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Avatar universal

t8-t9 disc herniation

I have been diagnosed with a large disc herniation at t8-t9(MRI).  I have pain radiating around my rib cage which is relentless and frequent muscle spasms around the disc area.  I can barely use my arms as it aggravates the problem and sets me back.  My surgeon had informed me that the surgery is very complicated and dangerous and does not want to do anything unless he is sure this will not improve with time.  He also infomed me that 3 out of 4  of these herniations will get better on there own without sugery.  Has anyone gotten better with one of these, has anyone had the surgery?  These are rare and no one seems to be able to give me answers.  I don't know if I should be active or do nothing, physio is giving me mixed messages and state they have never seen one of these before.  
163 Responses
Avatar universal
Wow, seems like I have been searching forever to find someone with a very similar problem. I have had this problem since Jan/09. Mine started with pain radiating around the rib cage down thru my stomach, when the pain eased up I felt frozen down my whole right side starting at the rib cage + going down to my toes. Things have gone from frozen to numb, spasms, sensitive skin, pins + needles, tightness in hips + pelvic area, but not much pain except the pain around the rib cage. I find I am feeling very tight in the right hip on walking +then a tight, numb ,very uncomfortable feeling sets in. I don't like to go shopping anymore.  I am seriously thinking about surgery.
When I think about how I felt a month after mine happened, yes you very well could improve without surgery. They try non-surgical treatment first.

I have not had much success with my physio, but everyone is different.
Are you on meds?
This is a very rare place for discs to herniate + no one seems to know too much about it.
I was told the same by my surgeon-about complicated surgery.
Good luck. Would like to hear how you are doing.

glue

Avatar universal
I have 3 bulging discs in the thoracic region which were discovered by MRI ordered by my family physician. Dealt with the pain every day solidly from December 08 to May 09. Physician referred me to a pain management clinic, but I haven't gone yet. The pain subsided in late May. Being ignorant of the nature of bulging discs, I thought this was the end of it and began a rigorous daily exercise schedule--felt great! 2 weeks ago, was doing a new exercise: lying flat on my back, lifting 5 lb weights straight up. No problem--until the next day. Severe pain in my right chest area directly under breast. (this was where my most severe pain was when I had this problem back in December.) Pain every day, NOW add to that a pain in my shoulder blade area, plus the chest/breast pain is spreading to the left side of my body. At times, I feel tingling skin in various places on my back, pins and needles type of feeling too. Sometimes, even while showering, the water spraying will "hurt" in these pins and needles areas.

Is it true that there is no cure for bulging discs? Surgery is out of the question for me, as I haven't even tried the physio yet. But from the other sources I've read on internet researching, physio is rarely effective for this problem. I sure don't see a lot of talk about thoracic disc problems. Is this condition hopeless? I shudder to think of living with this pain (or worse) for the rest of my life.

tmorgan
Avatar universal
Hi I am wondering how you are making out?  Not much has changed for me.  I did see my specialist + discussed the surgery required. I am thinking "second opinion" in hopes of a less invasive surgery.
Hope you have a good Christmas +  a healthy New Year.

glue
Avatar universal
I hope you give a DIFFERENT physio a chance--one who is more experienced in thoracic. I went to physical therapy beginning early November (2 months ago). WHAT A DIFFERENCE. The bulge that was pressing on a nerve has subsided according to the spine doc. What remains is the pain from ribs and muscles that have been trying to "take care of" the spine problem by shifting/moving/being pulled by muscles. My physio has concentrated on the ribs and muscles in the painful area. I can say without a doubt that I've seen much improvement. I even have pain-free days. Please, I encourage you to seek out this muscle/rib correlation and have your physical therapist work on it. I've also had traction and this feels good as well. There IS hope that's non-surgical. Please let me know how it goes with you.

tmorgan
Avatar universal
Thanks for your letter, am glad things are going better for you.
My situation seems to be different than most- I do not have as much pain. I have  more problems with  numbness + walking now, can't lift much either.  As long as I do not use my right side too much the pain stays away.  Physio seems to enhance the numbness. I seem to improve more by doing  some back strengthening exercises & doing as much in a day as I feel able.  I am not able to go to work which I miss very much.
Anyway I am hoping my Dr. will give me a referral to a spine clinic  that I have heard good things about.
What geographic location are you in?
Are you on any meds & if so are they helping?
Take care. Happy New Year
glue

Avatar universal
I'm so sorry to hear that physio only enhances the numbness. And not being able to work has to be awful. I did go to a spine doctor. She wanted to put me on anti-depressants which supposedly help for back pain. I didn't want that type of drug so requested the most conservative approach possible to start out with. She gave me mobic, which is a non-steriod anti-inflammatory. I can't say I felt any difference from this at all. Taking nothing else. I'm in Missouri, where are you located? Are you on any meds at all? Have you got referred to the spine clinic?

take care
tmorgan  
Avatar universal
It seems anti-depressants are very popular for herniated disc problems. I am trying gabapentin which seemed to help almost immediately, but not anymore. I really don't want to increase the dose because they all have their side effects.
I am on the prairies in Canada, our nearest spine clinic is 5 1/2 hours away. I am seeing my family Dr. tomorrow to make arrangements to go there or at least get a second opinion on the surgery.

