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Chronic Pain members - Welcome, please introduce yourself

Chronic Pain | Last Active: 21 hours ago | Replies (7049)

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@jenniferhunter

@albeit
The recommendation I would make is to see a neurologist who is familiar with spine injuries. If it has been 8 years since you had imaging done, you don't know if the herniations you described in your spine have progressed or if there is nerve or spinal cord impingement. When a disc is injured and bulges, it causes the distribution of pressure to be uneven, and that can cause bone spurs to grow. If the disc is damaged enough, the jelly like nucleus can be expelled through cracks in the outer fibrous layer. That can happen years after an injury because discs naturally dry out and shrink a bit as we age, and posture plays a role as well because poor posture will also cause an uneven load on the discs. Physical therapy can help try to restore the normal curvatures in the spine and reduce pain, but that also depends on what else is going on.

I am a Mayo spine surgery patient, and when I requested an appointment at Mayo, 5 local surgeons had missed understanding the diagnosis, and I had MRI and X-ray imaging that I sent in for review. I had been turned down for 2 years and none would help me. If you wish to start that process at Mayo, you might ask to be seen by a spine center neurologist first and they would make referrals based on what they find. If you possibly could be a surgery candidate, they would arrange an appointment with a specialist. I did request an appointment with a specific neurosurgeon when I sent in my imaging, and he had me see the neurologist he works with, who then ordered the tests I needed, and some consults with other specialists outside of neurosurgery. All of that was completed before my surgery consult and he had all the information he needed and he explained what he could do to help me.

Spine injuries are different in that the symptoms they cause vary a lot depending on what part of the spine is affected. There is a dermatomal map of the body that shows where all the nerves go after leaving the spine, and this applies if the problem is at a nerve root (in between the vertebral bodies). If the problem is spinal cord compression inside the central canal, it's more complex, and not so easy to understand specifically what would be affected, but that causes a lot of issues and weakness and can affect the entire body even if there is only one level of the spinal cord that is compressed. That was what happened with my case. I had pains all over my body from cervical stenosis, and atrophy of arm and shoulder muscle.

With your injuries from the car accident, there could be some additional issues with something like thoracic outlet syndrome. It can be caused by a whiplash or repetitive stress. TOS will also cause pain and numbness in arms and hands as well as decreased circulation. A lot of doctors do not understand TOS (which I have), and that is also why I came to Mayo because they can diagnose and treat it, and I needed to be where they understood both TOS and spine injuries.

Here are some links that may help.
https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961
https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://en.wikipedia.org/wiki/Dermatome_(anatomy)
https://teachmeanatomy.info/the-basics/embryology/dermatomes/

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Replies to "@albeit The recommendation I would make is to see a neurologist who is familiar with spine..."

Jennifer, I appreciate you mentioning Thorasic Outlet Syndrome. I was found to have bloodclots in both arteries of right lower arm. This led to the discovery of an aneurysm in my shoulder and a diagnosis of TOS. By the time they found the aneurysm, I was in crisis. Then was sent to University of Michigan for a complete work up and they quickly scheduled surgery. They removed 2 ribs and my scalene muscle to get at and repair the artery. It took about 7 1/2- 8 hrs, and the recovery was long and painful. Long hospital stay. Long months of therapy. But if it had not been for the PA at my docs office I may not be here. The aneurysm was fast growing and very large by the time they repaired it. I have not found a TOS group here, so it's probably not very common. Point being, complications can arise which will take a sore shoulder and aching arm to a whole new level. If someone does not get a satisfactory diagnosis, this possibility should be persued. Since this progressed to a dangerous point for me, I would hate to not give at least a warning to anyone suffering TOS symptoms, so they can at least be tested for it.

Thank you Jennifer for bringing this little known, but nasty condition to light. 🙂