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New here, thoracic cord impingement advice please

monicahollmmonicaholl Posts: 9
edited 03/08/2014 - 12:11 AM in Upper Back Pain, Thoracic
Hi, I'm new to the world of spinal issues even if I've been married to back pain for years now. I have been referred to a neurologist following intense headaches (tension, icepick, migraine), an episode of hemiplegic migraine, numbness in right hand and leg and shooting pain in various regions such as back, abdomen, chest.

I had am MRI scan and the findings are:

Brain scan - normal / no abnormality seen

Spine scan:
C4/5 - minor bulge. no significant neural compression seen
C5/6 broad based disc osteophyte complex causing narrowing of right exiting foramen with mild impingement of exiting right C6 nerve root. Although minor narrowing of the left is noted there is no significant left sided nerve root compromise.
C6/7 there is broad based disc osteophyte complex indenting the antherior thecal sac with encroachment into exiting foramen. Although there may be impingement of exiting C7 nerve roots no significant compression is seen.
T5/6 focal right centro-lateral disc protrusion which is impinging on the ventral cord with some flattening of the sagittal T2. Unfortunately no axial sections available for this level. No exiting nerve root compromise.
T6/7 there is again a right centro lateral disc portrusion indenting on the ventral cord on the sagittal T2 sequence. No axial sequences are available.
Rest of the spine does not show a focal disc herniation or neural compression.
Marrow signal is benign.

Multilevel spondylotic changes. Disc portrusions with ventral cord impingement seen at T5-6 and to a lesser extent at T6-7 on the sagittal sequence. Possible mild impingement of right C6 and both C7 nerve roots. Recommendation: if there are any concerns for myelopathy please requesr MR scan of the thoracic spine with axial sequences.

I'm struggling to understand the results especially the part with the ventral cord impingement. When I googled it it came up with spinal cord compression and talk of paralisis. Unfortunately for me the neuro I was seeing went on maternity leave and just gave me amitriptyline. a new one will only be available in two months time. I have just been given a referal for a second mri. my normal doctor doesn't know anything about spine and can not advise anything, some doctor she is!. I'm quite scared especially since the wierd collection of simptoms I'm experiencing seems to be growing bigger and wierder by the day, my right hand and foot are noticeably colder, new spots of pain such as in my left heel, right hand finger.
I would really appreciate if anyone can help me understand the implications of thoracic disc herniation and cord impingement and provide some advice on what I can do to avoid further dammage while having a computer based job and two young kidds? I may add that I just need some reassurance.
thank you


  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Hi, thanks for your reply, unfortunately I can only access the second link. I do apologise if I somehow broke the rules.
    I understand that interpretations of MRI results are not allowed and I was not asking for that, I was just hoping for some help in understanding the implications of the cord impingement part and hopefully getting some advice or reassurance from people with a similar condition. As I do not have a diagnosis yet I only have the MRI and the symptoms to describe and my efforts towards finding information regarding thoracic spine have not been very successful.
  • mickkrmmickkr Posts: 166
    edited 03/09/2014 - 12:47 PM
    I had a t5/6 herniated disc with cord impingement which gave me weird and painful sensations and motor deficits all over my lower body, particularly the legs. I was provisionally diagnosed with MS even though no lesions were found.

    After my legs were giving way and I became bladder/bowel incontinent I had a further MRI which identified the calcified herniated disc impinging the cord.

    Surgery followed and now I am fine. Surgery was horrible, but that was 2003. Things have moved on since then and now minimal invasive is common.

    Here's a blog from Caroline who used to post here and had almost the same as me and, by the sound of it so far, you could also be a candidate. http://thoracicsurgery-backtolife.blogspot.co.uk/2012_03_01_archive.html

    As Liz says we can't interpret MRI scan results or diagnose your condition just share our experiences.

    Let us know how you get on and don't be too harsh on your GP. Mine told me there was "..no doubt about it..." when he diagnosed MS.