Avatar universal
I'm post surgery from spinal fusion at t8/9 and t9/10 on Dec. 4th.  I'm on Gabapentin as well, I don't believe it is a antidepressant, my understanding is that it is a drug for nerve pain.  I'm on morphine LA and Perkoset as well.  I will be 5 weeks since my surgery as of tomorrow.  I am slowly getting better, and hoping for a full recovery.  I was told 3-4 months to recover and 6 months to get right back to normal. Time will tell I guess.  I'm in a lot of pain now, I have to sleep part of the night in a recliner.  I have my first checkup on the 21st of Jan. to see if my fusion has started.
Avatar universal
Gabapentin is not an anti-depressant, that is why I chose to try it rather than amitriptyline.
Before your surgery, was your surgeon  quite optimistic  that you could expect full recovery after surgery?    I  left with mixed feelings from mine.
Do you live in the same city where your surgery was done?
How is it to travel 3 - 6 hours?
Thanks, I appreciate all your info!
glue





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1147125 tn?1265118365
I have a herniation at the  T7-T8 with a hemangioma at the T-7 T-8 as well.   I have gotten NO answers.  My Neuro set me up with an appointment to see a surgeon.  I have not be able to get ahold of any one to answer my questions my neuro cant see me for 3 weeks. The only thing I have been told is that I was put on a priority list for the surgeon and it was the secretary who told me that.  I had MRI 2 weeks ago and go see surgeon next week.  Is it only t8-t-9 that is rare or are any herniations in the thoracic spine rare.  I just dont understand why I can not get answers.  It says on my MRI My thecal sac is decreased by 50% I dont even know if this is bad. I am so sore and so frusturated and scared of surgery and dont know what to do
Avatar universal
Any thoracic herniation is rare, mine was the result of a bad ski accident.  The problem with surgery is that it is risky and complicated to get to the spine because they have to perform a thoracotomy.  In my case they had to collapse my lung as well.  I really did not have much of a choice as far as surgery because I had very little use of my arms.  I was too young to live like that for the rest of my life.  I hope I fully recover from the surgery, but it is only been 5 weeks since the operation so it is too early to tell.  I was told it would take 4-6 months to fully recover.  The surgery is very painful because of the spreading of the ribs, also the fusion donor site was my ribs as well so that hurts too.
1147125 tn?1265118365
My gosh, I had no idea the surgery was so invasive ! I feel bad for what you are going through.  My right shoulder always feels like it has been smashed and the arm always aches into the hand although it wasnt injured in the car accident that caused my back issues. I hope my surgeon has some other suggestions for me that will help before having all that done. Physio did not help. I truly wish you a fast and full recovery.. im still shocked as to what you have gone through, I had assumed they went in from an inscision in the back had no idea it involved ribs and.....i just really had no idea it gives me the willies.
Avatar universal
Hi !  I am wondering how you are all doing.
Am waiting for a second opinion, hoping to hear something soon.
Avatar universal
I had the same surgery you had!  Mine was to remove the calcified herniated disc between the T-7 and 8, and insert a piece of rib harvested from me so it could fuse the two together.  My surgery was urgent because I was stricken with near paralysis in the middle of the night.  Luckily, my spine surgeon is in my hometown and he is very good.  He confidently performed the mini thoracotomy and fusion by going in on my left side beside my breast.  They did not have to cut the lat muscle, thank goodness, because that would have left more pain afterwards.  There were no problems.  I am 6 weeks out from the surgery and am s-l-o-w-l-y getting more feeling back, but still am limping around.  I was unable to walk because my left side was so very bad, but now I have gotten so I can walk, but am still numb from the breast down.  How are you?
Avatar universal
Hi,

How is your recovery going.  I am going to see the surgeon tomorrow to review my catscan results.  I'm up and down with the pain, I'll be manageble for a few days and then sore for a few days.  It seems to be changing all the time.  It is a slow recovery for me.  How did they get around your lung?  Did they put a plate in as well?  Sounds like you had quite the ordeal too.
Avatar universal
Hi,

  It is nice to find some other people who are having the same problem as myself as I also have a problem with my T7-T9 region. I have been on the anti-depression medication for a couple of years now and find that it works well as long as I only take it when I am in a lot of pain. The more frequently you use it, the less effective the medication is.

