I have been having severe pain in the thoracic spine for at least two years with constact stabbing burning pain in the middle of my spine with no relief in sight! The pain radiates into my ribs and takes my breath away like I can't breathe. I just recently had an MRI of my cervical spine because I was in an automobile accident last month and they found several disc bulges C-3-C4, C5-C6 and C6-7 deforming the thecal sac and spinal cord. They also found a Hemangioma of the bone on the T2 with an abornormal signal intensity in the marrow cavity. I am so very tired of these doctors just excusing the pain that I feel and just giving pain pills instead of fixing the problem. I am only 44 years old and hope not to have to live the rest of my life in pain. The pain is so severe that I can't breathe and feel like I am having a heart attack! I am scheduled to see a neurosurgeon and hopefully he does not excuse the hemangioma and say that it has nothing to do with my pain! Any suggestions anyone might have would be appreciated! Is there anything specific I should be asking the neurosurgeon. Also, wanted to mention that I am a legal secretary and work at a desk for 8 hours a day and can not work anymore because I can't sit at the desk and type all day without having significant pain in my back! I need to work but I can't work under this pain!
Thanks for all your help!
Hey hello jeclose522.
When it comes to car accidents there it not much to do.
I believe you had a whiplash? bulging disks can cause severe pain. I have exactly what you have. I have 2 bulging disks and it is causing severe pain but I can still breath.
I dont' feel like i have heart attack but I'm in a severe pain.
I would look at this hemangioma. Perhaps it is pressing and cause you severe pain.
I believe but not sure they can take this hemangioma but you need to discuss that with yout doctor.
I can tell you that in most cases people who have been in car accidents and suffer some kind of injury will suffer pain till the rest of their lives and I am one of them.
I'll page our hemangioma expert....Feelbad...she had one at T1-2 in the cord itself...she can give you more info.
As for the rest of your neck, do you have the report from the MRI? If not, can you get it and post it here?
I also had herniated disks from C3 to C7 and cord compression down to half thickness of my cord. I had a new surgery called a laminoplasty that doesn't involve fusion and it's the fusions that cause all the long term problems with the spine. You may be a candidate and I know you'll find someone who does it in NYC. Another poster here, Webdozer, also had one about 4 months ago.
So if you have or can get your MRI report, post it and we can tell you what it says in plain words and not radiologist speak. That makes it so you can get what you need from your doc. You have to understand THEIR language to get what you need. and it makes life so much easier when you understand what they are talking about.
I second what Jenny said about posting the radiologist's report. The more I read these boards, the more convinced I am that there are way too many docs out there who are either ignorant or indifferent.
Thank you for your replies! Any help is appreciated: Here is exactly what the MRI's read exactly both cervical and lumbosacral:
Diffuse posterior bulging disc C4-C5 is identified deforming the thecal sac and spinal cord diffusely. Central posterior bulging disc C3-C4 and C5-C6 is identified deforming the thecal sac and abutting the spinal cord centrally. Hypertrophic changes of the bilateral zygapophyseal joints and joints of Luschka is identified at the C3-C4, C4-C5, C5-C6 and C6-C7 disc space levels. The residual neuroforamen are adequate. Loss of normal disc signal intensity is identified from all visualized intervertebral disc space levels. A nodular zone of abnormal signal intensity is identified involving the marrow cavity of the anterior inferior aspect of the T2 vertebral body consistent with a focal hemangioma of the bone. An increased cervical lordosis is identified.
Diffuse posterior bulging disc L3-L4 and L4-L5 is identified deforming the thecal sac and bilateral L4 and L5 neve roots respectively. Posterior bulging disc L5-S1 is identified extending into the epidural fat abutting the thecal sac and bilateral S1 nerve roots. Hypertrophic changes of the bilateral zygapophyseal joints is identified at the L3-L4, L4-L5, L5-S1, and to a lesser extent the L1-L2 and L2-L3 disc space levels. The residual neuroforamen are adequate. Loss of normal disc signal intesity and height is identified from all visualied intervertebral disc space levels. An increased lumbar lordosis is identified.
Thanks you for your help! Just received first set of cervical epidural injections and in two weeks they will do facet joint injections in the cervical spine! I haven't even gone over the lumbosacral findings with the spine specialist yet and just had an MRI of the Thoracic spine which I have not received those results yet! Any help is so appreciated: Thank you all again! Have a pain free day!
Jclose.... the disk problems in your neck definitely could be causing problems, but I would expect them in your arms, shoulders and neck if nerve roots are affected, or even in your legs if the cord is affected. I don't see lumbar problems causing thoracic symptoms.