    I'm not young enough to know everything - Oscar Wilde
  • monicahollmmonicaholl Posts: 9
    edited 03/08/2014 - 11:12 AM
    Thanks for your reply, it's good to know that someone with worse problems than I have now can recover. Could I ask you if you can tell me whether there should be any limitations to the routine activities other than the obvious don't lift heavy things, or do jolty sports. I'm quite a doer and I find myself doing things (such as pulling weeds or cleaning the cupboards or going for long walks) because I get restless with the pain and doing things takes my mind off the pain, however the pain gets worse after such activities and then I worry I should not be doing things like that. My GP only advice was to keep active. I'm a bit torn between the abhorrent idea of becoming a 'victim' of this ailment before it really is true and the fear of doing myself more harm. I'm not asking for personilised advice but any suggestions or personal experience of others would be appreciated. At the moment I don't have a clue and nowhere to ask.
  • thoracic spine painthoracic spine pain Posts: 566
    edited 03/08/2014 - 11:19 PM
    I have a damaged 80% wedge crushed to the right thoracic vertebrae, caused by trauma.

    Have a look at the dermatone chart on this site and you can see which levels of your spine interact with different parts of your body. You will see the levels that effect your hands and legs. The shooting pain is could be nerve pain. Use the search button at the top of this site to search for thoracic discs. There are people on this site who have damaged their thoracic discs and it is worth reading what they say. I hope jellyhall and anelsen don't mind me using their avatar names but they have both experience in this area as has Dilauro. I'm sure they would be able to give some great advice. There is a thread from not so long ago where they discuss thoracic disc herniations and seem to have some of the same symptoms you describe.

    Start by doing a pain diary one side, time, activity - then pain level. It really helps you see what causes the most pain. I did mine every 30 mins for a week. It was worth it and I stopped doing those activities or if I did, was really careful cause I knew they would put me out of action.

    How much pain are you in? Have they given you anything for it?

    Low dose amitriptyline is what I use for sleep. The thing with amitriptyline is you need to take it 3 to 4 hours before you sleep. Sleeping with a pillow between your knees takes the pressure off your spine and should help.

    I used to push through activities as well. I don't now as the pain isn't worth it afterwards and I don't want more damage. Bending and twisting at the same time is the worst thing you can do for your spine. Also hunching over a computer all day doesn't help. You can look up the pressure put on your spine with different activities on the web - standing and lying down put less pressure than sitting - especially hunching.

    Most GP's don't know much about thoracic spine. Mine was extremely painful but with some thoracic injuries people don't experience pain. The cervical and thoracic spine protects our spinal cord. The thoracic spine and ribs also protect many vital organs. It's our central nervous system and is extremely complex - even a lot of specialists have trouble with thoracic as it is very rare to damage your thoracic spine when you are younger. I was reading an article about a baseball player and they said only around 2% of younger people damage their thoracic spine.

    That's why many spine specialists haven't seen it before let alone GP's.

    What finally helped me was going to a sports physiotherapist where she mechanically aligned my spine into the correct position and took my vertebrae off the spinal cord and nerves. It was the one above my damaged one causing the pain, it was slipping out to the right as there was nothing to hold it into place. Most specialists will tell you you thoracic spine should be stable as it is attached to your ribs. Mine wasn't stable as it crushed to the side and nobody could work out why I was in so much pain.

    I was misdiagnosed for 8 years.

    Try to get a correct diagnosis now and see if they can do anything for you. Don't leave it and please don't aggravate it more by doing activities that cause pain. I know it's difficult but I have made heaps of adjustments in the way I do things now.

    I take strong opioids now and when they combined them with a muscle relaxant that really helped.

    If you can, try and get some relief before you go down that road, but as your spine is damaged your muscle spasms are probably quite bad although you don't notice them 'cause they're in your back and can't see them. My physio tapes everything back into place.

    Sorry for no reassurance but I thought mine would get better and it didn't. Please don't wait to try and get a correct diagnosis. It is your central nervous system. Don't aggravate it more even if you feel like doing things - don't do the things that cause pain.

    I don't know where you are from but if you look up SH on the web there is a story about a baseball player who had surgery and it relieved his pain. Give it a read if you can. The Dr there is one of the only ones in the States who specialises in thoracic spine. There isn't much on the web about it as it is very rare, I had no idea how rare until I researched.

