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Car accident 9 months ago - PT, pain block, 3 surgeries and still no real diagnosis.

erikam240erikam240 Posts: 1
edited 05/08/2013 - 5:53 PM in Upper Back Pain, Thoracic
I will be 24 this month. I am a healthy female, and I was very active before the accident. I'm 4'11 and 92 pounds. No prior illnesses or injuries. I have a BA in literature and I'm doing post graduate work now.

In August of 2012, a man in a utility van ran a red-light doing about 50 mph. I was driving to work in my small Honda. He hit the driver's side. Completely smashed in my drivers and passenger door. Totaled the car. The side airbags deployed and my car did a full 180. I was wearing my seatbelt. There was a full foot of intrusion and the paramedics had to use the jaws of life to get me out.

Went to the ER. They did X-rays and a ct scan. Found nothing wrong. My lower and upper back and neck hurt severely. Went to an orthopedic doctor. He prescribed flexiril and such and put me in PT for 6 weeks. PT grew concerned after 6 weeks. My muscles were still swollen and pain was still severe. Doctor did a bone scan, more X-rays and an MRI. Saw that my hip joints were "hot" and that I was having spasms, but didn't note anything else. He said I may have some spinal disc tears, but those should heap within a few months and we would treat the pain until it did.

December - I go to get an epidural pain block. Nurse ignores my protests that my arm they put the iv in was hurting. They didn't dilute the meds enough either. Fast forward to that night....I had been in agony for several hours. My arm was swollen. The doctor wouldn't answer his emergency service calls. I go to the ER at midnight. The pain gets so bad I start vomiting. Morphine nor dilaudid, given at two hour intervals will ease the pain. I start having a hard time breathing and eventually start dry-heaving. I cannot move my hand. My fingers are frozen in place, and I can neither close my hand or open it all the way. My arm has swollen to more than twice its size. It took 6 nurses and 3 doctors to see me before they decide to call an orthopedic surgeon. At this point, I've been at the hospital for 12 hours. No one knows what's wrong. The surgeon walks in and I see a look of panic and surprise. Within 3 minutes, I'm being wheeled to the OR. Turns out I have all-out acute compartment syndrome. Compartment syndrome doesn't respond to pain meds because the blood flow has been cut off.

For those who don't know what that is (I didn't), here is a textbook definition: "Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells. Compartment syndrome can be either acute or chronic. Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury. Without treatment, it can lead to permanent muscle damage."

The doctor said that when you have 30% pressure buildup, you must operate. At this point, because they had waited so long the pressure was at 80%. Normally the operation consists of what is called a fasciotomy. They cut you from wrist to elbow to relieve the pressure. If they don't do this, and sometimes even if they do, you can lose your limb, lose use of it, suffer severe damage, etc. The pressure in my right arm was so much that they had to do a double fasciotomy. They cut me open from the middle of my palm to my elbow and then on the other side (my forearm) from right below my wrist to my elbow. It took two more surgeries to close it up completely. I spent one week in the hospital, one month in a cast/splint type thing, two months in OT, and it was a nightmare. The first doctor kept seeing me until my arm healed and then dismissed my back pain saying it was just bad posture.

When the pain block started wearing off, I started having pain again. The pain is in my upper back. It runs down either side of my spine. It's between my spine and my shoulder blades. My neck and shoulders also hurt. It hurts constantly. It starts at about a 6 of 10 in the morning, and by the end of the day (I work in an office) it's about an 8 or 9. By evening, it can be a 10. The pain is a constant severe burning. It is often accompanied by throbbing and aching. My muscles are extremely swollen and tight at all hours. I can't sleep. I'm irritable. I can't sit still for too long. I can't stand for too long. Activity hurts. Inactivity hurts too. Just this past week, I started having one particular spot that is a stabbing pain every time I turn or move too much. Heat and massage seem to help but not much. Advil and ibuprofen just keep the tears at bay. I've developed little bead type things in my shoulders and neck.

