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Thoracic Pain at T7

Hello all,

I am a 25 year old female. I am 5'4" and am 139 lbs. I have had chronic thoracic back pain after a car accident in December 2009. I was in the back seat, with no seat belt and the driver was in a rental car with no insurance. At the time, I did contract work and could not pay for any treatment - nor did I realize immediately something was wrong. A few months later, I realized I was having increasingly bad pain in my upper to mid back, eventually it was so bad one morning that I had to go to the emergency room. I was given an x-ray, which showed nothing and then dismissed as having a "sprain". I asked if they could do more, but they refused, wrote me a prescription for pain medication and told me to rest. I was told my injury would heal in time.

It did not.

Out of pocket, I got physical therapy through a practitioner recommended by the hospital - I could barely move, the therapist said that the measurement she had done and my range of motion were some of the worst she'd seen. Months before I was flexible, and agile having been athletic all my life. She expressed concern because of the placement of my injury, however, at this time I just wanted to get back to work - I figured, "Why bother with an MRI? I'd spend all my money on the imaging and not be able to afford the care." I figured this was the best option. And it helped, assuredly with my movement but the pain was still there.

Now, my daily life is: Wake up, horrible side pain - it feels like my kidneys are failing me. For a while I was certain I had some sort of renal issue but this was ruled out via blood and urine tests. This is combined with a dull (but very painful - if that makes sense) pain that feels as though it encompasses the whole of my upper back and over all "heaviness" especially in my legs, some times accompanied by a slight lack of coordination for the first 15-20 minutes after waking.

Driving to work: I absolutely cannot get comfortable in the seat, and have tried a number of pillows and supports, I experience radiating pain stemming from the T7 site, ranging from a nagging dull ache, to a sharp pain as though a nail is suddenly hammered into my spine. I experience similar pain from spasms ranging from around the T7 site to my neck and shoulders. For whatever reason, these often occur on the left side of my body. After a drive, I feel similar to how I feel when I wake up and must decompress by standing/walking for some time before this resolves itself. Similarly, sitting causes me severe discomfort. I am often sitting, my hours can range from 9-13 hours a day and I drive two hours to work, so you can see why this is particularly unfortunate. Other symptoms can include, what seems to be lack of coordination with my hands - nothing severe, but when this happens I notice I will drop things or make the same typo over and over again. Also very rarely I will have trouble breathing and feel like I am experiencing severe chest pain when I breathe. Strangely enough, I occasionally experience pain starting at my knees, and it feels like the bone itself aches if that makes sense.

Luckily: I am no longer under contract, and will be receiving the benefits of health insurance. I am excited to share the results of this with you here as a follow-up. Still, as that is a bit off, I was just wondering if anyone had experienced these type of symptoms and what type of treatment helped you. My GP has prescribed me painkillers on and off, but I do not like to take them because of the side effects. (extreme nausea and constipation to start, I cannot take this type of medication while working which is when I experience some of the worst pain, and I do not want to be physically dependent.) I also take prescription strength NSAIDS, and a drug to treat spasicity. (my back, neck, and shoulders feel like a brick wall, and massages have to be done so hard it leaves me with bruises) Unfortunately, I am left with little choice when the pain interrupts my ability to sleep. (was getting so little sleep I was falling asleep at the wheel) I have been told by other sufferers that I will likely be repeating this vicious cycle for the rest of my life, but I'd like to believe that is not true.

Any words of wisdom, support, or guidance would be appreciated. :)


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Obviously if your symptoms have not abated after nearly 4 years your problems are more serious than originally diagnosed!

    Hopefully your insurance will cover you for a preexisting condition because you desperately need a proper diagnosis which is bound to involve at least one MRI scan and plenty of other stuff besides. Check before you say too much.
    Any sort of physical therapy is unwise until you have received a diagnosis and may even be dangerous.

    My advice is ask, plead, nag and if necessary kick @ss until you have tests and get answers.

