Car Accident/Thoracic herniation/complications

[Jeri__0]

  I posted a note back in May and had a very informational response.  I've now
  had 3 more months to work with a neurologist and have further tests.  In a
  nutshell here is an account of my problem:
  On 2/21 I was rear ended on the interstate by a drunk driver.  I was driving
  65MPH and his speed was probably 80MPH at least most likely more.  My car
  was totaled but surprisingly at the time I only had chest and some slight neck
  pain.  Finally after a few days and then going to my local doctor, it was
  supsected I had torn/bruised chest muscles.  I started PT, was taking MS contin
  for pain.  The muscles started finally healing and just about the time this
  happened the pain in my legs and mid back started.  The doctor ordered an
  MRI of my thoracic spine and it showed a 5-6 mm herniated disc at T6-7 level
  and a 3mm disc protrusion to the left at the T7-8 level.
  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
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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!