Hi Dr. Junig, Can you please clarify something....Thanks

[Mark2929]

Hi Dr. Junig,

Thanks for the input and thought of a herniated disc. Would the chest CT I had picked  up a herniated disc on the thoracic spine?

Also you mention there are other conditions that could cause a similar pattern of symptoms. I was wondering like what based on the the wide range of tests I have had including negative Bone scan, Chest X Ray, Chest/abdomina/pelvic ct with contrast, Gastrocopy, ecg/s heart stress test and allot of blood work ? Hopefully you are not thinking anything serious when you mention possible other conditions??? If I have to live with pain for a while I wont like it but I guess I wont have much choice. I am now seeing a chiropractor to see if that will help. My Dr. feels with all of the tests I have had that heart and malignancy have been ruled out, again just curious as to what other thoughts you might have and what other possible conditions you mean. I am feeling pretty anxious.

Thanks again for your responses they have been helpful and much appreciated.

[J T Junig, MD PhD]

Hi Mark,

A chest CT might pick up a herniated disc;  it would depend a bit on exactly where the image slice 'falls' and the resolution of the imaging.  A large disc herniation would probably show up.  The other tests that you have done wouldn't show a disc herniation but they would show many other more serious things.  It would be very hard for a tumor, for example, to be large enough to cause your pain, and somehow escape detection despite a chest CT, bone scan, and gastroscopy.

Understand that the way our healthcare system works is to first rule out the 'bad things'.  I think it does an OK job of that, for the most part.  But all of the less-bad-things are much more difficult to sort out.  I am known by my family members as a person who rarely goes to the doctor;  I consider them mostly unhelpful for most of the things than bother people.  (I can't believe I am writing this publicly!).  The reason is because our tests are designed to find dysfunction-- not to measure function.  And if a person's body is basically firing on all cylinders, most tests come back normal.

I suspect that you have arthritis at some small area that doesn't even show up as abonormal;  a bit of bone spurring where the end of a rib moves against the spine, for example.  You could have a small bit or irritation of the end of the bone spur, and that would be enough to cause exquisite pain that wraps around your chest and worsens when you breathe.  Those types of areas tend to heal eventually, but over a long time-- maybe 6-12 months.  Many people develop those types of pains;  they never find the source, and it doesn't matter because there is no cure except time and comfort measures like heat, tylenol, ibuprofen...    sometimes chiropractic manipulation can help, or exercise, or massage.  Keeping your mood up is always important with chronic pain.

i'm sorry for sounding like I thought you had something more serious.  As I said in a post a few minutes ago, do your best to trust a negative result with as much certainty as you trust a positive result.  And if there is something that interests you, dig into it to keep your mind as occupied as possible.

Take care,
JJ

[Mark2929]

Dr Junig,

Because of ongoing mid-chest & back pain/discomfort & the tight chest sensation I get along with extreme anxiety about it My doctor today has ordered a nuclear stress test, which I will have at the hospital in about two weeks. My family Dr. doubts that it will show anything wrong because of the recent normal ecg's heart blood work ups & normal stress test.

He says the calcium & alk phos blood tests, bone scan and chest ct are both  very good at looking at bone and the the spine and I shouldn't worry about a back/ spinal tumor causing my pain. what do you think? I FEEL EXTREMELY PANICKED AND HAVE HIGH ANXIETY ABOUT THIS and would appreciate your input.

I know in some previous posts mentioned various diagnostic tests I have had for my mid/back chest pain. I would like to clarify all of the tests I have had in the past 5.5 weeks. Abdominal Ultrasound, Chest abdominal and pelvic cat scan with contrast, Chest X Ray, Bone scan, 4 Ecg's and heart panels on different days when I had pain. Bruce protocol stress test. These tests have all been normal.

My family doctor is sticking to he is not sure exactly what is causing the pain except that it is nothing serious(benign no heart or cancer problem) and that by depression anxiety & health worries associated with pain are making the pain focused and worse because I am completely fixating on it.