I went to a new doctor. He did X-rays and an MRI. All he really told me is that the pain has caused a minor case of scoliosis. He prescribed flexiril and steroids. Like the other did. He said I need to try PT again. I start tomorrow.

It has been 9 months since the car accident. I'm already less active due to the 2 pound weight restriction on my right and dominant arm. This pain is making activity even more difficult. I cannot concentrate in school or at work. My grades have slipped. I'm irritable and my whole life has changed and I don't know what to do. Please help. I'm starting to lose my faith and hope that treatments will help or that this will ever get better.


  • AllMetalAAllMetal Posts: 1,189
    edited 05/08/2013 - 5:33 PM
    I am so sorry all of this has happened to you. I had a CSF leak (not nearly as dangers as compartment syndrome) that went on for 3 weeks... I ended up in the ER dry heaving for hours (because I had been throwing up for days) due to the pain. It is one of the worst feelings in life to be in so much pain all you can do is dry heave over and over again. I am glad they did (finally) get you to surgery. I hope now they can figure out what is wrong with your spine so you can get the treatment you need and deserve. Please hang in there and do what you can to stay positive. With all you have been through, I know it will be hard, but do try... positive thinking is sometimes all we have going for us. Let us know what you find out. And if this doctor doesn't seem interested in truly helping you, find another and another.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
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  • I have had unrelenting upper thoracic pain for 7 years. My T5 was wedge crushed in an accident but it was so long ago my last MRI said scoliosis because they didn't realise it was crushed from a trauma accident. Had that stabbing pain that feels like someone is twisting a knife constantly in your back and also shoulder pain which I spent heaps of money on investigating but now think that was a waste of money.

    Each of your thoracic spine is joined to a rib - and they don't think it should hurt, it is not a common injury because it takes great force to crush your spine there. There is a belief that thoracic spine injuries are stable.

    I don't believe mine is stable and neither does my physio now, because she can see the one above (T4) move back into place, by moving my ribs back towards my spine. It's taking all the pressure because I virtually don't have a T5. Remember your ribs curve up where they meet your spine so she kinda pushes upwards as well. This is the only thing that has given me some relief really. Also noticed my hips were not aligned and got a built up shoes on one side. A magnetic underlay also helped.

    PT made mine worse because it was pulling my ribs back out of place, therefore pulling my disks out, the only thing that ended up working was pain killers and muscle relaxants together which took them 6 years to work out. Steriods change your personality and make you grumpy - I don't know anyone who was on steroids whose personality didn't change without them realising it. They became agressive so I wouldn't go near steroids if it was me. This is just my observation and I'm not a doctor.

    I wish I was braced after my accident - there are a lot of warnings on this site about bracing because you loose muscle strength, but soft bracing helps you not to twist your spine so it has a chance to heal in the right place.

    I worked on a computer too and it does involve twisting all the time. Have said this before, if you broke your arm, didn't splint it and kept twisting it it would hurt and not get better. If you can use a soft brace you will realise how much you twist everyday and it makes the pain so much worse. See if your spine is in the right place. I would really advise not twisting, driving used to really hurt too. Make sure if you take time off work they know it is for your back. Don't take your holidays to get over the pain.

    If you see a neurosurgeon make sure he treats adult spine conditions because childhood scoliosis is different to trauma accident scoliosis. Also see if any of your ribs were broken.

    Sorry if this is too much info at once but it's taken me seven years of research, and you end up doing your own research, to realise this and I don't want anyone else to have to go through the pain I have had and the consequences.
  • thoracic spine painthoracic spine pain Posts: 566
    edited 05/11/2013 - 12:59 PM
    What is an ESI and what do they do. Have never heard of it in Aus and no one has ever suggested one.
  • Hey Thoracic.......EPI is "epidural steroid injection". I just learned this a couple days ago.

    Passing on the knowledge..... :-D

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