    You need a balance between activity and no activity. No activity makes it worse and bad activities make it unbearable, for me at least. As I said mine are not discs. Thoracic damage is rare if you are young - that's why there is not much information. Hope this helps a bit.

  • mickkrmmickkr Posts: 166
    edited 03/09/2014 - 6:15 AM
    Monica you must be very careful not to do anything which might exacerbate the situation. Discuss this with your doctor when you have a diagnosis. When I was diagnosed all physiotherapy was stopped and did not resume until after surgery.

    I'm not young enough to know everything - Oscar Wilde
  • thank you for your advice, it's two month to go until I see the neurologist and my GP coulldn't give me much advice so I will follow your advice and take it easy as much as I can under my circumstances. the thing I find most difficult is not focusing on the pain, especially when I rest. I'm taking low dose amithriptyline before bed and that helps with the headache but the back pain is just as bad as without. as for how much pain, I would rate it at 9-10/10. Most of the time I can handle it but I'm sure you know how tired it can make you after month and months of it. That's part of the reason I'm fighting it, I don't want it to rule my life. It's so sad and scary to see how many people live with it for years.
  • thoracic spine painthoracic spine pain Posts: 566
    edited 03/10/2014 - 1:17 AM
    I set up a TV and a video in my bedroom and watched every movie I could to take my mind off the pain. I watched a lot of TV series as well as I couldn't sleep and they went for hours and hours and hours. My laptop is set up for lying down. It's raised and I can type while I'm lying flat. Also I do a fair bit of research and have found some great sites and some with free Ebooks such as Guttenberg press.

    I also use the hypnosis tapes on the web - there are good and bad ones - they are free but you have to want to do it or it won't work. I use mostly the ones with the circle with a line through. The guys voice is a bit annoying but he has very professional sessions.

    So if there is anything you are interested in but never had the time, research it. Pain sometimes rules my life.

    If it's that high it must rule your life - 10 is normally dead and 9 isn't far behind - but I know how painful thoracic pain can be. I found it really hard to ask for help but now I do for the things that make it worse.

    Heat does help me, it seems to settle the spasms. I don't know why they haven't offered you some pain medications to get you through. I take someone with me to verify the pain and I take the things I have written here about how badly the pain impacts on my life. That really helps and you don't have to keep explaining it over and over again.
  • Pain relief is important, of course it is.

    But there is a problem if you are being heavily medicated before you have a diagnosis and the medication is masking the symptoms the doctors need to know about in order to make a proper diagnosis.

    In the long run there is no advantage to us if the immediate pain is being treated at the expense of not treating the underlying causes of the pain.

    I was in that position for years. While I was being kept afloat by increasing amounts of pain killers my condition was worsening to the point that I was only a whisker away from permanent paralysis when I eventually received emergency surgery. Even so I still had to undergo prolonged inpatient treatment (some 4 months altogether) and two years outpatient physiotherapy to be able to walk again.

    Looking back I would have been much better off suffering more in the early stages and getting properly treated sooner.

    Prescribing powerful pain killers is, for some doctors,as much to do with keeping the patient quiet as keeping the patient comfortable.

    I'm not young enough to know everything - Oscar Wilde
  • Guess it was the exact opposite for me. As they didn't know what was wrong I didn't get enough pain relief and was always in constant pain - I still worked though but it was crazy looking back.

    When they finally diagnosed my pain correctly after 8 years it was the first time they gave me proper pain relief as they all understood what had happened and why my pain was so bad. I know they can't operate risks vs rewards but I would not wish the last 8 years on my worst enemy. I think constant excruciating pain takes such a toll on you psychologically as well as physically it probably does more damage to you psychologically than any thing else.

    At one stage I started to believe I must have been crazy as well but I knew I wasn't and the pain was real. Pain changed my personality. I covered as much as I could, that was stupid as well, but for people who knew me they saw the difference when they expected me to be the same cheery happy person and cheer them up, one night I had four phone calls after one another, not just one night but many nights - I was the strong happy focused person who knew what to do and could have them laughing by the end of the conversation so they called me and told me their problems.