    I went years without a proper diagnosis and it very nearly left me paralyzed. I spent far too long being nice, polite and compliant in the assumption my GP was "on the case." He wasn't. He was just sending me to one pointless appointment after another convinced I had MS and that eventually this would prove to be the case.

    I'm not young enough to know everything - Oscar Wilde
  • MLCampbellMMLCampbell Posts: 7
    edited 08/15/2013 - 3:18 AM
    Thank you for the encouragement and advice, mickkr!

    My GP hasn't done me wrong in that they are unwilling to find a diagnosis, they just had pretty much told me that they couldn't do much more without an MRI at the least, which I understood. He always asks me, "When are you going to get a job with insurance? When are you going to do something about this?" - Unfortunately due to my line of work - which is very competitive - I was stuck for quite some time in contract work and work anywhere from 3-9 months at a time making good money, but with no benefits - no holiday, sick time, or insurance. Luckily, and when I say luckily I mean it, I just recently have taken a full time job for this company and the insurance I have signed up for is very good it seems. I've chosen one that allows me to go out of network without too much of a penalty and also does not require a referral - I DO believe that it covers pre-existing conditions as I did not see anything on ANY of the plans that stated otherwise. I have had a place in mind to start my diagnostic journey, a local facility that specializes in skeletal-muscular medicine, and has a center devoted to diagnosing, treating problems of the spine (including lesser used non-surgical options when possible) as well as performing spinal surgeries, and rehabilitation.

    I had PT after going to the hospital and being diagnosed with a sprain, and haven't gone since then (so several years) it didn't seem to fix the problem, but it had been useful because I had struggled through it for quite some time and ended up really compensating with the surrounding muscles. It took a huge toll on my movement, so the PT seemed to help me get some of that back. I have gotten a few massages since then, but they leave me in more pain than I was before, so I was definitely weary of doing PT or any kind of manipulation until I knew more. I do try to stay as flexible as I can to avoid this and have adjusted my posture, I also do stretches before I get in the car, etc. I did not realize PT could be so dangerous; however, so thank you for that word of advice.

    There has been a visible "protrusion" or "bulge" at T7 and over the years (just now actually noticeable to the eye, but I could feel it) the area just below it appears to stick out just a bit from the rest of my spine. I assume this is from compensating for the one above it for so long, but I do not know for certain. I do feel as though many of my symptoms are nerve related. The "kidney" pain - the closest thing I could find to that online it seemed was nerve compression. And I have an incredibly "hard" back, neck and shoulders which I'm at my wits end trying to treat. (heat, muscle relaxers, massages (as I already said, left me in more pain), etc.) The issues with my hands, and legs also seem as though they could be nerve related.

    Anynow, now that I have the means to do so, I fully intend on fighting that battle for better or worse, to find a diagnosis.I am nervous, honestly, and I am fearful, of a bad diagnosis, or NO diagnosis. But I intend to do my best to go into it confident that I'm on the way to relief after all this time. I will update here when I have my first consultation!

    And as I said before, any words of wisdom, guidance, people who have similar symptoms have any tricks or tips to help alleviate the pain - even a little - feel free to share. :)
  • mickkrmmickkr Posts: 166
    edited 08/15/2013 - 6:25 PM
    I understand your concern about receiving a bad diagnosis, but not knowing doesn't change anything. At least you can plan and prepare once you know what you are planning and preparing for and any therapy/medication can be tailored to your precise needs.

    For me it was such a relief to have a doctor point at my MRI scan and say, with confidence, "...there's the problem". I had been 'in the wilderness' for so long, in constant pain and feeling my body deteriorate by the day, but not knowing why.

    I never bought the diagnosis of MS but was never really sure. Once you start researching you find there are many conditions worse than MS and it's easy to persuade yourself you've got them all!

    Keep positive, but be persistent. If what you are being told doesn't sound right or feel right, challenge it. Ask why the Doctor is saying what he/she is saying. They don't always read your notes thoroughly, sometimes they just glance through and make all sorts of assumptions.

