Thoracic Spine Pain Management

Bones, joints and muscles
1

Hi

Been a while since I've posted - I guess you get to the stage where you accept you're in a persistant pain cycle, and carry on regardless, despite the oppressive dull ache which is always there, like white noise.

Just passed my two-year 'anniversary' of having developed thoracic/cervical back pain, coupled with Dupuytren's Disease and muscle dysfunction in the shoulders. The underlying cause is still unknown...hypermobility, fixated joints, scar tissue build-up and tethering have all been suggested...scoliosis, Charcot-Marie-Tooth and rheumatoid arthritus all speculated due to family history on my mother's side.

All I know is I live with it, deal with it and try to remain positive - faith in a positive outcome, and to keep on fighting and searching for a way out - I guess these are the unintended benefits of membership to the club n one wants to be part of.

I find that heat (sauna), swimming, body balance classes and posture exercises do help alleviate the discomfort, so have built them in to my weekly routine. Movement movement movement! But I hate the constant popping and clicking. I went to a Tai Chi class and even the old people were looking at me funny (for this reason only I might add!)

Acupuncture and acupressure also help, even if only for a few days. My experience with Chiros and Osteopaths were poor - manipulation only goes so far in my experience - it certainly doesn't help the muscle knotting.

Next step for me is using a TENS machine to see if that has any more lasting effect. In the meantime, I guess the time is nigh to once again pressure the NHS into sending me off for an X-Ray or MRI - just got to get past the MSK specialist first. A year ago he accused me of catastrophic thinking. Thanks doc - but you don't feel what I feel.

Has anyone had any success with TENS? I've managed to find a couple of treatment protocols, so with a bit of luck I might get some assistance from this.

Medication-wise, I've tried to avoid pill popping. I don't think the severity of pain justifies it, although ibuprofen does help.

Does anyone ice on a regular basis? The heat vs ice debate is a frustrating, it seems the go-to answer is 'whatever works for you'. Well, they both do, but it would be good to know how it works for others. If ice is for acute pain only well I better stick to heat...two years equals chronic in most books I think.

Thanks for reading. I think there was a question in there somewhere! And all the best to those suffering in silent dignity.

2

Have you tried magnesium and vitamin D? Magnesium helps to relax the muscles and also is responsible for dozens of functions in the body.

Tens helps.

Also coconut oil, biotin, silica capsules. I do not know where they can be purchased from but a quick search will reveal sources I am sure.

Has anyyone suggested a dexa scan to check for osteoporosis or doing a vitamin D level. Other treatments for thse spasms is Vitamin E, Biotin, Iron, Magnesium as mentioned, silica, there is a website on neuropathy too.

3

I too am a chronic pain patient. I have three sources of pain and have suffered for over 11 years. But enough about me I just wanted you to know where I am coming from.

First off I am really disappointed that you have not had an MRI yet. That should have happened long ago. In fact right after the X-Ray didn't show anything. You need to work on your doctor to get that ordered.

I use a TENS unit and am in fact on my second one. I do get temporary relief from the pain. I actually only use it on bad days. I also use ice almost exclusively. I used to do heat in the winter and ice in the summer just for comfort. But I am now on prednisone and that makes me hot all the time so a heating pad sounds just awful. I always have several ice packs in the ready in my freezer. I was told by a couple of different PTs that it didn't matter which you used. It's a personal preference.

Whether you choose to use opiates to control your pain or OTC medication is a personal decision that should be made very carefully. Personally if I could manage I would not take opiates, but my pain is much to great for mere OTC drugs. But here is where I want to warn you. I spent the first year of my back pain using naproxen every day. I ended up with GERDS and acid reflux. So please use caution when using ibuprofen as it will do the same thing.

I realize that you don't want to take opiates for pain control but it might be worth asking for muscle relaxers. Take one at night and that might help with your pain the next day. Unfortunately it will make you sleepy, that is why I am suggesting using it at night. Muscle relaxers are not addictive so you will not have that worry.

And lastly you are right on with the moving. Keep moving. I did not and ended up making matters worse. And it was a long haul back to flexiblity.

One last suggestion is to find a group online for chronic pain patients. It will give you support and suggestions for treatments you may not have been offered. There are so many treatments out there. Email me if you want the names of some of the sites I belong too or alternate treatment ideas. Otherwise they will be monitored here.

Good luck to you. I hope you find relief soon.

4

Sory to interject but I was very interested in your posting and wondered if I may ask you a few questions?

1. What exercises do/did you do to keep mobile?

​2. Have you heard of an ultra sound portable machine for home use. I ask because I was thinking of buying one for my stiff ankles and buttocks.

