How Can Chronic Thoracic Back Pain Be Treated?

Posted on Tue, 24 Apr 2018

Question: Good morning, I have been having thoracic back pain for about 18 months and it’s been a progressive pain that gradually got worse and worse to the point that it is a 24/7 pain. The pain is a excruting pain that has affected many aspects of my life. Sleeping is difficult as well as doing any type of physical activity. I had a mri in XXXXXXX that showed I had a paracentral disc herniation of the t5-t6 with mild narrowing of the spinal canal. Also showed bone spurs from t5,t6,t7,t8,t9. Significant spurring in t5,t6. Also disc degenerative disease across the entire thoracic spine. I also had a mri if the lumbar as well at that time that showed L4-L5 disc herniation along with bone spurs and DDD (disc degenerative disease). The pain from XXXXXXX until now got a lot worse. I went to a pain clinic and they did steroid nerve block from T5 -T9 on both sides. It didn’t work so they did nerve burnings (rhazotomy) from T5 to T9. Also did not help. I started getting hand and leg tremors so I went to a neurosurgeon that ordered a new mri of the cervical, thoracic and brain. I had this mri last week. I got the results today and the brain mri was normal, the cervical mri showed c3-c6 small right para-central disc protrusions indenting the thecal sac at the midline. Now the thoracic mri showed the t5-t6 herniation as well as a new herniation on the t6-t7. It said t6-t7 small paracentral disc protrusion on the left side distorting the thoracic spinal cord left of midline. Marrow signal appears to be with in normal limits. It also shows mild DDD on multiple disc levels in the thoracic back. My question would be how would you interpret this? Is this bad news? My thoracic back pain is very bad and it never goes away. I have a very difficult time sleeping. They put me on percocets and naproxen and I have been at home resting for 4 weeks trying to get it to calm down but rest is not helping either. I just got the results this morning but I have not spoken to my neurosurgeon yet. He is out until Tuesday. My Ferritin blood levels are really elevated so I don’t know if that has anything to do with this. I have also had several cat scans of the abdomen to rule out other diseases. Any thoughts? I have not been in any accidents or injuries. I have a desk job so it’s not physical labor. So I am guessing it’s bad genetics

Answered by Dr. Dr. Erion Spaho (3 hours later)

Brief Answer:
You probably need surgery.

Detailed Answer:
Hello and thanks for using HealthcareMagic.

I have read your question and understand your concerns.

As a Neurosurgeon, my opinion is that you initially need surgery to remove the herniations at the T5-6 and T6-7, because this seems to be the main contributor to your symptoms.

After that, physical therapy should be initiated ( after one or two months ) in order to get further improvement.

TENS also may be considered as a possibility after the surgery to address pain caused by other levels of degenerative disc disease.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Erion Spaho (2 hours later)

Is thoracic back surgery risky

Answered by Dr. Dr. Erion Spaho (21 hours later)

Brief Answer:
Thoracic surgery seldom may be risky.

Detailed Answer:
Welcome back.

All surgical procedures could result in risky complications that rarely may be serious ones.

Surgery to remove herniated discs generally goes very well in about 95% of cases.

Some risks should be accepted in order to get treated.

Hope this helps.

Greetings.

Above answer was peer-reviewed by : Dr. Prasad