a ribhead out at one point and looked online and found a pediatric thoracic surgeon who agreed to see me and then sent me to the spine surgeon at The Spine Center.

    I appreciate your advice about seeing a pain specialist though. Part of my problem is I just don't even know where to go. Is not something I want to just pick out of a phone book, you know? I am hoping that an injection of some sort can be tried, but as far as I knew they could not do that until they pinpointed the source of the pain. This forum has definately given me some helpful advice and options I did not know about though.

    Thank you for taking the time to respond. I appreciate it!

  • Patience is a virtue I have struggled with my entire life. Thank you for reminding me that finding a solution is likely going to take me some time.

    I should know this already as I have watched my mom suffer with a number of chronic pain issues that were ignored, untreated, treated incorrectly, etc, before she found relief. She has fibromayalgia and just had a sacral iliac fusion. She has OA in her whole spine, bursitis and some other things I can't pronounce. She actually travels out of town to get her injections and drove across the state for her fusion because she was not satisfied with the care she was receiving in her hometown.

    I am currently looking for a new doctor. I think I was so discouraged by what the surgeon said, I just gave up for a while and had decided I was just going to have to grin and bear it. My mom's recent successes and finding this forum have made me more hopeful and renewed my ambition to get to the bottom of this. I am going to talk to the chiropractor again this week and plan to ask if he has any recommendations for providers. I do plan to ask for new tests as well. From what I have read on here, there are a lot of things that I have not tried yet, as far as tests, possible injections, etc.

    Thank you for taking the time to read and respond. I appreciate the advice and sentiments.

  • since we have long time to work in office , in front of computer, so our body are lack of sports, so we will have sick on back and so on .
  • I believe seeing a neurosurgeon who specializes in the spine and its nerves may be useful if you feel it is related to the spine.
  • I have not had surgury yet, bigger problems starting up. But the upright MRI is called fonar upright MRI. Just research for ones in area. It's what I did, they are usually weaker machines though but def worth shot just to eliminate that chance to find something. Mine showed some new stuff and missed some old
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • Sorry about feeling hopeless as I can completely understand.

    I have multiple problems throughout my spine and have just recently seen my first neurologist. My family doctor had an MRI done and treated me with many different narcotics. I literally would have him change the amount of dose or drug all together every month or so because it seems like nothing will work.

    My last visit with him I told him once again that I needed more/something different. He had already prescribed me everything from lortab 7.5/10 6 times per day to percocet 6 times per day and everything in between along with nerve meds, muschle relaxers, and some other stuff I dont even remember.

    He asked me to go see the surgeon before giving me anything of a higher dose to make sure he was trying to treat me the correct way.

    Well went to the neurologist last week and he was very nice but didnt give me any good news at all. Said that pain management would be pointless since there isnt a focal point (too many different problems) and surgery is out of the question right now as it would be anterior/posterior 12 hour ordeal that wouldnt fix all of my problems.

    His words to my wife (family MD practitionor) and me were that narcotics are the only way to treat the actual pain accompanied by exercise, physical therapy, chiropractor possibly daily, and stretching.

    He said all the other medications were a waste of time and money as I've already been on opiates for treatment for the pain that I've just grown tolerant to. Sucks but atleast he and my family doctor are trying everything they can to ease my pain. I understand that it will take time to find the right combination of meds and strengths will always need to be changed once my body starts to tolerate them.

    I'm just so tired of hurting and building up a tolerance to these meds that arent even working. If I were building up a tolerance to meds that were actually easing my pain I would be fine with that.

    Just make sure that once you find a doctor you are comfortable with that you explain to them that you are willing to do any and everything they want you to do in order to give you some relief. That is so important to drs today as there are way too many seekers out there begging them for drugs. Trust me on this as I'm at my wifes office all the time and am friends with all the drs there. When we are in the break room eating lunch seekers are the #1 topic of conversation between them. Sure I feel a little weird setting there listening to it while one of them is prescribing me countless different drugs but he also knows I have true organic pain that is multiple levels of problems. There is a big difference in their eyes to those patients whose tests show the cause of the pain and the others who just have a protrusion or something without any impingements.

    Just make sure that you stress to them that you will do anything it takes. It may mean trying things that make you sick, drowsy, or even give you headaches, but if you atleast try these long enough to see if the side effects will subside then they will have it in your file (the drs backup protection).

    I'm really rambling here but started to comment to you last week after I returned from the neuro and had similar advice as you but my newborn woke up and I accidently closed it out.