3 . TENS Machine. My physio told me to leave it on for a few hours each day as this is supposed to be more effective at blocking the peain messages to the brain and it also stimulates the flow of blood to the root of the pain to wash away the toxic chemicls produced at the nerve roots.

She  said that this is called the mechanism of pain.

Lastly I have an annulartear between L4 and L5. I wondered what treatment is available for this as drs do not seem to know much about it.

 

5

I have the same thoratic pain . Mine is not so much dull as more a sharp burning ache . The tens does help . My wife connects it on either side of the spine where the pain is and then I put the unit in my pocket . It helps block the pain but obviously when you remove it the pain returns .

6

Which muscle relaxer is best . And where do you position the tens if it's for thoratic pain as hope I'm doing it right

7

I've had a few questions possed to me by a few posters that I will try to address in this comment.

First of all regarding muscle relaxers I found the best one that worked for me was one that's called Tizanidine. The brand name is Zanaflex. Unfortunately it also causes a great deal of drowsiness so I found it impossible to use and then still function. So I just took it at night time or when I was hurting really bad and was going to be staying home in bed anyway. But most doctors start out by prescribing Flexeril. That too is a good muscle relaxer and also will make you drowsy but I don't believe it is as drowsy making as Tizanidine.

Now I want to address the TENS unit. It is important to place the patches of the TENS unit correctly. I was taught this method. You have two patches attached to one wire you put those two patches caddy corner from each other so one is up and one is down across from it. Then you place the patches attached to the second wire in just the opposite form. This creates a cross between the wired patches.

On the annular tear I'm afraid I don't know anything about that. I would go into doctor Google and see what you can find out. I trust the Mayo Clinic they give good accurate and professional information. WebMD is also not bad but I still prefer Mayo Clinic. But remember don't trust everything you read on the internet. Also I am surprised that you're having doctors not know how to treat it. Have you tried seeing a neurologist or an orthopedic surgeon? Because they're the ones who are experts in back problems.

Lastly I wanted to recommend using something called Biofreeze. I purchased the roll-on type so that I don't have to get it on my hands. But essentially it's a cream that you rub on the area and much like Bengay it warms up. But for some reason it works better than most of the other stuff out there for me. It is very short lasting. It also does not have a strong odor like Bengay does although it does have a light slight smell that dissipates quickly.

8

Hi icecool

I did begin a vitamin/supplement regime back in March. I alternated day-by-day with the following:

A: Garlic, Vitamin C (high strength), Korean Ginseng, Gilko Balboa, Turmeric

B: CoQ10, Multi-vitamin, Turmeric

Before that I did take calcium with magnesium, but something was making me feel funny. Glucosamine & Chrondoitin was also something I was taking previously but stopped because the doctor said it was linkd with a build-up of the tissue found in Dupuytren's Disease - something else I've picked up in the past two years.

I haven't had any scans for osteoporosis and to be honest I think my Medical Practice here in the UK is fed up of seeing me. They have tested for Rheumatism before as there has been incidences of that in the family. It came up negative although logic would suggest that a lot of the issues I'm having with my hands, crepitus and back is that there is something underlying.

I'd be really interested to hear your thoughts about vitamin intake - I like to think I get most of the nutrition from my diet. But I do want to re-assert myself with nutrition and make sure I'm eating an anti-inflammatory diet. I would like to stick within daily allowances though. Also dubious about how I can measure the efficacy of supplements.

9

Thanks for this reply amkoffee. I appreciate the time you've taken to message me.

What is your email address? Or is there a way I can direct message you? I would love to find about some of these websites. As mentioned in my reply to icecool above, I'm curious about supplements and the relief they can bring.

Having seen my doctor again on Friday it was pretty much spelled out to me that I should finish the current course of acupuncture and physio I am to see what effect it has. From that point there will be more justification to be referred to a MSL specialist and ask for a MRI (her point, which I took, was that the NHS usually do MRI's with a view to surgery or some primary form of follow-up - unfair as that seems).

I also had a chat with her about medication. I am going to stay away from this for now because I really feel I'm managing the pain okay. I have made a mental note about muscle relaxers though; although again, I feel that gels/rubs and TENS works well for me in this regard.

I tend to be okay with both ice and heat - I think heat probably does the job better for me.

10

Ray there are some useful videos on Youtube in terms of placing the TENS. It's quite flexible - you can put the electrodes directly over the pain but you must get the +/- right. 

There are a couple of PDF files you can get from Google if you type in 'Tens placement for thoracic spine' or something along these lines.

11

Hi icecool.

Don't know if this reply was intended for me or amkoffee but I will reply anyway.