    I hope things work out for you.

    Keep us posted.

    I'm not young enough to know everything - Oscar Wilde
  • MLCampbellMMLCampbell Posts: 7
    edited 08/22/2013 - 3:42 AM
    Bad news: I'm in crippling pain today, so painful and stiff from spasms that I threw up. For whatever reason, especially when my neck feels really stiff I get super nauseous. Good news: I called, and the new doctor I wanted to see, who was booked several weeks out had a cancellation for tomorrow morning. His is an an institute dedicated to spinal health,with mostly every thing on site for imaging, testing, etc. Hopefully I will be on my way to some answers. :) I am in a surprisingly good mood, albeit a little nervous. Wish me luck.
  • MLCampbellMMLCampbell Posts: 7
    edited 08/23/2013 - 6:40 AM
    The receptionist had scheduled me for a cancellation that was made because the doctor would not be in that office today. At first they claimed I went to the wrong building, but my appointment in the computer showed that I was in fact at the right place. Got all my paperwork done, but it will be a month before I can be seen. I drove from work, sixty miles away for this appointment... But what bothers me the most is how it completely destroyed what little happiness I had left. I was so excited for this appointment, they don't get why if I had this for four years, I can't wait a little longer.... Because it is destroying me, mentally, and physically. And with the demands of my job, I find a solution or all that time doing crap contracts and fighting my way to the top of a not only competitive but male dominated industry, well that will be wasted, cuz I will either quit or be fired. Another month of 3.5 hours in the car. Another month of 12 hour days. Another month during a really bad flare up. Another month is a big deal. I am so depressed, I just don't know what to do...
  • thoracic spine painthoracic spine pain Posts: 566
    edited 08/23/2013 - 12:35 PM
    Hi long story, but I wedge crushed my T5 80% in a motorbike accident. I, like you, thought if I didn't use it I would loose it and worked a stressful job for over 6 years in incredible pain with out a diagnosis on what was actually causing the pain. I used opiods and muscle relaxants to get me through the day - then came home at night in agony - at lunchtime closed the door to my office and lay there in agony. In the end I gave up work. I had private insurance, I spent at least $30,000 of my own money on every type of treatment both Eastern and Western. Nothing helped except heat packs, PT and tens machines made it worse.The pain used to make me vomit at times and I never went out at night or on the weekends. I had to copay a lot 'cause it doesn't cover MRI's or some eastern therapies, but I did a lot of other damage as well. They just kept telling me my thoracic should be stable, so I started to think I was going insane.

    I have just found a wonderful physiotherapist who realised my pain was coming from my T4 not T5 which is 80% crushed. As my T5 was so badly crushed they just kept focusing on that area. Your body tries to heal itself and the ones above tried to compensate for the missing, damaged one below. My T4 never showed up on an MRI, I believe because I had prone MRI's and there is a 20% miss rate for spinal conditions if you do not get a weight bearing (standing or sitting) MRI.

    My shoulder was also not mechanically in the correct place. My physio has taped my T4 and shoulder back into place - my spine pain is not so much agony if I am careful - it is the first pain relief I have had in 8 years. You need your vertabrae to be taped into the correct position otherwise the muscles just spasm it out again.

    My new specialist has also found active pathology in my shoulder which has been there for 8 years and has written a letter saying how I had been mismanaged from the very start.

    Please try and get a correct diagnosis. Try to have a standing or sitting MRI - you can see the difference on You Tube. Get a physiotherapist who touches you to feel your spine and tape it into the correct place.

    I fended off becoming addicted to opoids for years but in the end had to take them combined with a muscle relaxant. I ended up on quite high doses but the pain was always there. If you are diagnosed you might be able to get away with taking enough to ease your pain a bit and swapping them round.

    The good news for you is they can operate at T7 with minimally invasive surgery to stabilise your spine. Anything from T5 and above they can't do minimally invasive surgery, until they get to the cervical vertebrae. Traumatic thoracic damage is quite rare and you have to research yourself as it is only caused by high impact accidents, as it is attached to your ribs and nearly 80% of people die from other injuries in a high impact accident.

