Severe pain

I have a history of three herniated disks in my cervical spine from trauma, hyperkyphosis and levoscoliosis in my thoracic spine with degenerative arthritis and an anterior chest wall deformity that was not there a few years ago and no physician has been able to diagnose.  For two years I have suffered from severe chest and thoracic spine pain radiating through the bottom of both shoulder blades.  There have been no observed disk herniations in my thoracic spine although I have many Schmorl's nodes.
Can the herniations in my cervical spine cause the chest pain?  If so, at which level?  Also, which thoracic level would be likely to be responsible for the pain shooting across and under the bottom of both shoulder blades?

[ggreg]

Well, hello, Jeff from Ohio,
I have all sorts of trouble with my back, in particular from a car accident that caused compression fractures of three vertebrae in the thoracic spine, so I took an interest in your situation.  I can tell you the answers to most of your questions.  I am sorry you have this deformity going on from the kyphosis in your spine.

T-7 is the thoracic vertebra from which the nerve originates that goes across the bottom of the shoulder blades.  I have the identical pain, it is a deep, profound ache, and I have to stop everything I'm doing and lay down.  T-7 was one of the fractured vertebrae I have.  One of the things that happens when your spine curves like yours, as mine is also curved (to one side and forward), is it yanks all the muscles, tendons and ligaments out of place, not to mention nerves being compromised, so that all those muscles can ache, too, and they get to spasming and cause some of the pain, as well as the certain pain from nerves.  Laying down with my legs bent or having someone rub out my back is the only way to make it stop.  

The cervical spine nerves have NOTHING to do with your chest pain, because the thoracic spine nerves control ALL of that, with the second thoracic spine nerve beginning about where the armpits are, progressing vertebra by vertebra to the twelfth one around about your waist, just above the two big pelvis bones.  The closest the cervical spine nerves get to the chest is the last few cervical vertebrae nerves control the arm and hand from top and front of shoulder area around the collar bone, on down to the fingertips.  The first thoracic spine nerve also controls the arm, but from the inner armpits on down just three-quarters of the inner arm.  Another way to look at it is, only the thoracic vertebrae connect to all the ribs.  In addition, those nerves wrap around the back AND the chest.  The first couple weeks in the hospital after my spine injury, I thought my ribs were broken and I could barely breathe, but this was because of how those thoracic spinal nerves wrap right around the chest and they were on fire from inflammation.

You know, Jeff, I thought my thoracic spine pictures were bad until I saw yours.  I have stared at your two MRI pictures, and the one on the right, that is your thoracic spine, and I see the sharp bend in the spine of kyphosis and chips off vertebrae from schmorl's nodes and s-shaped scoliosis of the whole spine, which your radiologist and docs have reported, but I also see numerous places where disc herniations have pushed right into your spinal cord canal and I find it unbelievable that you are still walking around.  I do not know why they say the thoracic spine does not have herniated discs, it seems so plain to me, but I am not a doctor or radiologist, so who am I to say?

But if you yourself will look at the right picture, and look at and below where the sharpest curve is in your thoracic spine, you will see between each of the vertebral bones there is a dark space, and that's the disc, and just to the right of all those bones is the spinal canal, which is clearer towards the top of the picture, and then you can see where those dark disc places push right into where that spinal canal is supposed to be.  The pain you must be in has to be terrible, and it has to involve not only your chest and under your shoulder blades, but it could be that you may have been experiencing some loss of feeling in your lower body, for if the spinal cord is damaged, from where it is cut off and straight down to the tips of your toes, you will lose feeling.  This is a very bad sign, so if you have noticed this or whenever you do notice it, you are in an emergency situation.

Now, I don't know what's going on between you and your doctors that you would come here, unless you've brought this pain to their attention and they declared you okay, or you are just thinking of returning to them, but actually were it not for the appearance of those discs bulging right into the spinal canal, I wouldn't suggest you do anything other than ask for some moderate treatment (rest, meds, maybe PT).  But your kyphosis has gotten so severe as to appear to have compromised your spinal cord, thus I think your back has become very unstable, and SOMEthing has to be done.  There are some fairly easy remedies, perhaps, which can include a very strong back brace can be laced up and help prevent any spine movement when you're up and about.  But I should think at the very least any good orthopedic or neurologic surgeon would be wanting to perhaps operate and get all that herniated disc material out of there, to take the pressure off the cord.

So, let us say I am reading your MRI incorrectly and that some other bodiy mass is making it LOOK like your spinal canal is compromised, and that it is NOT in any danger from disc bulges, and I'm just plain all wet on the issue.  Well, then this leaves the pain you have.  I can tell you what I take, altho it is not enough, and that is Codeine #3 and Lyrica (pregabalin).  I have asked my neurologist to change the opiate to a stronger one, which about the only one the U.S. will prescribe with refills is hydrocodone, which gives me headaches.  What I need is a morphine drip!  Ha!  And you probably do, too!  But no docs are going to do this for us, despite our scary pictures.  Also, my neuro is going to order a new back brace for me, since my back has gotten so much worse in the last year.  I'm just wearing an elastic brace from the drugstore whenever I have to be active.

If you have indeed been to your docs and they are dismissing you, I would strongly suggest you go to a larger city to a hospital in a university setting or find a larger group of neurologists or orthopedists you can go to, for a second opinion.  Someone needs to recheck your back, they could even use your MRI pictures that you have to avoid the expense and delay in getting a new one, and by geting a second opinion, you would improve your chances of getting adequate pain relief, as well as SOMEONE looking at what I see as disc bulges into your spinal canal and making some determination about your risks and what to do about it.  

If you have any other questions, either myself or someone more learned than me here can answer them, or you can even go to the "Ask the Doctor" section in the Forum List, I think you pay a nominal amount and get more professional advice.  Keep us posted when you have time.  GG