Question Title: Car Accident/Thoracic herniation/complications

Forum: Neurology Forum
Topic: Thoracic

Symptoms have been and still are:
1. Hands fall asleep at night, depending on which side I'm lying on i.e. lying
on my left side, my right hand falls asleep and viceversa.
2. After almost any activity, legs ache but more recently it seems to be
both of my heels that ache terribly and feel hot.
3. Activity such as raking, weeding has brought on headaches, high pain in
the thoracic region and a stiff neck.

Tests done to date:
MRI of thoracic and lumbar spine (lumbar negative)
Carpel Tunnel tests for hands (negative)

This has been so frustrating and the pain has been intense but controlled
with oxycontin 10 mg twice daily as long as I don't do anything strenuous
in the slightest. At my last neurologist appt. 10 days ago he told me that
since it had been 6 months since my accident I could now start resuming
my normal activities. I am still doing PT and now having E-stim and traction.
Well, I'm determined to prove my doctor correct and do my normal activities,
but to be honest, it's killing me (gg). But seriously, everytime I do
something, I spend at least one day or two recovering from the pain incurred
by the activity. When I asked about the leg pain, the doc said that until
I can tell him what brings it on or where it originates he can not give me
an idea of what the problem is since the MRI of the lumbar area was negative.

These injuries have my life pretty much at a standstill. I was very active
before and now I can do positively nothing that doesn't bring on some form
of pain whether it be the leg/heel pain or the neck/headaches/thoracic pain.

In my previous post it was mentioned that possibly thoracic injuries could
cause leg pain, I am curious about this and would like to know more information
on the subject.

Also at my last PT, my therapist did a relaxation technique for a sore
muscle in my back where she put pressure on the muscle in the back close to
my left armpit and then held the arm over my head. When she was done and
brought my arm back down, I asked her if my hand was supposed to be "asleep"
and of course she said no. She could find no pulse in the wrist. Finally
as it does at night when it falls asleep, it regained it's normal feeling
but bothered me more than normal the rest of the day, feeling cold and
tingling like it was trying to go to sleep again. She says this is a
symptom of TOS which just leaves me with another diganosis that is hard to
track.

Any suggestions, information, etc. would be greatly appreciated. I just
need to know what to do next, what to possibly expect, any other tests that
should be run, etc. They have never done an MRI of the neck but have taken
x-rays that appear to be normal. Of course the thoracic spine xrays taken
the night of the accident also were negative but yet when the MRI was done,
it showed a herniattion so I know that the xrays are not proof positive
that here is nothing wrong there.

Jeri

Dear Jeri:

An MRI of the cervical spine may not be inappropriate in your case, since cervical radiculopathy can indeed cause hand numbness, thoracic back pain, and headache. What your physicians should do in they did find some abnormality is another question.

I see no clear explanation for your heel pain, and certainly cannot relate it to your accident. Also, I do not know if your thoracic disc herniations have any relevance to your symptoms, or if they are related to your accident either. Varying degrees of disc disease, specially in the lumbar and cervical areas, are commonly found in normal individuals without symptoms. I am not aware of thoracic lesions causing leg pains without causing other obvious abnormalities related to spinal cord involvement.

The possibility of mild carpal tunnel syndrome may not have been entirely excluded, depending upon how the EMG was done. Your symptoms of hand numbness at night are indeed typical. Such carpal tunnel syndrome is not usually treated with surgery anyway, so I see no harm in your trying wrist splints at night, if your doctor thinks it is appropriate. TOS (thoracic outlet syndrome) of the nerve type is very rare and does not really appear in the differential diagnosis.

People differ in their pain tolerance, and this is difficult to measure. If pain is is the only significant problem, and if you have reassured yourself that there is no major or minor neurological problem (probably after consultations with with more than one neurologist you trust), you probably need to see a pain specialist and have the pain treated, so that you can return to a normal level of functioning.

Good luck!

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