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Thread: Cervical thoracic pain

  1. #1

    Exclamation Cervical thoracic pain

    Hello
    car accident in feb 09
    accuired at scene headache backache slurred speech inability to group words.
    Cleared at ER. Dailey HA back neck pain pins needles In arms loss of gag reflex.
    MRI shows low lying cerebral tonsils minor disc buldge In cervic area. No MRI of thoracic. Negative Braine MRI. No problems states nuerologist.
    Had dx of occipital neuralgia greatter and lesser negative
    spenepalentine blocks negative.
    Chiro for short period of time
    now D.O. since Jan 2010 With treatment of TOS, atlantoaxial lateral rotary. Cranial sacral therapy. Trigger shots. Sympathetic nervous sytem blocks. Cortisone on supraclavicular nerve. Now doing better with constant adjustment with cervical and thoracic area with aching hand and forearm. Gagreflex has returned. Slightly deviated hyoid from muscle spasm torticolis corrected. Now without adjustment on cervical and thoracic area I have droopy right eye with blurry vision, face feels droopy on right. Headache neck Paine occipital pain and pain in rt side of spine and scapula. All symptoms are unilateral on right. side.
    What questions should I be asking now? Syrinx? Decompression? Chiari? Just kind of loss. Medications are now discontinued due to progress with dr.
    Thank you for any input.

    Thatguy.

  2. #2
    thatguy. What specialists have you seen? Must have included a Pain Specialist who gave you blocks. Have you seen a Physiatrist or a PM and R doctor? Maybe they could take a step back from all the treatments you have and review the data and get a better picture of what is happening after this accident. Must be frustrating to have to go from treatment to treatment with so many doctors and therapists.

  3. #3

    Question Specialist seen

    I haven't been to a physiatrist note PM and R will have to research them. Unfamiliar with the names. I agree on getting a better picture of whole situation but that seems to be a big problem with seeing so many dr's. They all don't communicate with one another. Have seen ENT confirmed absent gag and lack of sensation in pharyngeal area. But that was a few months after accident. I have been to two different physical therapist but to no vale and added more pain and tight mucles.
    How crazy would I sound asking for full spine MRI and cine MRI. I have been down the route with antidepressants and thank the man upstairs to have them discontinued they only added side effects and didn't address the pain issues. It's confirmed structure issue.
    Only history is migraines since age 3. That were controlled with immitrex for the past 8 or so years until the accident. Then nothing helped.
    Thanks again.

  4. #4
    Also the MRIshowed retro odontoid with brainstem bending around it? But I guess not quite basiliar invagination in foramen magnum.

  5. #5
    I wonder if it would be best not to attempt to be your own physician, but rather to keep trying to find a physician, whether it be a neurologist or a physiatrist who you can have confidence in. Maybe you need to see where the nearest tertiary teaching hospital is that has a neurology department and try to be seen there.

  6. #6
    I agree it's the irritation of in and out appointments that leave PTA with many questions. Thanks again

  7. #7
    just wondering a few things here? the actual MRIs that were done? were those done immediately following the very direct trauma of that MVA? were there EVER any follow ups done to compare the immediate post MVA films to what just can and does usually take a bit more time to actually 'show up' after severe trauma when it even involves spinal, esp c spine? things really CAN change alot from the initial trauma films and like even a few motnths to like a year down the road once the always there swelling/inflammation and other levels of the spinal landscape just kind of 'settle down and in'? films done as a routine follow up to the type of trauma you suffered are just usually ordered by your doc usually down the road during that first year,at least? if these have NOT yet been done, they really should be just as a good comparritve? and getting that T spine scanned too wouldn't hurt just to see how THAT is? trust me here, it would NOT at all be 'crazy" to ask that your whole spinal just be scanned, esp the repeats done on the areas that WERE once scanned to see anything that should not be the way it is and how possible progression over time just can change alot of things within the spinal too?

    also in ANY MVA, you just are dealing with alot of different "forces and energies" and some opposite direction forces that just DO force your body to not only be impacted directly, but the way your body simply 'moves' during the initial impact and the rebound impact as well? its ALOT of direct and indirect and opposing forces being all taken in by your body. and if you were indeed wearing a seatbelt, that too would matter? esp with that lower T and lumbar area? while YOU are moving backwards with the hit in the upper, the lower is simply tending to actually move in the opposite direction. this is kind of how whiplash occurs too?