    My advice is to try and get a weight bearing MRI to show what is actually happening. They ended up picking most of my problems up on a bone scan which no-one else had ordered. Have a physio put your spine in correct alignment and ask for muscle relaxants so it stays in place.

    You need to be careful in your activities - no bending or twisting, pulling hurts me but pushing seems to be OK. Don't carry heavy stuff around. I take a wallet while I am shopping, not a handbag full of stuff. Be really careful with housework. Sleeping with a pillow between my knees has really helped as it is supposed to take the pressure off your spine when you sleep.

    Keep a pain diary for at least a week every half an hour, it just needs to be activity then pain level from 1-10. it will surprise you what makes it worse. I was given a lot of misinformation and thought it would all heal by itself. Mine has ended up healing in a really bad place and it is too late to operate so don't just think it will resolve itself, it won't.

    Also have a look at the dermatone map on this site and on Sandi's avatar. You can see where the pain radiates. Everyone gets depressed no matter how much you fight it. Incessant pain is incredibly mentally wearing as every second you are using your mind to control the pain. You need to hang in there for another month. Work hurt heaps but was good in a way. It took my mind off the pain a bit. I never want what happened to me to happen to anyone else again.
  • I know exactly how you are feeling, In 1990 I had a really bad accident that caused me to herniate my cervical, thoracic and lumbar spine. I was in the Navy and during a time of war you can't be allowed to be sick.

    Fast forward to 2006, I became very ill, my cervical spine had developed stenosis with myelopathy for which I underwent a laminectomy, C3-C7. Fast forward to 2013, in may of this year I under went a T6-T7 costotransversectomy, T6-T7 discectomy and Multi-level fusion T4-T9. Diagnosis; Thoroacic stenosis with myelopathy. Now let me tell you what 23 years of pain and discomfort has brought me; Last year the VA diagnosed my spinal condition as incomplete quadriplegia C5-C6, Neurogenic bladder, neurogenic bowel, chronic arm pain, Leg pain and depression. Today, I feel like I have been set free and given a new lease on life. The surgery on my thoracic spine relieved so much pain and now I can focus, exercise, be myself again.

    Please if you have waited 4 years, get help immediately. What I have had to endure has been very cruel and if only someone had listened 23 years ago I wouldn't be a 100% Permanent and Totally Disabled Veteran. Now I have to worry about my liver because with all the medication I am on, I am surprised it hasn't failed. My blood is anemic and I have very serious stomach and esophagus issues.
  • mickkrmmickkr Posts: 166
    edited 08/24/2013 - 7:36 PM
    A month is no time at all, when you're looking back, but looking forward in pain and anxiety, it seems like a lifetime.
    Hang in there. Use the month prepare a log of your pain and what causes it to flare up.
    It's surprising how much you forget to say when you're actually talking to the doctor - you remember everything afterwards!
    You waited a long time for this. Make it pay!

    thoracic spine pain - I concur with your sentiments entirely.
    trueblue6- I'm glad your t-spine surgery is helping matters. For me it has transformed my life. I feel normal (nearly) again. It's a pity you had to wait so long.

    I'm not young enough to know everything - Oscar Wilde
  • Trublue6TTrublue6 Posts: 10
    edited 08/26/2013 - 3:38 AM
    Ironically, all of our stories seem to connect because we have all been in that "place" in our lives when pain overtook our daily lives and interrupted our marriages and caused strain in relationships with our children. No one will really understand pain like we do. Sure a person could have a slight pain in their back and they rest for a day or two and their fine. Not us, its like it has become a new normal and that is just sad. After my surgery, I was in a lot of pain but as I got further and further away from my date of surgery I started to feel a lot better.