Have you gotten a thoracic MRI? Sometimes, on a cervical MRI, they don't do such a great job of imaging the top thoracic vertebrae because that wasn't what they were asked to do. Apparently, your image is clear enough for the radiologist to detect a problem, but what about T3 on down?
The Following User Says Thank You to WebDozer For This Useful Post: jclose522 (10-23-2011)
Funny you asked I just had the thoracic MRI a couple of days ago and going to find out the results tomorrow. I do have extreme pain in my right arm and shoulder which has caused me to be out of work for approximately six weeks now! I am a legal secretary and it is unbearable to sit in the the chair for 8 hours and type with my right arm! I did have the cervical epidural injection last week and I am scheduled for the cervical facet injection next week! The spinal surgeon did not see the lumbar or thoracic results as of yet so I dont know what he will suggest for those issues. I really didnt want to be out of work this long but this pain is unrelentless and have to take the pain pills and muscle relaxers round the clock not to mention restless night sleeps! I really hope the injections work as well as chiro and PT so I can get back to life in a couple of weeks! The doctors have told me it does take about 3 or 4 months to get back to feeling better after an automobile accident but I guess I am so impatient and so are my bosses! Thanks for your reply is it very much appreciated! As for the hemangioma I am hoping the thoracic MRI will show more! Thanks again!
Hi Joanne....sorry I'm just getting to your MRI results now but I had a bad weekend myself....go to see if I have surgery on Wednesday.
So I'll try to explain your MRI results so that you understand them. Where they give you that long list of vertebrae with "hypertrophic" changes, that basically means arthritis as well as changes in the ligaments around the joints. If you were to look at the spine from the top down with the vertebra cut in half, you'd see the front of the vertebra is big disk of bone, round in shape, and in between each vertebra is a disk acting as a cushion between the bones. Behind the disk of bone is the hole where the spinal cord is. It has a covering called the Thecal Sac and that holds spinal fluid in around the cord. And then there is some room for the entire cord and covering to move within the spinal canal. The canal is anywhere from 12-18mms wide and the cord is usually about 11-12 mms. wide.
The disk is a hard but flexible "doughnut" that sits right in front of the canal...literally abuts the canal. Inside it is softer with a harder ring around it to hold the contents inside. With age or injury, that hard outer ring can develop a soft spot and cause the entire thing to bulge out the side or it can actually rupture and the insides then come out(herniated disk)and form a smaller 'width wise" bulge but often longer as it squishes out and can continue to squish. So when a disk starts to bulge, if the bulge is backwards, then it hasn't far to go to hit the Thecal Sac and then can push even further and hit the spinal cord. This is what you have at C3-4, C4-5 and C5-6. The only difference is where the bulge stops. At C4-5, the disk is hitting the thecal sac and your spinal cord but at the other 2, it's only hitting the sac and just touching the cord(means no signs of indentation in the cord).
Luckily for you, the big pain maker is when these bulging disks also hit the spinal nerves. These are nerves that peel off the spinal cord at each vertebra(kind of like peeling a banana) and exit through small holes in the vertebra and go out to the body. The cord, like the brain doesn't feel pain but those spinal nerves hurt like he!!. But those nerves and the tiny holes they go through are okay for you...that is good.
And along with the arthritis you have, the disks are slowly getting smaller as they do with age(everything shrinks with age, doesn't it..except the medical bills).
But the last thing they added was a first for here...the lordotic curve in your neck is getting deeper, instead of straightening. Lordosis refers to that inward curve we have in our necks and it normally gets straighter as we age...yours is getting a bigger curve to it...and the same goes for your lower back too.
As for the hemangioma...I'm hoping Feelbad will come along and explain them...she had one in her actual spinal cord that had to be removed. They are benign and so can stay there unless they cause a problem with your spinal cord. It may hurt a lot but there is not a lot they can do for it as far as I know. Eventually, they will probably have to remove the damaged bone and fuse the area from either side.
Now your lumbar spine......the situation is somewhat the same but here, the vertebrae are much, much bigger but the cord is much smaller as so many nerves have peeled off and even the holes where the nerves go out to the body(foramina or neuroforamina)are twice as big as in the neck.