    hopefully, considering what symptoms were present immediately post hit, the responding FFs and medics stabilized you appropriately given the level of trauma? that really matters too, trust me. the overall impact and what any patient will actually end 'up with' as far as any levels of real injury just take in sooo many different factors that include the 'how" of what took place during the MVA, like how were you hit, seatbelt usage(and was that lap belt even actually ON the lap or more over what would be the bladder level like alot of people do?),how fast you were going,and how rapidly you just deceled among other things, and of course the first responder level care as well.

    one thing i am wondering about tho is the underlying reason for the sympathetic block? was this a stellate ganglion block that is done at the side of the trachea and for upper torso eval or Dx reasons or one further down the spinal somewhere that is actually done more like a simple nerve block? you did mention you had the 'droopy eye"? is that pupil actually at all more constricted than the right when you are not on any narcotics, or more importantly does the affected eye actually even react to light like the other eye probably would as long as it is not damaged? i am just wondering if you have a horners syndrome from what would be sympathetic nervous system damage that very easily could have taken place during your MVA given the way the symp just 'is' in that upper area within the neck and pops out at around c 8 nerve level then runs thru the T 1 on down OUTSIDE the spinal column and not 'in' it making it more vulnerable to injury?

    they just must have had a specific reason to even decide to actually do that type of block on you, thats all. i have horners in my L eye from MY SNS damage done so i have also ended up with RSD which i do use the symp blocks to help control pain for? RSD can just happen after having your symp system damaged.

    i would most definitely seek out a really good physiatrist at this point? these are very well trained types of more physical medicine docs who are very very good at knowing muscle and nerve and how it should all just work? they can even tell you ALOT about how your basic condition simply is by watching you walk and perform simple tasks. thats just how well they know the body and how it works. this would be a really good doc to see for your situation right now. and DO obtain the follow up MRIs there. that really IS rather important since they only know how you were THEN post MVA, but NOT how you really are down to that critical spinal level NOW? you do also have a ton of what really sounds like myofascial damage or at the very least here alot of overly tightened muscles from being in the 'guarded posistion' that has never been knocked out with something like a really good myofascial release therepist can do? i have been getting this therepy now for three years for the insane level of upper back and neck muscle damage i have from my cord surgery and them having to cut down thru all the thick and deeper muscle and also a seriously messed up c spine that keeps firing to the fascia surrounding the muscles which is what creates the "wads" of contracted muscle in the first place? but this is what I would do if i were you right now at least to start getting kind of back on track and best define things? you also have questionable chiari that needs another looksee too just to see if the level IS indeed chiari or is simply also placing some level of real compression upon your spinal cord too? so the MRIs really ARE a needed thing for you for a ton of good solid reasons. just find out THAT much from the MRIs and let that kind of dictate what comes next? just be very very careful if you are seeing any chiro for any adjustments upon your c spine, esp with the possible chiari there too?

    but DO work on obtaining the MRIs right now and see what shows up. that is what really needs to be seen and found out in order to best gear any real treatment options. i wish you lots of luck with this. please keep us posted on anything you find out TG. marcia

  8. #8
    Thank you for your input! The xrays were done day of accident. MRI done about 2 months after on cervical and brain MRI 7 moths after. no follow ups since for images. Except barrium swallow scan. 3 months after accident.
    The stellate ganglion is what I believe was done. But with local anesthetics to right and left of trachea and under jaw rt side. Before I seated seeing the D.O. I had opposite pupils with minimal reaction on rt side but pain management at the time said cluster headache. I was referred to my regular eye doc for followup and he said it's from muscle relaxers and antidepressants. Not once was I on any narcotic due to levels of pain being so high in cervical area. Just antidepressants muscle relaxors and triptans. Now bently for ibs.
    I have been experiencing a lot of pressure in tailbone afteradjustments. I was reading very interesting things dr young posts about tethering. I learned quickly that the chiro had nothing for me with the trauma produced to get movements on the tight muscles. Which only provides a traumatic muscle memory.
    Thanks again take care.

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