    It is still a work in progress and I still don't know what pain free feels like but Its getting there day by day. Don't give up on your quest for a good doct


    Post edited to remove specific doctor's name. Please read the Forum rules
  • thoracic spine painthoracic spine pain Posts: 566
    edited 08/26/2013 - 2:23 PM
    When you go to the specialist try and take someone with you who knows what pain you are in everyday. When you are in pain it's really hard to explain things in a logical manner. I used to have to take meds just to cope with the car ride. With my new specialist I also took along what I had written on SH about my pain and asked him to read it. Saved me having to explain everything over and over again. I really think this helped him understand a lot better than answering the endless questions. They see so many people and they forget.

    I know as in my old job I used to see about twenty people a day and they would expect me to remember their specific circumstances. Although you take notes, people morph into one after a while especially if you are really busy. So please take a person with you and take the notes you write from SH and ask him/her to read them. It made an incredible difference for me and helped the specialist remember who I was.
  • MLCampbellMMLCampbell Posts: 7
    edited 09/03/2013 - 5:48 AM
    That's a good idea, and you're right my thoughts have been everywhere. Took a week off work, and still can't put clothes on in the morning without pain. Also losing weight? Ugh... I don't know what to do. GP says two more days, rest heals all. Blah...
  • After being rescheduled several times, I am finally seeing this specialist on the 14th. I hope it's worth the wait. In the mean time, I've written up what I want to say and kept a pain journal. I ended up in the E.R. for suspected appendicitis, and an x-ray for breathing issues from referred pain. (I didn't have appendicitis, thank goodness!) So - x-ray caught that area of the spine, and it showed no fractures or anything which wasn't surprising - I've already had an x-ray in the past which was the same. Hopefully, she will have some idea from our consultation and I will definitely ask for an order for an MRI if she doesn't suggest it herself. She's been known to work WITH you, so I'm hoping for the best. I will tell you what we find! Just gotta get through the week, although that's easier said than done. Wish me luck. :)
  • thoracic spine painthoracic spine pain Posts: 566
    edited 10/09/2013 - 9:14 PM
    I have had some more time to think about this.

    My pain was only on one side which the specialist thought was really strange.

    If you have pain only on one side like me it may be that the disks are herniated on one side - I don't know if they can be damaged on one side and not the other. I have had more time to think because if it was bone it would be picked up in an XRay so it is probably disks or muscle damage and I can't comment on them as my disks were not herniated for some unknown reason which is strange in itself.

    Sorry True blue there are not many surgeons who seem to know about thoracic. I wish I had listened to the first old doctor I saw from work. he had dealt with a lot of thoracic crush injuries from pilots ejecting from aircraft. He told me I would not be able to work and that he would put me on a pension straight away. I stupidly said no, I wanted to work so I did in incredible pain for around seven years then finally had to give up. In hindsight I wish I had taken his advice as he was the only specialist I have gone to that had seen my specific injury before. I think he must have retired by now.

    Sorry True Blue you have already done that. Now I feel like a total idiot and am very grateful for the information you PMed me. I live in Australia but no-one I have seen will touch me here - I can still walk and just have pain - the risk vs reward they say is too dangerous. I must admit my physio has worked wonders and as long as I don't over do it the pain is now manageable most days with painkillers and muscle relaxants - before this it wasn't as I had constant knife like pain, even with painkillers and muscle relaxants they hardly touched the pain, it was always there. If I do something stupid, carry shopping bags, use the rake, try to live some form of normal life, guess this is just the new normal for me but it is so frustrating when I was fit I could breeze through things, now it is a massive exercise to get something done.

    Anyway this isn't about me. Please take someone with you. I also bought a new car that doesn't hurt so much to drive, maybe becuase it has stiffer suspension and I can strap myself in really tightly. I sleep with a pillow between my knees and can't believe the difference this has made as well.

    Hope they can find out what is wrong. Good luck. They told me my injury would heal also.

    Sorry as I said before I have had more time to think about this.