At L3-4 and L4-5, again you have that bulging disk that has bulged backwards enough to hit the thecal sac of the cord and is pressing on the "peel off" nerves on both sides....those side nerves can cause pain and/or numbness above and below the knees and the back inside of the calves. At L5-S1, the bulge is even worse and is hitting the fat that is around the vertebra, the thecal sac and both the nerves going out to the body. This would cause pain/numbness in the feet(top and bottom) and the outside aspects of the calves. And you have arthritis in the vertebrae all the way down. Although the nerves are being hit, it says the holes where those nerve go out are all open so the bulges may be like mine are...hitting the nerves outside of the canal area on the sides...hard to explain but picture a doughnut that had squished out to both the sides and back and it's hitting things all over the place. I've got the same thing and until they show it to you on the MRI, it's hard to picture...but disks can bulge anywhere around the circumference and the nerves come out from the back of the bone and wrap around to the front so they can be hit in lots of places.
As above, the disks show loss of height and "signal intensity"...think losing substance....like a shadow gets lighter as the disks shrink up they look lighter on the MRI.
And as I said above, your back is developing a deeper curve to it.
So I hope this helps you understand what is going on. The arthritis alone can cause tons of pain. The nerve compression in your lower back can cause pain, numbness, tingling, pins and needles...all sorts of stuff. They didn't put in what they classified the amount of compression as. If you see the words "minimal, mild, moderate, or severe" in the report, that is how the list the amount of compression to the nerves or the cord.
Oddly enough, the one thing that probably worries you the most is where the disk bulges are hitting the spinal cord and thecal sac. When that happens slowly over time, it is not a big problem and the cord can take a lot of compression. The normal cord is about 12mms...mine was down to 5-6mms at 4 different levels before I had surgery. It's only when it happens suddenly that you have a big problem. With time, as it worsens, you end up with problems walking and numbness anywhere from the level of compression on down as well as others.
Anatomy lesson over...questions?????
The Following User Says Thank You to jennybyc For This Useful Post: jclose522 (10-24-2011)
Thank you Jenny for your response! It was so useful and has made me feel alot better now that I understand exactly what is going on!!! I do have severe pain in my neck and lower back from the accident I had on 9/6/11!!! I have weakness, tingling and numbness in my right arm/shoulder and weakness in my legs! I also had a MRI of my shoulder and as I had not rotator cuff tear it said it could exclude a partial tear of the bicep tendon! But all they suggested at this point is Physical Therapy for my shoulder! I can't even stand over the sink and wash dishes for long from the burning pain in the middle of my back!!! I take muscle relaxers and pain pills throughout the day! I have been out of work for 6 weeks and hoping the pain management (spine doctor) i just started seeing will help me get out of pain somehow. I did see a neurosurgeon who suggested I see the pain management doctor! I did one round of epidural steroid injections in the neck and in a few day he is doing the (facet joint injections) for the arthritis in my neck! We haven't discussed my lower back yet, but I'm sure he will be doing injections on my lower back as well! I have been getting chiropractic care, but unfortunately I dont think its helping much! As far as the hemangioma the surgeon said it is an incidental finding and it doesn't cause pain! I don't know if I believe that!!!! Thank you so much for your time and explanation I really appreciate it!!! I hope your surgery goes well and wish you good luck and a speedy recovery! Thanks Again! Joanne
soo sorry it has taken me so long to just get here, been tied up with another post and dealing with all my c spine crappy stuff too, but jen pretty much nailed it as far as what YOU would more than likely just be feeling from actually having ANYTHING that is simply even in or impacting bone, PAIN. usually like a more radiating/aching type? so your upper T, and since the bones are all interconnected, wrap around pain very easily could be generating this constant 'ache' there(it could also be simply following that T2 dermatome too which would wrap around, esp if anything is just 'central' in location when it comes to the spinal). and with, in MANY cases, only becasue this hemangioma just IS there 24/7, it can create a type of non stop 24/7 pain to have to deal with too. mine was inside my actual cord so it was generating the most INSANE types of 'perceptions of 'activity' going on that WAS also a non stop and 24/7 flippin nightmare(i had this totally insane 'prying" sensation like someone was litterally trying to pry off my shoulder blade on the R side,and a TON of real solid pressure pushing out from under that same blade as well. just sick). thankfully for you, this is in bone. sucky yes, but not nearly as bad as could be, trust me.