    They were shocked when I couldn't look after them as well. I could barely look after myself. One ex friend used to stay and I would buy the food, cook, have the house spotless,have the garden looking beautiful, always put clean sheets on his bed, clean towels in his room, get the videos to watch on a ridiculously big TV, run him round places, Have a stock of booze on hand, my place was like an expensive hotel without the cost as I lived inner city, as well as working long hours in an extremely demanding job.

    After my accident when I couldn't be the perfect host he told me I was selfish.

    So it was the exact opposite for me - 8 years of pain and hell until they finally worked it out and realised why the pain was so bad and finally gave me enough pain killers so I could function.

    I totally agree you shouldn't mask the pain before you get a correct diagnosis - but if they don't work it out as you are such an individual case and don't fit into a textbook, you are between the devil and the deep blue sea.

    At least Monica you have a diagnosis, you are lucky and they can probably help as they know what is wrong.
  • monicahollmmonicaholl Posts: 9
    edited 03/11/2014 - 12:58 AM
    I do wish I had a diagnosis - I don't though. I have some MRI results, that's all. In fact, my first neurologist has dismissed the MRI findings as 'incidental' and the symptoms as 'non specific symptoms which can not be explained neurologically'. go figure.
    It has been five months since I've been referred to the neurologist and all I got is some pain relief which works for the headaches only. It's three years since I've been to a physio and got a pat on the back and some advice. My husband used to give me back massage but for the last two years I just couldn't bear anyone to touch my back.
    I can tolerate pain fairly well, so I just accepted that my back is sore and moved on (TSP - the scale they use in UK has 10 as the worst pain someone has ever experienced). Unfortunately it did not make things better and all sorts of seemingly unrelated symptoms started to appear, hand and foot numbness (now arm and leg), chest pain, abdominal pain and the monster headaches. I gave up going to doctor because I got tired of being offered antidepressants every time. they explained numbness as panic attacks, chest pain as anxiety or stress. I even started believing them at some point, I thought it was all in my head. Only when my face drooped a bit (it only dropped for about ten minutes) I was referred to a neurologist.
    I agree that masking and in my case ignoring the pain is dangerous but I do so wish someone had invented a pain dial. What people (and doctors) can't see they choose to ignore. My kids seem more understanding and considerate than adults sometimes.
    In any case I have two young kids (3 and 5) and need to get better so I can go on a bike ride with them. They are my motivation, even when I have to grind my teeth so I can cook their dinner.
  • Monica, If you are in the UK, as your post suggests, try changing GP's. It is quite straightforward to do and you don't have to speak to your old doctor at all. I did it and it changed my life.
    Here's a link http://www.nhs.uk/chq/Pages/1088.aspx?CategoryID=68&SubCategoryID=158.
    I'm not young enough to know everything - Oscar Wilde
  • You have to find a new Dr - Mick is really right. I wasn't diagnosed correctly for 8 years and went through the some of the same things. Sorry i wasn't meaning to be dismissive of your pain - I had one level and that was agony, I can't imagine the pain from multiple levels.

    No-one could touch my spine until I found my sports physio. I had seen a lot of physios, western and eastern medicinal specialists, neurosurgeons, orthopeadic surgeons, oesteopaths, psychologists, pain clinics, tens machines $30,000 bucks worth of tests and specialists out of my own money. I didn't care as long as I found someone to take away the 24/7 pain. $30,000 spent on people who made my pain worse. My psychologist could see my pain, but others wanted my money and some blamed me because firstly they had no idea why I was in so much pain and secondly they couldn't fix it. What a joke.

    I can't believe a Dr would shrug off your symptoms. Even blind freddy should see there is something wrong. You can also look up an MD rating site and look for a specialist - that's what I did in the end. I researched myself - the people here helped with their experience. I found other people who had damaged their thoracic spine and had pain. Finally I found other people who 'got' thoracic pain - not many but enough to help.

    I must admit I would be worried if I had your symptoms. I think Mick found one of the rare Drs in the UK who knew about thoracic. I'd travel to see him if it was me. There are so few who know about it as it's so uncommon.

