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jimbob0802 jimbob0802

Thoracic Spine Pain Management

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.

24 Replies

  • icecool icecool jimbob0802

    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.

    • jimbob0802 jimbob0802 icecool

      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.

    • icecool icecool jimbob0802

      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

  • amkoffee amkoffee jimbob0802

    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.

    • icecool icecool amkoffee

      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.

       

    • jimbob0802 jimbob0802 amkoffee

      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.

    • jimbob0802 jimbob0802 ray63269

      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.

    • jimbob0802 jimbob0802 icecool

      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.

  • ray63269 ray63269 jimbob0802

    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 .

  • amkoffee amkoffee jimbob0802

    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.

    • jimbob0802 jimbob0802 amkoffee

      Hi amkoffee

      Sorry for troubling you, but I just want to get your opinion regarding a painkiller (muscle relaxer?!) I've been prescribed. Have you ever had any experience of amitriptyline? I believe the brand name is Elavil.

      I am slightly dubious about taking it, but equally willing to give it a try. My GP believes that it will allow me to get the most out of the physiotherapy I do, as outlined in my original post. I guess the thing that is bothering me is the potential impact it will have on the rest of my aerobic performance, or the other things I want to try....such as some of the things mentioned in this discussion (e.g. magnesium) 

  • hope4cure hope4cure jimbob0802

    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. 

     

    • jimbob0802 jimbob0802 hope4cure

      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! 

    • hope4cure hope4cure jimbob0802

      I am in the the US, west coast. Where are you located? Chronic pain seems to be universal as well as finding the source and treatment. I can't change what I have but have learned to cope and adjust to living with it. And still be happy, have a full life and do the things I love doing, drug free. Regardless of what weather it's a good day or a bad day.

      Well it has taken the tenacity of a Gorilla to continue the search for the health issues and docs that properly diagnose and treat my pain. 

      What works for me may not for others, yet it's taken many years to understand that I had to be my own self advocate . I knew for example I had duyptrends before the first hand specialist visit from reading many online searches, the first doc who wanted to do the worst thing for dupretrends...surgery. See duyptrends society for all the treatments for various stages of D.C. Helped me and learned a lot.

      It also took many years to diagnose hip pain needing hip replacement because no one would X-ray my hips until I finally asked for a hip X-ray knowing that it was not a hernia which docs thought from MRI . After hernia surgery no hernia was found, that's when I became a researcher for my symptoms to get a better idea for treatment, rather than spend a lot of time on guessing what's wrong not always counting on doctors for correct diagnosis.

      At night I take Tylenol for pain, I am highly allergic to pain meds. I sleep as described in previous post on a Sleep Numbers bed examples are online.The head and feet can be raised and bed adjusted to zero gravity. I really miss my water bed it was several separate water tubes in the bed not one water mattress and adjusted to zero gravity. Had to give it up no one made replacement tubes anymore. I am very stiff if I over do the day before, I can't stress enough how important it is to be mindful of your movements constantly and rest. Saves a lot of pain issues.

      I don't know what diagnosis you have for the stiffness could be Elder Danlos Syndrome . There  are various degrees of this connective tissue disease, which could account for the clicks and pops you hear. Have you been tested for it. See more info online for symptoms,just a suggestion.

      Also, you might try magnesium spray helps sore muscles, cramps and muscles creams are helpful. Heat wraps I sleep in especially for my back and neck.

      An MRI may not necessarily mean surgery or it may answer the pain issues you are experiencing, I hope you can feel better and find a solution soon. 

      Never ever give up and don't let the stress makes it worse. Cortisol is a stress hormone when we are stressed this hormone causes more pain. Plan a 20 minute rest period daily listen to music or stories you like to completely relax. Go for messages I swear by them both to help keep our minds free of stress and our bodies free from constant pain. 

      Keep talking with your doctors do some research for ideas on questions to ask. I,also use my IPhone to record all doctors visits . Ask first and they seem to be much more helpful. Also it helps me to remember the conversation or any instructions given at the time . 