the one thing i WOULD hold off on til you can at least possibly also see a vascular specialist to get the actual angioma much better and more clearly defined is NO more chiro treatments up in THAT particular area at least since most hemangiomas just also can have the tendency to bleed(but that totally depnds upon how much vascular if any is feeding this too). the thing about hemangiomas is they just ARE a vascular lesion and in almost every case, they are also usually attached to what are called 'feeder vessels' too. this is what kind of 'keeps it alive' so to speak and filled with venous fed blood(you need to find out just 'what is "alive' in there or if this is/has kind of died off in some cases but would leave what IS a vascular congenital malfomation behind). and in your case, given this is in the actual bone marrow cavity, it 'could' just possibly be like 'leaching' its blood FROM that marrow too? just a thought considering this IS vascular in nature. angiomas ARE also venous and NOT arterially fed like an AVM would be(the AVM is the arterial counterpart to the V fed angioma). i din't see any sort of actual dimensions given as to haw large this is, only that it is anterior and inferior, meaning front and lower?
the hemangioma just being there at all in an actual vertebrae will make that particular vert just a bit more susceptable to possible fracture at some point too since this is NOT 'just' all solid bone? but that could happen wayyy down the road for you too esp since you just had an MVA and nothing happened to it then, so it sounds very stable anyways(plus T spine is pretty well protected unlike the highly susceptable to injury c spine. nothing really 'has its back' ya know?? but i DO definitely think the majority of what are the pretty standard for c spine issues are what IS the more impactful part of your report tho. the most prominant 'symptom", as i mentioned above for these in how they will 'present' or simply show themselves IS with more of an achey radiating out type of pain. have you ever tried ANY type of actual NSAIDS for that particular pain(you DO have a good level of inflammation going on just from having this in a place that it should not be as well)? that, just because it IS bone pain would be in my opinion anyway in having severe bone pain myself from something else, these meds just have a much more direct impact on THAT type of pain from most types of more 'boney" inflammation.
the one huge 'myth' about hemangiomas is that they do not cause pain(and "they" do not, themselves since there are no nerves, but there ARE vessels and vessels can generate their own pain too depending). BUT, it all really comes down to location location location. if this is impacting ANY actual nerves, or as in my case, my cord, or in the brain(the most common area for these to form, and what i had as a "cavernous hemangioma"), it all comes down more to where they are located and what they are impacting as to whether or not any given angioma will generate pain of any kind, or other off the wall insane symptoms too.
getting a more in depth look into the overall make up of yopur particular angioma really should be done. but if you end up with a much more aware and knowledgable type of NS, he may try and get this figured out FOR you too. but PAIN will usually be the most common and sometimes ONLY real symptom of even having one at all,esp within the spinal structures of bone. but given what ypou have going on up in your c spine seriously overrides anything that the angioma would or could actually impact or do, so i would seriously try and concentrate on that area right now and what needs to be done. the angioma is kind of a secondary thing that right now needs the pain better managed. there really is not a whole lot else that CAN be done for that part. i don't know if given the location of yours tho, they possibly 'could' sclerose it with a chemical and dissolve it in some form? but that too would depend very highly on any actual feeders attached to it too since if they ARE feeding it and if not able to be closed off, you cannot inject the needed sclerosing agent since it would also follow the vessels out as well which is NOT a good thing. otherwise, it will just 'sit there' and probably do nothing else actually TO you. alot of people have these in the verts,among other places, too and really do not have any other issues other than simply trying to keep that edge off the pain they can sometimes generate. i KNOW there are people on the back boards here too who have mentioned these also being 'found' in verts upon MRIs they have had. that may be helpful to read if you can find those particular posts by doing a search on 'hemangiomas" in THAT particular boards search?
but for now, your c spine is what really does need more attention. i hope this helped some at least. there are many other places you could have ended up having this that truely would/could make your life hell. hopefully you can find a good way to get this pain managed, and also figure out 'IT'S" actual 'make up of what is within your particular angioma too, just for a better chance in treating that particular pain in the most 'appropriate' ways. marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
The Following User Says Thank You to feelbad For This Useful Post: jclose522 (10-25-2011)
Thank you marcia for your reply I really appreciate it! I did see a neurosurgeon and he just said OH alot of people have them and its an incidental finding and doesn't cause any pain!!!! I find that hard to believe as I also have severe pain in my shoulder blade and shoulder itself! I am seeing a pain management doctor for the cervical issues and hope I can get this taken care of first!!! What type of doctor should I make an appointment for the Hemangioma??? Is it a specialist??? Thank you again so much! Joanne
quick question joanne. when they did both of thoese MRIs on your upper(the initial then T spine one) did they use a contrasting agent of some kind to better highlight esp the vascular components or was this esp T spine one done without any contrast? i can make a real difference in even what, within any hemangioma, simply gets seen or where the feeders(if any) actually are. for the most part, your NS is right in that soo many people DO end up with these lil suckers simply forming somewhere within the spinal processes and the cord/brain(within that CNS) too, but that is much more rare than within boney parts of spinal. these are actually formed while YOU are forming in utero for some insane reason. and there really is not a whole lot that even CAN be done, unless as jen stated, they ARE generating insanity like mine started too. but considering where yours just IS within that marrow, i would NOT really want to disturb THAT sucker unless something a bit more insane starts occuring. if and when they do your surgery which i am assuming would be hopefully ACDF, they WOULD be able to better visualize the hemangioma since it would almost have to be at least partially out of that vert, and also anterior too, unless it is extremely small, which IS better for you anyways.