Does anybody else find that sitting at a desk aggrevates their back and leads to a lot of pain?

Katie
Avatar universal
i have a sever hernated t8-t9 pressing on the nerve root a small L3-L4 herniation and bulging L-5 S1 cant sleep went from a size 8 to 1 slim in for months i have trouble sitting standing cant bend backwards at all and i have been going  threw this since last nov had pt makes it worse pain injections dont work and im scared and been of work with 5 daughters i feel helpless.
Avatar universal
Have any of you tried chiropractic care for your thoracic issues?
Avatar universal
Just some clarification: disc herniations/protrusions etc tend to clear up spontaneously over a generalised peiod (nothing specific) between 6-24 months and is why healthcare professionals and certainly surgeons only wish to operate, as a last resort. I.e. the problem will usually resolve whether you receive physiotherapy, perform stability exercises or stretches or, arguably, whether you chew gum on the left side of your mouth every other two days....the end outcome is the same regardless of any intervention......In the MAJORITY of cases.

There are exceptions i.e. the minority, which is when surgery is more apt. Such cases occur mainly when people start to experience problems of muscle function. Generally, surgery is only directed towards pain if the pain is that bad and persistent, hence why the preferred route for pain is medication, especially nerve-pain medications e.g. gabapentin & pregabalin. These act to take the 'edge' from the pain, to allow a little more relative rest/relaxation and might be combined with muscle relaxants e.g. diazepam/amitriptyline (generally: daytime/night-time use...from my understanding: I'm a healthcare professional with limited knowlegge of this but, pharmaceuticals are not my area of expertise). Other medications might also be used e.g. anti-inflammatories (especially if an injury has recently occurred) or other medications aimed at pain e.g. paracetamol/codeine phosphate etc. It is your doctor's responsibility to put the drug to the diagnosis. Pharmacists have a greater understanding of which drugs interact with other drugs and in which way and therefore tend to advise patients or doctors when one medication might interfere with the working of another and which, if any, alternatives might be more suitable.

An important note pertains to detrimentally labelling medications with 'good' or 'bad' connotations e.g. Amitriptyline acts as a muslce relaxant, in order that people can gain sleep. It is also used in mental health for the some of the same reasons: to help relax muscles which have become tight e.g. due to stress/fear. The importance is not labelling a drug as e.g. 'a mental health' medication, rather than 'a medication', like any other; in this instance, the objective is the same: for the person to gain greater sleep.

Physiotherapy for many of these cases is to descrease muscle disuse occurring and therefore help muscles maintain flexibility and strength and thereby help keep a joint mobile.
It can also be argued that physiotherapy acts as a stop-gap, i.e. it takes up some of the time (6-24 months) during which the problem should spontaneously resolve regardless of what happens. The use of physiotherapy from this perspective, I used to think was a poor one but, this came from my own inadequacies of knowledge at that time. I think as long as I am able to determine what is wrong (diagnose) and provide a brief genearlised knowledge of the likely prognosis (i.e. what might occur as a result of the diagnosis), then I am able to offer people informed choices regards which, if any, options are available to them.
Unfortunately, with approximately 5-10% of disc problems, at any level (within the spine), people are in a significant amount of pain for a non-specific amount of time. Guiding people to 'wait' is clearly not a great option but, if provided with knowledge of the options avaiable, the risks of these options versus others and, what to look out for (regards a large negative factor which would sway a persons' prognosis towards e.g. surgery) and how to act should that occur (i.e. attend your doctor or accident/emergency dept), then maybe I've done my job, eased a person's fears and given them some ideas on how their pain might be reduced by movement/exercise, different postures and medications.

I hope this clarifies. Should anyone wish to dispute the above, please do so but, try to do so responsibly, as other not-so knowledgable people will look at these inputs to cyberworld and may take what you have to say literally. The above, from my perspective is to be used as a rough guide. It was 'placed' here due to the clear lack of knowledge from other inputs.

R.
1043790 tn?1297008244
Wow, this is the best thoracic forum thread I have found yet, so I feel obliged to contribute knowledge of my experiences.