    The thing that most helped before a correct diagnosis - was taking someone with me to verify how it was effecting my life and taking what I had written here. A pillow between my knees for sleep helped as well. Muscle relaxants combined with pain killers - the pain killers didn't work by themselves and hardly touched my pain until my muscles settled down as they were constantly in spasm trying to tell me something was wrong. Think I already knew that.

    The other thing that helped was that I realised my hips weren't aligned. I now have my right shoe built up 10cm more than the other, that's how much my vertebrae was crushed on the right during my accident. Should have worked it out then, but I didn't.

    I can't imagine how painful it would be to have multiple levels. My thoracic vertebrae only has to go out a tiny bit , touch my nerves and cord and I am back in incredible pain.
  • Had a bit of luck and was offered the second MRI earlier than expected due to a cancellation. No results yet but I'm hoping that I can convince the neuro to see me earlier than end of April. I'm quite scared now as the numbness is becoming permanent and is creeping up my arm and leg. I can't feel the top of my foot (I can feel poking but no pain when pinched, a bit like when you get a local anaesthetic) I can move freely and I want to continue to do so. I'm hoping I can speed things up enough to never experience immobility.
    Mickkr, I would change my GP but for the fear that things will get messed up because of the change. There's a better GP within the same surgery and I tried transfering myself to him but they don't like getting into each other's stuff, hopefully the argument that my own GP admitted she is not able to help me will do the trick.
    TSP, I didn't think you were dismissive, I doubt there are many people here who don't know lots about pain and how even a moderate pain level takes its toll when you have to live with it every moment. We all adjust to it more or less, make changes to the way we function and face up to the limitations it imposes on us.
    TSP can your vertebrae not be stabilised or reconstructed. I know it's possible to do bone graft for dental implants surely it can be done for spine too.
  • thoracic spine painthoracic spine pain Posts: 566
    edited 12/29/2014 - 10:42 AM
    Nope they won't touch me - mine is T5 very crushed and that level and above with thoracic they have to go in from the front - move all your vital organs and then there is no guarantee about pain. A surgeon who I found who knows about thoracic said i had an 80% chance of paralysis if they operated at that level. He also told me outcomes were not good at that level and above for the T spine in his experience.I know Mick found a great surgeon and I thought it could be fixed but it's just too high.

    I can walk and talk - it's amazing my accident didn't paralyse me, have no bowel or bladder problems and as spine surgery is so massive they normally won't operate just for pain. There is too much risk for me.

    I have also found a physio who tapes my spine, scapula and shoulder into the correct mechanical position and it's the first pain relief I have had if it stays in. So now I drive to see her - she is the only one who realised.

    When I had my accident they didn't brace thoracic as they thought it was stable because of your ribs. I was flat on my back for months and as I wasn't braced it healed in a bad position. I did so much other damage as well to my shoulder and scapular, think when I came off my motor bike my right shoulder must have smashed into the road, I know I flipped a couple of times and ended up sliding down a cliff. I don't remember much of my accident and the psycholigist won't take me back there to remember as it's our bodies way of coping. Most of the accident is really a blank space.

    I tried to go back and have a look where it happened - I had been riding for about four hours before it happened but just couldn't go back How I wish they could wave a magic wand or operate but they can't so have to wear it. At least on the bright side I don't have to go through a rare and major operation. Have to wait and see what happens.

    As long as it's working with my phsio I'm so happy not to have the nerve and spinal pain 24/7, I'll stick with her. We both think once my body is used to being in the correct mechanical position it may be able to hold it there itself. I ripped some of the taping the other day , my T4 only has to move a little bit to be back on my nerves and spinal cord I was in agony but have phusi wedge I can lie on to gently push it back into place.

    So now I try to lean to the right if I lean to the left my T4 goes out again. I can feel my ribs go out of place as well - they kinda stick out on the right hand side. It's not that easy with spine as it's our central nervous system and is so complex - I don't want to be paralysed so now I can cope with the pain - before this I couldn't.

    The operation would be so major I now understand why they won't do anything, unless I lose control of functions. My physio saved my life, I know I would have topped myself after 8 years, with nothing to look forward to except excruciating pain.
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