    I need to update my thread but check it out as some of it is the same as what you are dealing with. Title is something like t3-t7 problems, just a few threads down. Oh, and the neuro found stuff in the MRI that the radiologist missed. He said that is rather normal as the tech doesnt have the oppertunity to see the person and ask them questions while looking at it.

    Good luck and hope you find something to help you deal with your everyday problems!
  • Thanks anelsen15. I am going for a consult at the place that does the upright MRI on Thursday. Going to ask about a discogram or whatever that is called also. Good luck with your pains. Hopefully you can get some relief soon.
  • Wow, all that pain and a newborn! You have your hands full. Sorry you are having so much pain and no good answers. I am going to have a consult at the place that does MRIs and stuff this week with a CNS I think? Don't quote me on that. Went to the chiropractor and asked for a referral somewhere. He has been great with trying to help me find answers. So, am hopefully to get new tests at least and praying they will at least show something that will give some sort of answer. I think at this point I would almost take some bad news over no news. It is so frustrating to not have answers.

    Good luck finding pain control! If I get any good advice I will be sure to pass it on!
  • I just read through this thread. I am sorry to hear about so many problems- many of us have been here a while know that there is always more than one way to get there....

    Please do not give up hope for treatment just because one doctor/neurologist has told you that there is no point in it anything other than pain medication.

    Not every bulging or herniated disc will be a pain generator. There are some diagnostics that can be done to narrow things down. Also opiods are onlyone of many different treatments that add to our comfort.

    I have a little experience with my friend "chronic back pain". I had a PLIF 2008, acdf c567, t-boned in MVA. I have substantial T-spine issues now (click my name for full history)

    I have been in Pain Management since 10/2010 and it has saved my life. Literally. I see my PM doc each month for my meds, and we discuss other treatments. I don't want to take the medication I take since I have to work. I don't want to have another fusion either. I am trying to get a Spinal Cord Stimulator and or a Pain Pump. If that won't work maybe I will get RFA's? My point is there are other options. Massage, Accumpuncture, Hydrotherapy, Tens, etc.

    I use a lot of heat, ice, pain meds, nerve pain meds, muscle relaxers, tens unit and massage therapy.

    Finding the right doctor is very important. Someone who will help you get every treatment that may ease your pain even if his clinic dosn't offer it... Someone who is up to date on current procedures.... Some one who is compassionate about your care.

    Feel Better,

  • I feel for what you are going through, as so many others here do.

    I am so glad that you are taking in all the support that this thread has offered. It is very touching to hear the level of gratitude that you have for each person who responds.

    Having life changing pain can be so difficult on every level of our being. Learning how to navigate through a diagnosis, treatments can be mind boggling to say the least.

    Now you have the support here with us each step of the way.


  • Desk work in front of computers definately hurts our necks and backs! My posture is a mess! :)
  • Thank you for the advice! I am getting new MRIs next week, and am working with a PA who specializes in the spine. She mentioned neurosurg. at our consult this week, but wants to see what the new scans say. I am hopeful! She seems very determined to get to the bottom of this.
  • Wow, I don't know how you do it! Your story is heartbreaking. I can't imagine the pain you are going through. Like I told Cindy, it makes me feel like a wimp for complaining at all. I should be counting my blessings instead as I see through this forum that things could be much worse!

    I got some good news this week. My chiropractor sent me to a PA who specializes in the spine. After my exam, she decided to have new MRIs done (standing ones) and said that if we need to add films lying down, we will do that as well. She told me not to be discouraged if things come back "unremarkable" again, that there are options and she will help me explore whatever is available. I am hopeful and excited. I bust into tears as she was leaving the room because I was just so relieved to have a Dr. as motivated as me to figure out what is wrong. I really had given up last year. I credit all of the wonderful people on this forum for giving me the hope I needed to start looking for answers again.

    You are in my prayers! Bless your heart. Your courage and determination to continue living your life is admirable. I hope that you are able to get the support and justice you deserve!

  • I just read through your history, and oh, it just made me hurt. Bless your heart for continuing to push on and live your life through the pain.

    Finding this forum has been such a blessing and inspiration for me. It has given me so much hope. Also, it has put me in my place as far as seeing that I need to count my blessings that what I have going on is not worse. Reading people's stories on here is just heartbreaking. But inspiring as well. You all have a will to live and continue your lives despite of the pain. Many would give up, quit doing the things they love. It is neat to see people "fighting back" so to speak.

    Thank you for your response. Take care!
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