PLEASE HELP very severe thoracic back pain

[brainy26]

I'm a 30 year old male, this started probably 7 years ago, and gradually became more severe and frequent.    My middle back (I guess around T-10/11/12) will suddenly "lock up" ie the muscles surrounding the spine and lower ribcage... and convert to VERY severe pain for no good reason.  I can be doing something as simple as putting pants on  or more often than not it just starts immediately after waking up in the morning.    The pain is So severe that when it starts I usually collapse on the floor, unable to do anything but try to crawl to my bed or heating pad while screaming at the top of my lungs!     Then usually after a day or 2 I can walk again but lately it has been taking a few weeks or months to go back to semi normal.    I did have an MRI of my entire neck and t-spine which showed a mild herniation in the area I get the pain but the doctor who ordered the test thinks nothing of it.    

What can I do?  Would chiropractic manipulation help (high velocity adjustments?  had one before and it was great but scarey at the same time since it caused tingling in my toes and Erectile dysfinction for a couple weeks)  I dont know what else to do except live as a pansey and not lift more than a few pounds?

[Joyce K Lee, MD]

Dear brainy26,

Thank you for submitting your question pertaining to your husband.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms regarding your husband.
I am extremely limited in not having the opportunity to perform a full neurologic examination on your husband, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

To begin, I sympathize with you for the pain you are having to endure.

It is reassuring to me to know that you have seen a physican and undergone an MRI of the neck and T-spine.
At a young age of 30, it is unusual to have even a mild herniation -- were you a weight lifter, sports athlete in high school/college?
Although it seems that your doctor may have thought "nothing of it", that may be a good thing -- perhaps the herniation was so mild that he/she did not feel that surgery or any aggressive intervention was necessary.

We see a lot of patients of various ages with back pain -- most of these patients, we manage medically.
The severe cases end up being referred to a spine surgeon for surgical evaluation.

What I have found to be most helpful in patients with problems like yours is physical therapy.
It is often more effective than pain medications, from what I gather from my patients!
I would not recommend a chiropracter -- I have nothing against the art of chiropractry, but feel that its efficacy is controversial.
I have actually seen more harm than good from chiropractic manipulation.

That is what I would suggest -- ask your family doctor or a neurologist for a referral to physical therapy.
Give it a shot -- if it doesn't help or you get worse over the next few months, ask to be seen by a spine specialist.

Hope this helps,
Best of luck,
JKL, MD