Chronic Pain following Severe MVA

  I have suffered with chronic pain for 4 years....was injured in a severe, multi-impact auto accident in 1994. The first impact was head-on, my seat flew forward and my chest dislocated the steering wheel. Second impact (with 2nd auto) to my jaw. Third impact (utility pole) to my chin.
  Recovered fairly well after 6 months, but am left with right neck and shoulder pain that, on occasion, travels to elbow. Also continued sternum, clavicle and right breast pain. The back of my neck has large "lump" that is very tender and pain extends to upper back as well. Less debilitating has been the TMJ damage (right side also); the oral surgeon has prescribed treatment to include a splint for 6 months to stabilize, then surgery.
  On a pain scale, I experience a 5-6 every day, with weekly exacerbations to an 8-9 . Once a month or so I can say, "It's a 10!!". After reaching a crisis point with pain, my PCP referred me to a pain management specialist. Up to this point, my meds were ibuprofen 800-1000 mg per day and Ultram 400 mg per day.
  The "pain doc" was a wonderful person, who was amazed at the extent of my discomfort and multiple "tender spots". I have remained well-functioning despite the pain, and am enjoying life in spite of it. When he remarked at the severity of my pain, I let him know that this has been my reality and I do not know anything else at this point! He recommmeded an MRI, Epidural Steroid Injections and OxyContin. I had not asked for medication, as my PCP had trained me to believe narcotics were reserved for those with acute pain or terminal illness. The relief I experienced with the medication was BLESSED. I take 10 mg twice a day, and although i gain relief for only 3 hours each dose (and it is intended for 12 hours), I am very grateful for the respite.
  My question is this: Preliminary Report of my MRI showed "no significant abnormalities", but with a "slight" bulge at C6-7. How can my pain be so persistent and severe with the results of the MRI being what they are?? I KNOW I am feeling this pain, but I do not know why!! My lab tests showed an increased SED rate (66) and the presence of anti-nuclear anitbodies. Could these be clues to something?? I will begin PT again, and have gone through 2 years previously. I would very much like to know if I will get better, through any means?
  Any response or information would be greatly appreciated...thank you in advance.
  Mrs. B
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Dear Mary,
You suffered from quite an injury some years ago.  Chronic pain after such injuries can be difficult to manage.  Keep in mind that the MRI doesn't show all things that can cause pain in such situations.  It can, however, rule out any significant compression on the spinal cord or nerve roots.  This seems to be the case with you.  Given the information you have provided, the best course of action at this time is likely going to be continued conservative therapy as there seems to be no 'fixable' lesion on the MRI.
The consult to the pain specialist was a good move by your physician.  These physicians have experience with some things that the typical doc doesn't usually practice.  
Hang in there and keep working hard with the physical therapy.
Good luck.