I am new to your site, found it through another site while looking for answers or ‘ideas’ at least on the internet. I am not looking for a diagnosis on the net, obviously. But would really appreciate ANY feedback anyone could give me about the symptoms I am having & the state of my spine, and any correlation between them. (MRI & CT Myelogram results are at end of this post if you want to skip to that first!)
I do not know what tests or type of MD to seek out anymore. Have seen Ortho, Neuro, Urologist, Gynocologist over the last few years. No one has an answer nor do they seem to really care what the cause of the symptoms is, just medicate them. That is just not me or my feelings on how to use medications. (or I could just 'live with the symptoms as is'...or believe everything is just all 'in my head'!! ) But I really would like to know, if at all possible, WHAT is causing these things!! I have lived with it all long enough. (yes, some testing has been done, but seems there should be more than can be done to get an actual diagnosis) Are they all related in some way or different symptoms & different causes? Should I go back to an Orthopedic MD? Could all these symptoms be spine related? Should I continue with or seek out a different Neurologist opinion?
I know this is a super long post, but I feel that you need as much info as possible to be able to relate to or understand what is going on with me. I know this is a SPINE board, so feel free to only comment on that aspect of the symptoms, but I am giving it all to you incase it helps in any way..or sounds familiar to anyone else. (Especially: Could the condition of my spine & ‘neurological’ symptoms be related. What about the tingling that the Ortho dismissed as not spine related?)
Any suggestions or ideas on what I should do next or what the cause(s) could be would be GREATLY appreciated. I would at least like to have peace of mind to know that I left no stone unturned! THANK YOU!!!!
Starting within the last 1 ½ years, I have also noticed...
- 40 y/o female. 100 lbs overweight. Fairly active, gym 4x week, square dancing etc. (yes, I am an emotional eater!... but I am as active as I can physically be)
- No known injury that can be 100% accounted for causing symptoms/back injury. Was in car accident many years ago, but not believed to be the cause.
- Long standing upper back pain (about the level of my bra strap in the back, and in between my shoulder blades). Most noticeable/bothersome in the last couple years.
- 10+/- years with an area of decreased sensation (numbness) on the left side of that same area (mid back, left of spine, about shoulder blade level & lower, covering an area about the size of a large mans hand) Seems to be increasing in size recently.
- Occasional sharp pains in and around the spine in that area, but mainly the pain is an intense ‘ache’ of the upper back region.
- Pain increases significantly with activity that involves using my arms, such as driving, folding laundry, washing dishes etc. I can barely tolerate anything that requires use of my arms and holding weight combined, such as holding an infant or child, even of newborn weight.
- Electrical Shocks into & around the urethra area. No cause found by urologist after IVP & exam. First noticed about 2 years ago.
- Few other long term concerns, like trouble with my memory & such, but highly doubt they would be related to my spine.
(Most of these symptoms...except walking/balance that stays all the time..seem to come & go around same time periods)
(I explain the tingling in detail because the Orthopedic MD used this to say that the tingling was not related to my spine based on how it was in hands AND feet at same time & was random in WHERE the tingling occurred in hands/feet, then referred me to a Neurologist)
- Numb patches on skin in various areas.
- Muscle twitching all over my body, many many times a day!
- Vibrating sensations in my legs & deep in my torso area (also in my spine when I bend my back forward, like to touch toes)
- Burning/itching areas that often turn out to be numb patches on my skin
- Balance/Coordination problems. (difficulty tandem walking, sometimes feeling like I may fall when I move but no dizziness ) I have been able to grab onto something a few times & kept from falling that way. Balance is worse in dark or with eyes closed.
- Difficulty walking at times, as in I feel like I have to force my legs to move. They feel heavy & stiff at times, especially after sitting/laying down. My R & L legs feel different, like one is weaker & that the R legs hits the ground harder that the L & with a thud sound at times.
- Hands & feet tingling. Comes & goes, as in it may last for a few weeks, go away, then come back again in a few weeks-few months. When the tingling returns, it is in my hands & my feet...it is connected in some way. Not that the hands & feet tingle at the same time literally. But if during a time frame my feet start to tingle, my hands will start tingling also. The tingling is ‘random’ in that it does not just affect one part of the hands/feet. It is all over; maybe a toe & finger, than bottom of foot completely, then 3 toes, palm of hand, one spot on a finger, a spot here & there on my feet etc.
- And although this may be ‘way out there’, I would love to know if anyone thinks there could be a connection between ‘whatever is going on with my spine or whatever is wrong with me’ and GI symptoms. I have had 4 ½ years of food regurgitation (spontaneous) that happens most often after I eat a meal. It does not burn. I just feel food coming back up into my throat, sometimes enough that I have to swallow again. Lasts a few hours usually. 2 Upper Endoscopies & no answer for cause yet. GERD meds & diet are of no help.
- 2 epidural injections in the T7-8 area, with no pain/symptom relief.
- TENS unit & a muscle stimulator of some sort that was to relax the back muscles. Neither device offered me any relief, and in fact the TENS unit caused sharp pain where the nerves were being stimulated, even when on low intensity. Unable to tolerate the use of these units.
- PT Evaluation done (one visit). Was told by therapist there was “nothing they could do” to help me.
- Orthopedic MD. Over time ordered- MRI’s, CT Myelogram, TENS unit, etc. Final visit he said “No need to come back, I have nothing to offer you”. Suggested pain management in the form of a ‘medication cocktail’ of some sort (pain med, muscle relaxant, anti-inflammatory, antidepressant etc.) The antidepressant would be to help with the side effects of the other medications he said. I chose NOT to go this route!