have you ever tried what are lidocaine patches over the back area to see if it would stop at least the overall radiating from occuring? there little wonder patches have helped me sooo flippin much with so many areas of my pain that nothing else seems to even come close to touching. it 'could, tho yours is anterior, STILL help with what you are feeling in between your blades, under blades, and potentially also stop that wrap around pain as well. its just something that should at least be tried for PM considering how much of 'you' is being impacted and around the bones. tho they can be a bit spendy, even with most peoples co pays, if it actually works on ANY real pain, in my book, it IS money well spent. they can also be cut to cover smaller skin surface areas too so you do not have to use an entire patch to hit what sounds like a much smaller overall generator. these patches also should be running out on their patent here soon too since i was initially given these while in the rehab hosp post cord surgery and that was back in 2003. it would automatically make them much cheaper than they have been costing once they run their patent out and another drug co can simply also manu these too.
it is great that they tried and rule out your rotator cuff before deciding what pain was actually being generated by rotator issues, since the nerves FROM c spine at the lower end DO also run thru the shoulder levels and then downwards and eventually(with the c 6 thru T 1) hitting the fingers. tho T 1 only has 'some' fine motor function and NO actual sensory components in the hand level. i DID have some really messed up damage in my rotator cuff with my very top run across the shoulder to the top of that humorus which is also innervated by the c 5 with sensory, and we NEVER ever checked out my rotator back then so it was simply 'assumed' that what I was feeling WAS generated by ONLY c spine crap. it was not til that very top tendon simply snapped in half on me one fine morning that i HAD TO have my immediate loss of ROM and any damage defined in 07 that we DID find out just how much real impact 'my' particular rotator had on my pain and ROM loss. then of course it was too late to 'undo" the two seperate c spine surgeries(the initial ACDF in 02 followed only 9 months later by a plate and screw placement when i only fused one endplate). so that is a good thing that they did that one MRI on yours, trust me. but i am a bit confused tho while reading thru THAT part where you mentioned a 'possible' torn bicep tendon or something to do with your bicep, if that IS or is NOT actually damaged(if i remember right that one is called the inferior supraspinatus(that one in me was also tearing trying to compensate for the ongoing bigger tear in the one above it and i had one heck of a very sore bicep as well too, just did NOT know why til that MRI showed the connection. that also had to be sewen during my surgery. the one above it is what i snapped which is the 'supraspinatus)? it was just kind of confusing to me while reading that as to whether it IS or is NOT torn or an ongoing tearing is taking place? you most definitely CAN have both going on at the very same time like i did tho with rotator issues AND c spine crap. i simply did not realize that then and my NS never ever mentioned that either. we DID end up having another surgery on my rotator cuff to repair a ton of damage in there tho.
i am just wondering where all of your spinal damage/impact came from tho. you just DO have alot up top and within that lumbar too? i know i played alot of sports that also trashed, or "began' MY rotator crap anfd a ton of 'accident prone' types of stupid things that kept me and my dad running to many an ER run that did impact me mostly from ongoing trauma. i too also had an MVA but only X rays were taken then so nothing really 'in depth' actually showed itself then(this was like 87-88?). my pain and radiculopathic symptoms that you are also now having, really did not flare up in me til around 2000 or so? but i had spent many many years working as a ff/emt too which seriously messed up alot as far as spinal goes. i am only 5'2" and tiny frame but i could lift more than my own wieght which was back then about 115lbs. i did lumbar damage, but mostly c spine. finding out i even HAD that cavernoma inside my cord was one of those lil 'incidental findings' that no one wants to have. my cord amp is only around 10mms and this 'glob" was taking up a TON of my overall cordspace right AT the c 8 nerve level. it was approx 4x6x8mms in size.
