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Old 09-19-2008, 12:42 AM   #1
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Question Unknown cause Thoracic Back Pain

I'm female, 47. I'm currently 47 yo, 5' 102 lbs. I have Scoliosis with a 41 degree thoracic curve with a compensatory lumbar curve of about 21 degrees. I have no other major health problems. The curve was a stable 27 degrees from ages 19-42. The curve increased by ~13 degrees to 41 degrees in the last 4 years. (this seems to have coincided with menopause. Along with the curve change came ever increasing back pain. The pain is right side only from About T2 - T3 with radiating burning pain that wraps around the front of my right side lower rib cage. I have had multiple MRIs showing only slight disc degeneration, some say normal for my age. I have tried 2 years of various spine injection at the Stanford pain clinic. Also tried deep tissue massage, acupuncture, a physical therapist trainer three days a week for 8 months. Three rounds of standard PT. Botox Muscle Today I went to see a renowned minimally invasive spine surgeon in Sacramento who told me the Scoliosis change could not be causing the pain and spine fusion surgery of this type improves the pain less than 50 % of the time and he would not perform it in this case. He said there must be some other cause of the pain. He did not however give me any real path forward other than another MRI. I am now on Hydrocodone (a little afraid of the Acetaminophen liver affects) daily just enough to take the edge off the pain. I wake up from the pain at night and have trouble getting to sleep at times. I was on Tramadol intermittently before. I have tried Flexeril and Neurontin with no success. I don't have an addictive personality so that is not particularly a worry. I don't drink alcohol more than twice a month and don't smoke. The pain is just getting continually stronger and more frequent over time and I am out of ideas and totally frustrated with the ongoing pain. I am being sent for yet another thoracic MRI. The last one was in November last year. I work full time managing an engineering team. I have no desire to ever go on disability. I have enough frequent flyer miles to go just about anywhere to see a specialist. I am looking for suggestions or the experience of others. Thoughts? Feedback? - Sandy

Last edited by Mod08; 09-19-2008 at 10:12 AM.

 
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Old 09-19-2008, 07:04 AM   #2
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Re: Unknown cause Thoracic Back Pain

Unfortunately because you do have "small" herniations and scoliosis this may be the source of your pain. Even the smallest of herniations can cause some pretty excruciating pain depending on their location.

I too have scoliosis in my thoracic region, thankfully the curve is very minimal but oddly has increased over the years. I do have pain in that region as a result. I can't imagine how hard it must be for you.

The only thing I can think of outside of traditional tests is to have your vitamin D level tested. Low levels cause early osteoporis and severe back pain among other things. Also your body can not process calcium without D and A.

Docs don't normally test for this, I had mine done last winter and was horrified at the results, I basically had no vitamin D. Under doctors watchful eye I was take large amounts of D which has helped some with the pain.

As far as the Vicodin goes, do not take any extra acetominophen. Staying under 2500mg a day is optimal. I took it for years without issue but do get my liver and kidney tested every 6 months. Because it's not helping fully with your pain it may be time to seek out a pain management specialist who can prescribe different medications without acetominophen in them that you may find better for your pain coverage. Because you are not a daily drinker the risks are even less (or so i am told by my pain management specialist)

There are other muscle relaxors out there that you might find better suited. Some MS medications are actually pretty benificial to those without MS but have back pain so don't give up, be assertive.

Wanted to add something, individuals who suffer from chronic pain such as yourself rarely to never become psychologically addicted or abuse medications, the number is said to be less than some 3 percent, that number varies by studies but have never seen it over 5%. Phsyical dependance does happen but it is not the same as addiction. Addiction is defined by the psychological need to abuse medications and abusers will often use any means they can to get medication to get high. Individuals who are true chronic pain patients such as yourself don't abuse medications and often do not get the same high feeling that an abuser does.

In a nutshell, get another MRI, get a second opinion, if both are indecisive perhaps it's simply time to seek out the assistance of a pain management specialist. They do not rely soley on medication, therapy, topical treatments, TENS units, meditation etc should encompase treatment.

Good luck
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No matter how great your illness or pain, there's always someone else who may be worse off.

Last edited by Kissa; 09-19-2008 at 07:13 AM. Reason: added info

 
Old 09-19-2008, 08:14 AM   #3
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Re: Unknown cause Thoracic Back Pain

Thank you for your thoughtful reply. I will check with with My doctor on a vitamin D test. A followup question for you. Do you know of any imaging techniques in the way of maybe an MRI device with better resolution or some type of enhancement injection that do a better job of detecting small disc herniations? or Do you know of any radiology practice better at looking for this? -- Thanks Sandy

 
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