1. I follow the exercises on the website Posture Direct - 17 exercises to improve your thoracic spine

2. Never heard of this!

3. Yes I have received the same advice. In this way it works like acupuncture.

12

Yep that is the placement I do as well. I think providers of TENS are pretty clear when they say it's not a cure to the problem, but helps alleviate pain and therefore helps quality of life.

13

How often are you using the tens unit and the heat too. Can your thoratic pain be constant unless treated

14

Hi Jimbo

You really need a baseline of any vitamin that you take or have been taking.

The dr is unlikkely to do a Vitamin D.

A bone profile is usually the choice but the dr may refuse to do it due to cost!

Bone profile consists of vitamin D, calcium, phophate, parathyroid hormone level.

Vitamin B12.

​If you have this test done then it is important  NOT to take any supplementaion of B12 for a long time as this can skewer the results.

​DIET. The anti inflammatory ones sound good.

Take care

15

In my case back injuries scoliosis, Ankylosing spondylitis, degenerative arthritis and Elders Danlos , fibromyalgia, Psoriatic arthritis

For management of my disc issues from arthritis and both hips replaced I wear a compression back brace , treat with heat and always must sleep on my back knees up on pillow. And neck pillow for neck injury.Heat muscle rubs help relax muscles they really work for me. Tried arthritis injections and tens just didn't work for me. I hope they will for you. Water therapy helps. I always am aware of my limitations don't over do and adjust. 

For hyper mobility management depending on the joint I wear joint supports quite comfortable while recommended by phycical therapy. This keeps the joints from tearing ligaments and connective tissues.

For management of dupytrends in both hands and feet are effected. For hands two  fingers were frozen in fist position. Went to a duyptrends specialist first doc wanted to do surgery then was also seen by another doc that ultimately discourages surgery explaining it will cause more activity as the collagen will cause my hand to actually activate the collagen and nodes to cause the hand to contract more. The treatment was Xiaflex a enzyme injection which only targets the collagen  (see online),  it had disintegrated the built up of collagen on the cords causing the fingers to contract to a fist then the doctor manunipulated my fingers to a straight position . I wear a hand splints nightly to prevent the contraction to cause the issues again.  If you only have nodes in palms with no contracture that's a whole other treatment. 

Then I had the same rreatment for frozen shoulder enzymes broke broke up the built up collagen in the joint after a few weeks the doc manunipulated the shoulder and regained movement and was in therapy for a few weeks. I wear a brace at night on that shoulder.

Be mindful of all body movements pay more attention to movement and try to use leverage when lifting anything. Stay is shape keep muscles strong will help with back and neck. At night sometime Imwear a soft neck brace when I sleep really helps by the morning the pain is much more manageable. Also treat with heat wraps. 

I hope once once you have a MRI you have a better explanation for treatment and there are many new treatments available today. Bio drugs and PRP thearpy just read about how promising they are if injuries are caught early.

Pain management doctors understand our pain and understand treatments better have helped me a great deal. It's takes time to see improvement but I am very happy with the results. 

Sending you lots of healing vibes your way. 

 

16

Hi, thanks for the ideas, I appreciate it. It seems like you have been through the mill with your health, I am sorry to ehar you've encountered so many ailments but also admire the way you go about dealing with your pain.

Can I ask where you live? As in UK or US? (or elsewhere?) As mentioned on a previous message, whilst my general practitioner will refer me to the musculo-skeletal specialist, the latter is reluctant to send me for a MRI as the expectation is that there would be some follow-up to that, usually surgery. I am 34 years old and have a full range of capabilities, which plays against me because they obviously don't feel the clicks, pops, soreness, pain, discomfort and aches I live with on a daily basis.

So I am interested to know how you came to have so many disorders, and how they have come to being diagnosed?

Also, can I ask what mattress you use? I am currently using a memory foam topper on top my bed base, as I feel the extra hard firmness was better than my old and soft mattress. That said, I am extremely stiff in the morning and think this current arrangement might have something to do with it. Hopefully the others will chime in with their opinion here! 

17

Have you had an mri yet . I have mine this Sunday . Just hope I can lay still long enough while having done as will be laying on back so it will hurt

18

Where you from ray? US or UK? I'm the latter - haven't had a MRI as explained in other posts. All the best for your MRI, hope you find out what's up.

19

The UK . My gp ordered my mri . I don't understand how you are not being allowed one . It's terrible that you haven't been yet

20

Yeah I know, you'd think they would just to get rid of me...must have made a dozen visits in the last year...I know I could invoke the NHS charter but would be easier if they just acknowledged I haven't got very far with the problem.