      You have lots of options list them as per discussions on these postings.

      I try to always understand before any doctors visit that it never goes as planned, I stay in a open frame of mind and to be open to try new meds and learn as much as I can can about them and the doctors background. 

       

    • jimbob0802 jimbob0802 hope4cure

      Thanks for such a detailed and honest response, I appreciate it.

      I'm based in the north of England, and although our NHS here in the UK is great in terms of accessability, it can be extremely frustrating to cut through when you feel you've got something underlying. As mentioned previously, I believe there's also an element of prejudice against me because by all intents and purposes, I'm still quite young and seemingly as fit as a fiddle.

      The past two years though have been a drag, especially as everything seems to have appeared at once, at a time of my life when I was just ready to move in terms of relationships, location and career.

      I too have Dupuytrens and seeing a consultant this week about it. I'm still at 0% contracture and the nodules and cords haven't increased in size, so will most likely be leaving it whatever is suggested. I know from being part of the support group on facebook that radiotherapy is the way to go in the early stages of the disease: surgery can make things worse.

      Thank you for the tip re magneisum spray. I have heard this before and will revisit it. I have bought some biofreeze to accompany the other rubs I have. Arnica gel is also something I am trying.

      Decided to abandon my current course of acupuncture. Have decided that it's too passive: I'm going to focus more on sustained exercise with the addition of the TENS regimen.

  • hope4cure hope4cure jimbob0802

    Thank you for your honest answer and evaluation of your treatment.  I get it it's frustrating when our doctors can't seem to understand that we are in true pain.  

    I also have fibromylagia and psoriasis it hit me very young and it causes pain everywhere. If you have and opportunity to see a Rheumatologist they specialize in bones joints, muscles and tissue/nerve compression. You may consider some of the new bio drugs available. Some helped me so much, side effects caused me to stop them. I will give another a try soon it's very safe . I have researched many bio drugs very expensive but block the IL- 17 / lL-23 pathway immunosuppressive drugs. 

    I tried diet,supplements, exercise helps low grade and Cymbalta also helped for a year but had to stop the due the meds side effects. I always eat a good diet. I can tell the difference in a few days if I slip up.

    On Cymbalta and bio drugs I felt like I had my life back for about a year each time. In the long run until you are diagnosed then and only then can you start to win your battle with pain and feel like you have control of your pain and not the pain running your life. 

    I realized that after some time of course there is greater mental acuity and clarity, once we understand our pain and given alternatives for treatment but also there is more time for productive thinking and creative coping . 

    I wish you well and find your diagnosis which which will give you the ammunition to better live with treatment, be happier learning coping techniques be positively every day. The glass is half full. 

     

  • jimbob0802 jimbob0802

    Hello all. Thanks for your all your inputs on this discussion, it's really helped me develop a new perspective but also some ponderment.

    One of which is how I go about dealing with this going forward. Clearly there are still a lot of things I need to try. Contrary to my original post, I've decided to dump what I deem to be the passive approach...i.e. acupuncture, chiropractic, osteopathy, physiotherapy. Clearly, they don't hit the root of the problem, and I feel strongly now that I can be my own best hope on this.

    But in taking an active approach, how can one measure it's success? Here's a list of stuff I feel I need to try:

    - supplementation

    - nutritional

    - deep tissue massage therapy: twice weekly

    - living in a hot climate!

    - medication

    The last point is particularly pertinent within this discussion, as I know that you all have tried certain meds. I've always assumed that my pain and clicking/popping of joints has been caused by inflammation, hence the only med I've taken for it is ibuprofen.

    Certainly, I haven't considered analgesic meds. Having looked into all of the ones you've mentioned, I'm thinking I need to give Tylenol a go in the first instance. It would be great to wake up without so much aching, and be able to go about my gym and swimming work with a bit more confidence.

    Clearly, I will have a better chance of getting a MRI done if I can go to the doctors and say I've tried everything. One thought that has creeped into my mindset is, what would a MRI achieve anyway? I guess if I get a diagnosis, they will probably put me on to a meds regimen anyway right?  

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