I have had problems above and below T8. Tried different chiros, chinese doctor but nothing took pain away better than swimming. Chinese back doc did do a great job of grinding out dead blood/scar tissue under the skin of my back with his elbow though. That helped me get more than 5-6 hours sleep per night. How many of you have that problem, excruxiating pain at 6am or earlier - before the hot shower????????  

I get that same pain radiating around the ribs and 'hot poker' like shooting pains that some our you mentioed already.

My cause was a rugby injury about 1997. After comparing 2009 MRI's pre-swimming and a year later (swimming about 5km a week on average) I came to the conclusion there is no natural cure.

The doc said the future risk for me was nerve damage. Naively I asked how I would know if I have nerve damage. Yeah...he said I would clearly know, and it was irrepairable(**** is that even a word?)

Just had a costotransversectomy(that is a word) 2 weeks ago. Involved the doc making a 60mm cut, making about a 5mm hole in one of those knobbly bones near rib end, then cutting out T7/T8 herniated disc between spinal cord and vertabrae. 2 hours surgery.

I walked out of hospital 2 days later (1 day ahead of schedule). Doc said I had initially recovered quicker because i wasn't operating in an emergency situation, rather he referred to the planned op scenario equating to faster recovery.

Scar healed and plaster fully removed after 12 days, swam 650m after 13 days, 1km today after 14 days.

Still alot of pain sitting, especially with any hint of poor posture and also becuase I am off the post surgery drugs now. Pain still subsides as usual after swimming but the location feels 'lumpy'. Touch it and it feels numb like a local anesthetic, which I guess is a result of surgery.

Based on how I feel now, only time will tell the truth, genuine success story or not?

I have decided that I will continue the swimming regime, have another MRI in 12 months and reconfirm whether to do the remaining T8/T9 disc problem also.

NOTE the doc said its too risky to do both discs in a single operation, he didn't feel comfortable about that idea. Remember that finding a doc that has experience with this type of rare surgery is a sure bonus. My doc/ ie.specialist back surgeon said he has done this surgery less than 10 times over a period of 5-10 years. Definitely ask.

Learn yourself online, thoracic cases are rare, approx. 1 in 1,000,000 diagnosed anually, 1 in 5,000,000 for multiple thoracic disc. Read the case studys and you will discover there's about an 85% sucess rate, 5% of ops will have no benefit/end worse off, 5% end in neurological problems, 5% end in mortality.

Seriously people, I hate swimming, but definitely recommend doing it. The pain relief from swimming (freestyle) is equal to taking NSAIDS. I started off swimming 6x lenghts of an 18m long pool, stopping at each end, I was useless - so have faith, you can do it too.

Hanging from monkey bars for 30 secs once a day helps too.

Avatar universal
I have a herniated disc at T8 along with several other herniated disc in the lumbar. I was wondering if you guys have lots of pain around the rib cage and around the sternum.
539478 tn?1296624612
I have 4 herniated discs in my thoracic with the worst ones being at t7-t8 & t4-t5 as well as many micro fractures, schmorl nodes, etc. (my updated journal post on my back issues is on my profile page if you want all the details). I can relate to everyones pain/issues/concerns. My pain began there over a year & half ago & although I've stopped teaching fitness classes due to my back injuries, it is only getting worse at 7/8 4/5 areas. It radiates around to my ribcage & hurts so bad I feel like I'm having a heart attack & I cannot breathe or even stand up straight & I throw up with the pain. The 'attacks' began gradually & now they are frequent &  I'm even having them in the middle of the night. It's begun affecting my bladder & I have numbness around my ribcage & foot. My sleep is affected - my whole life has been affected!

Doctors won't operate due to the location & I am at my wits end with pain. I've tried everything the professionals has suggested (inversion table, epidurals, facet joint injections, chiropractors, physical therapy etc etc). I'm a personal trainer so I try to lightly work out regularly to keep my muscles strong but I find I can hardly work at all now due to the constant pain. I'm in the same boat as most of you all & I know exactly what you all are going through. If anyone has heard of any other treatments or good thoracic back doctors (I'm in VA) please let me know!!

Good luck to everyone & try to hang in there...
1043790 tn?1297008244
I'm 6 weeks post op now. All is going quite well I believe,  Seen the doctor the other day who said to expect post op pain for about 3-6 months. He prescribed some Tramadol which seems really good, I'm dropping a 50mg cap once a day before bed.

Have also been outstanding in self motivating myself to stick with some swimming therapy.

Trust me people, swimming can help you alot, probably won't fix your problems but it definitely helps as a natural painkiller. Give it a go, nothing to lose and feel free to abuse me if it doesn't work.

539478 tn?1296624612
I'm glad everything seems to be going well after your surgery. Where (or who) did your surgery?
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