the overall knowledge that soo many different NSs simply do NOT have enough experience in dealing with led me thru THREE seperate opinions,which two of were totally different from each other as far as what this glob ment for ME? i ended up going to the u of mn here which thankfully was very close by to get a rea honest to god 'experienced" opinion that did change EVERYTHING for me. this is also when i found out i had an active bleeder in there and that it had actually already bled at least once even before that first ever MRI was done in 01. lovely.
luckily for you, this hemangioma you have IN the marrow cavity, i really do think it willmore than likely just 'be there', but will not react like the cavernous hemangioma type. getting a good CONTRASTED type of MRI would show the vascular levels of what is in thai in the best way tho. but i think for the most part, pain will be the biggger issue just considering its location. so getting to a good pain management doc/clinic seriously would probably help the most depending upon what the NS decides needs surgical intervention too. but DO see if ANY doc you are seeing hasat least one or two samples of the lido patches. i really do think, just knowing what these have helped ME with that they could really take the edges off of THAT particular pain anyways. they are always worth a good shot just to see. i now use them on several bad areas and i have to say, they DO beat my narcotics by a flippin mile in certain areas.
i will get back here with some stuff regarding the c spine findings hopefully tomorrow. as far as spinal deformity goes at the cord level? when the areas of compression are 'longer' and the pressure is much more "spread out like jens was, it is a bit less impactful overall since you do not have a smaller ,and usually a bit 'sharper' direct impact INTO a spot on the cord. but if that deformity of the cord has that very direct area of impact going on, than it DOES become more impactful because you do not have the luxury of wieght being displced over a longer/wider surface area? do ya know what i mean?
a good overall neuro eval should be able to tell just what is being impacted by virtue of the 'stimulate/response" type of testing they just do to tell impact. just how ARE your actual reflexes, normal(subtle bounce when the area right below the kneecap gets tapped with that lil hammer) or very 'brisk/rapid type of more pronounced type of bounce out? the more 'brisk or sudden snap out you have usually just indicates that at the very least, your upper motor neurons are being impacted much more directly. but having both the lumbar AND c spine.depending upon what governs what,can also skew the this type of test. but even when other L spine issue are going on, since the cord generally stops itself around T 12, there IS NO actual cord that runs down THAT far, so it can be much easier to tell true cord impact/reflex from upper motor neurons that are ONLY within our cords anyways. the end of our cord where it terminates is called "the conus'. it 'usually" stops around T 12 but there also CAN be in each individual,a few levels above that or below it too. but that t 12 is kind of the 'norm' for most. so what you get left dealing with after that is whole lot of nerves that innervate the legs, with no actual cord, but the thecal sac containing that needed CSF still runs down to usually the sacral level anyways.
gotta fly right now. but will be back joanne. marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
Hi Marcia: Just posted something but don't know where it went! It didnt come on the boards! I wanted to let you know that I have am still having severe pain in my cervical area as well as shoulder/arm and elblow it is ridiculous! This pain just doesn't stop!!! I am getting very agitated as well as depressed! I don't know if I mentioned to you that I have psoriatic arthrits and take Enbrel, methotrexate, folic acid and prednisone 5mg on a daily basis! The problem is every doctor seems to get tunnel vision when they treat me because as soon as they find out I have PsA it all has to do with that!!! How do I get them to look past that!!! I also forgot to mention I have had vaginal bleeding for two months can that me from the hemangioma!!!! They all say the hemangioma is not causing my pain but how do they know that for sure!!! They only did a regular MRI of my neck when they seen the hemangioma!! Should I ask for an MRI with contrast so then can see it better???? Also, I have another appointment scheduled with the orthopedic surgeon who didn't even care that the MRI said cannot exclude a partial tear of the bicep tendon and just gave me a shot of cortisone in my shoulder and told me to Physical therapy! It is so painful I can hardly use my arm!!! I can't work because I can't type!!! These doctors just don't care!!! Im sick of the pain!!! I did take you advice and put the lidoderm patches on last night it took the edge off at least! I have all kinds of medications and patches! I have lidoderm patches, flector patches and pennsaid gel!!!! I would like to think that I am going to be able to work again but that seems so far away at this point!!! If I do housework whatever it is I pay dearly for doing it (end up in bed from the pain) I am only 44 years old and feel like 75! I am also due for my second set of injections (facet injections in the neck) should I ask the spine specialist if there is something he can do for the hemangioma??????? And what exactly should I ask this orthopedic surgeon about the possible partial tear of the bicep tendon! Is there another test they take to see if it actually torn???? I really thank you for all of your help you have given me more information than the doctors!!!! I can't thank you enough! Joanne