    Crushed bone is usually picked up in an XRay so you probably haven't crushed your vertebrae which is good. So most of my experience is probably totally irrelevant to you. Mick and Trueblue seem to have suffered thoracic disk damage so they are probably the ones who will know the best course of action

    Please keep us updated on how everything went.
  • mickkrmmickkr Posts: 166
    edited 10/10/2013 - 8:38 PM
    Fingers crossed you will on the road to a proper diagnosis and proper treatment.

    TSP-I know you are in OZ and things are a bit more spread out compared with where I live (London,UK), but don't give up trying to get some surgery. I know it is risky, but so do the doctors performing the surgery so they prepare for this. When I had mine there was a chest team - expert in opening the chest cavity and a neuro team for the actual spine surgery. I was all wired up to alert them of any neurological changes during the surgery to indicate any contact with the cord and there were two anesthetists keeping a close eye on my breathing etc. I know this because they all visited me at some time during my recovery.

    Thoracic spine surgery is a rare event for these guys.For many of them it is the first and, possibly only time they participate. Mine took place at a teaching hospital and I was playing to a full gallery, so I'm told. I hope I looked my best, but I'm in no hurry to play the part again.

    My advise is BE PERSISTENT. Keep nagging until they are sick of the sight of you and will do anything to get you out of their hair. That's my experience. I wish I had staged a collapse on a busy road junction and had been rushed to hospital as an emergency instead of turning up for endless fruitless appointments week in, week out until I eventually became an actual emergency!

    I'm not young enough to know everything - Oscar Wilde
  • I have been to soo many specialists. They won't do anything until it becomes an emergency. I can still walk and am afraid of paralysis which they cannot guarantee would not happen. I must admit I am terrified of an operation but if that would take the pain away I would do anything. My new physio has worked wonders for me - it was immediate pain relief when she put my T4 and shoulder into the correct mechanical position.

    I can handle the pain now with opiods and muscle relaxants. It is not incessant like it was. If my body can get used to keeping my T4 and shoulder in the correct mechanical position I will slowly decrease the opiods, asked my GP and he said the muscle relaxants I am taking are not addictive.

    That is really what I am hoping. Just being out of pain for a few hours is a miracle for me. I think they treat thoracic trauma injuries differently now and put people in a full body cast which I wish I had. I did not realise it is such an uncommon injury until I researched. I thought the Drs had seen it before but they obviously hadn't so really had no experience in that area.

    I know what I have to be careful doing and if I don't take notice I really pay for it. Shopping really kills me for hours afterwards even if I only carry one bag at a time. At the moment, no-one in Brisbane will touch me because pain is my only symptom the wrap around pain - it doesn't seem to be effecting my breathing, I can walk which is a miracle in itself and do not get and I don't have nerve pain which is good, I would probably get nerve pain if I had an operation.

    I am so tired of Doctors and think I would have to go interstate to Sydney or Melbourne to get someone to operate. At the moment I am trying to enjoy a few hours without constant pain. It is like a miracle to me. I really don't know what to do next. I need to give the physio a chance, it is working at the moment if I am careful. The luxury of not having constant pain for a while is amazing.

    After 8 years I am just really worn down by the whole drama. I watched an amazing video on pain called 'The Secret Life of Pain'. It is on You Tube but watched it here on SBS but has been taken down now. It is well worth watching as now they know the exact part of the brain which receives pain signals and are experimenting with electronic therapy to that part of the brain that signals pain. They have also found the gene that causes pain - there is a family that feels no pain at all, they do not have the pain gene. I watched the whole documentary and if I was in the UK would try and get on the trial for it.

    Thank you for the advice. I think I have driven enough of them crazy in Brisbane and the Gold Coast. They say the outcomes and I quote 'are not usually good for this injury at this level.' As it is bone that is crushed I think they would operate if it was disks - I can't understand why my disks did not herniate as well. Anyway am so exhausted by the whole thing - will give the physio a chance. Thanks for your advice Mick - this is such a crap situation, I am so glad I have found a bit of relief at last.

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