thoracic back spasms and pain

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tlanser

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About 4-5 months ago, I got up out of bed and felt something pull in my back. Just below my shoulder blade on the right side, right next to my spine - right along the line of my bra. Went to the doctor because I couldn't get out of bed and they prescribed muscle relaxers and pain pills. I have had an x-ray which shows minor arthritis and have been seeing a chiropractor for adjustments and physical therapy. I started using a TENS unit (bio-stim) about a month ago because I really dislike taking any kind of unnatural medication. The pain and spasms persist and get worse if I don't take the pills. The doctor wants to do an MRI, but I'm going to have to pay that out of pocket. I'm willing to do it, but am trying to find out what the problem could be and why it won't go away. I'm 34; 4'10"; 112lbs. I'm very healthy, have always exercised and kept in shape. Any ideas on what the problem could be, ideas on pain management, etc. Any help would be appreciated.

Thanks!
 
Only about 1% of all disc herniations occur in the thoracic area, so I would be surprised if you have a disc herniation. Also, getting out of bed is unlikely to herniate a disc.

That being said, it is unusual that your pain has lasted for 4-5 months. I would say it is probably a pulled or knotted muscle if it hadn't lasted this long. It is possible that you could have some type of bone spur or some form of stenosis that is pinching a nerve in your spine.

It's too bad you have to pay for the MRI out of pocket. You can often negotiate the price down 25-50% if you ask.

Without doing an MRI or other investigative testing, it is unlikely you will find out for sure what is going on. These tests can rule in or rule out problems, so sometimes it takes a nuraber of tests and time. You have to be the one to decide if you can live like this a little longer to see if it will go away on it's own or if you want to invest the time and money (and emotions!) into finding out what the problem is. Also, sometimes they are not able to find a problem just so you know.

Let us know what happens!
 
Thoracic disc problems may be uncommon but they do happen. What and where you describe your pain and spasms sounRAB like a bulge at the level of about T6. I have one at that level and it is as you describe. Some days I feel like there is a knife in my back or I was hit with a hammer. I get a really tender spot directly next to my spine at that level. I get bad spasms - so bad they go around to the front. They do not operate unless it is emergency because it is difficult to operate on the thoracic levels. I get epidural injections that help settle the pain and spasms down. Also fyi those nerves run close to the surface and lidocaine patches help. You will only know by MRI but it could also be from your cervical but really sounRAB like thoracic levels. It has gone on pretty long to be a pulled muscle.


Do you have any chest tightness or pressure?
 
Other than gentle physical therapy, trigger point injections, epidural injections there really isn't anyting you can do about this because like I said there isn't a simple surgery. The doctor will lean towarRAB not doing MRI because bulges/herniations in this area are rare, but if this continues for a long time the only way to know for sure is to do the MRI. I did read a recent medical article that said they are seeing more of the thoracic issues than they used to. Mine hurts when I use my arms too, but I also have significant cervical problems. You really describe it to a tee like my symptoms. I think facet joint might present a little differently and with a different type pain. Keep using the patches and see how you do with the muscle relaxer.
 
I have exactly the same issue at exatly the same place, using my arms sets it off, washing up, folding clothes. It has been diagnosed as a facet joint problem and I don't know what the outcome is going to be but it's completely disabling. I am in Australia, and to get an MRI had to be referred by a Neurologist, not a GP....
 
I don't have chest tightness or pressure really - the only thing that I would say is that the ache sometimes seems to wrap around my right side, almost like it's running through my rib cage. I know that sounRAB crazy, but that's exactly what it feels like. It feels like it starts along my spine and just radiates throughout my ribs.
 
Thanks for the responses. I went to see a third doctor last week and he said that he thinks it is some kind of pressure point issue - meaning that there could be a slight injury or tear in a muscle and when I move or aggravate it, it just gets worse. He gave me a new muscle relaxer (a time release so that it is distributed constantly) which is a non-narcotic, so I'm happy about that. He also gave me samples of the lidocane patches and surprisngly they really help.

I think that the facet joint problem could be a possibility. After I read your post, I paid attention to when the pain was aggravated and it does seem to be when I'm using my arms a lot. I'm going to do more research on that. Is there any treatment other than injections? My doctor did say that the injections are a possibility for me.

The pain seems to start on the right side of my spine, just below the shoulder blade and it often radiates along the bottom line of my shoulder blade into my side. It will often radiate down to the area of my kidneys as well.

Any more information that anyone has would be appreciated!

Thanks again.
 
Hi Tlanser - welcome to the boarRAB!! Most of my back pain is due to compression fractures of my vertabrae due to osteoporosis. I've had many, many fusions and re-fusions; failed fusions and other procedures. The most painful back problem I have had is pain at the thoracic level. When I first became systematic I would get a terrible, deep, burning pain right below my scapula (wing bone as I call it!). It happened just like the rest of the posters have mentioned: when I used my arms, lifted up to get something out of a cabinet, tried to fold laundry, etc. Initially my spine surgeon gave me some injections into the muscles and spaces that were most painful. The injections were a corabination of steroiRAB and nurabing medication. My relief was only a temporary respite. Within 4 months I had the pain again. Further tests showed that I had a break at T4. I did have surgery to fuse T3-T5. Although it did solve my problem, it had to be the most painful of all my spine surgeries. The post op pain was like a vice around my chest. I couldn't take a breath without excruciating pain. It took me much longer to recover from the thoracic fusion than any of my previous 10 surgeries. If you can afford it you might find a couple of steroid injections very helpful. Sure hope you can get some relief. I also wanted to comment on your statement about not wanting to take unatural drugs for pain. I'm sure you know that many of the drugs that docs prescribe for pain are opium based preparations. Let's not forget that opium orginates from the poppy plant which is a very natural component. Feel better - BB
 
Tlancer, I'm not sure if this is what you want to hear but it does sound like a thoracic disk herniation with a protrusion to one side. I'll give you a brief of my symptoms/history and you can see what you think.

I had a car accident and herniated some discs - a couple in the thoracic spine, worst at T8/9. The pain didn't start immediately, in fact my flat mate and I went for a walk after the accident (quite a serious one) so that I could calm down. Next morning I couldn't turn over in bed and struggled getting dressed (hanRAB over head or away from my body, washing up etc, not good). Went and had scans which showed disks in my cervical but serious stuff going on in my thoracic. The pain was mainly localised to my back to start with, slightly more to the right side than left, muscles around there were all sore. Over the next couple of weeks the muscle pain decreased and I started getting stabbing pain in my right side, around my rib cage. I thought I was going mad because I could trace the stabbing pain around my ribs on the right with my finger. Neurosurgeon wanted to avoid surgery so prescribed meRAB and absolutely no rotation (twisting) at all or lifting. This helped somewhat. On days when I'd forget and even rolling over in bed, the pain would be so bad sometimes that I couldn't breathe. This got progressively worse to where they had to operate. The operation wasn't fun and of all spinal surgeries is classed as the most risky (sorry to scare you but it's good to know the facts). Of all discs herniated only 1 in 100000 is in the thoracic. Anyway, the surgery did help the severity of my nerve pain but it has never gone away. It hurts every time I breathe and I need medication, narcotic meRAB and others. Please don't worry if you need narcotics, it was difficult for me to accept too but without them I had/have no quality of life. My nerve pain is limited to the right side of my chest where the disc had crushed the nerve for too long for recovery. I don't regret my surgery at all, I just wish it had never happened. The things that are hardest for me are washing up, vacuuming (damn :)), any twisting, heavy lifting, rolling over in bed and driving.

I would strongly recommend getting an MRI. I know that they are expensive but perhaps you could go in in person and explain your situation. I know that lots of places in the US offer payment plans and reductions. I live in Australia so things are a bit different here but I still end up about $200 out of pocket.

I wish you luck, please don't hesitate to contact me if you have any questions. J.
 
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