- Evaluated by an Orthopedic Surgeon (only MRI’s at that point) who said I was not a surgical candidate. “Thoracic surgery was too major of a surgery unless I was paralyzed.”
- Referred to Neurologist for hands/feet tingling. He suspected MS. Ordered Brain MRI with contrast, ‘negative’ but did show "There is a small nonspecific focus of abnormal white matter signal in the left frontal region" Had negative EMG & NCS. Normal blood work. No other testing done, no new MRI’s of spine with contrast etc. No explanation for symptoms found. Balance/Coordination problems attributed to ataxia, as I have positive family history. (SCA & FSP diagnosed in my half siblings..or maybe they really had something else, including possible MS. No one knows for sure, no genetic testing done on them)
- Seen by a Urologist for the above mentioned Electrical Shocks.
MRI & CT Myleogram results:
(Myleogram was done about a year after the MRI's)
MRI CERVICAL SPINE WITHOUT CONTRAST
TECHNIQUE: T2 sagittal, T1 sagittal, T2* axial, STIR sagittal
The cerebellar tonsils terminate above the foramen magnum. The spinal cord demonstrates normal signal & caliber throughout it’s visualized course. There is straightening of normal lordotic curvature. The vertebral body heights & alignment is normal. The bone marrow signal is normal throughout.
C2-3: No disc protrusion. Spinal canal & neural foramina are normal.
C3-4: There is a small posterior disc osteophyte complex. The spinal canal is mildly narrowed to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes, slightly more prominent on the left.
C4-5: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is mild narrowing of the bilateral neural foramina secondary to uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.
C5-6: Small broad posterior disc osteophyte complex is present, which narrows the spinal canal to 8mm. There is moderate-to-severe left neural foraminal stenosis uncovertebral osteophtyes. Mild right neural foraminal narrowing is present.
C6-7: Small posterior disc bulge is present. The spinal canal is mildly narrowed to 8mm. There is mild-to-moderate left neural foraminal narrowing. The right neural foramen remain normal caliber.
C7-T1: Disc, spinal canal, neural foramina are normal.
The facet joints are unremarkable. Congenitally short pedicles contribute to multiple levels of spinal canal stenosis as described above.
1) Multiple levels of foraminal stenosis as detailed above.
2) Multiple levels of mild spinal canal stenosis secondary to small disc osteophyte complexes and congenitally short pedicles as described above.
MRI THORACIC SPINE WITHOUT CONTRAST
Technical data: Sagittal T1, sagittal T2, Sagittal STIR, axial T1, and axial T2
FINDINGS: The vertebral body heights are maintained. No compression deformity is visualized. There is no evidence of bone marrow infiltrating lesion. No edema is visualized on the inversion recovery weighted images. There is a small Schmoral node involving the inferior endplate of T7.
There is focal kyphosis of the thoracic spine centered at T7-8. At this level, there is a central disc protrusion/disc osteophyte complex measuring approximately 4mm in AP dimension. This causes moderate spinal stenosis with the AP dimension of the spinal canal measuring approximately 5-6 mm. There is no neural foraminal narrowing. The disc does abut the ventral surface of the spinal cord at this level; no abnormal signal intensity of the spinal canal is seen.
At T6-7, there is a small, 2 mm right paracentral disc protrusion. There is no neural foramen narrowing or spinal canal stenosis. The AP dimension of the spinal canal measures approximately 8mm.
At T9-10, there is a 1 mm right paracentral disc protrusion without evidence of spinal stenosis or neural foramen narrowing.
The remainder of the visualized thoracic disc spaces appears unremarkable.
Focal kyphosis at T7-8 with a broad-based central disc protrusion causing moderate spinal stenosis at this level. The focal kyphosis causes a kink in the spinal cord best visualized on the sagittal T2 weighted images. No abnormal signal intensity of the spinal cord is present.
MRI LUMBAR SPINE WITHOUT CONTRAST
TECHNIQUE: T2 Sgittal, T1 sagittal, T1 axial, T2 axial, and STIR sagittal.
Conus medullaris terminates normally at L1-2. Nerve roots are normally configured within the thecal sac. There is normal vertebral body height and alignment. The bone marrow signal is normal throughout.
L5-S1: There is no significant disc protrusion The spinal canal and neural foramina are normal. There is severe hypertrophic degenerative disease of the facet joints bilaterally.
L4-5: Broad posterior disc protrusion is present measuring 3-4mm. A periphery of abnormal signal intensity represents a small annular fissure. Moderate left foraminal stenosis is seen. There is mild-to-moderate right foraminal stenosis. The spinal canal is narrowed to 7mm. Small amount of CSF is maintained surrounding the nerve roots. There is severe hypertrophic degenerative disease of the bilateral facet joints, which contributes to the spinal canal stenosis. Additionally, there is moderate left lateral recess stenosis and mild right lateral stenosis.
L3-4: No significant disc protrusion. The neural foramina are of normal caliber. There is mild narrowing of the spinal canal to 8mm with CSF maintained surrounding the nerve roots. Sever bilateral hypertrophic degenerative disc disease of the facet joints is present, which contributes to the spinal canal stenosis.
L2-3: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.
L1-2: Disc, spinal canal, neural foramina are normal. There is severe facet arthropathy.
T12-L1: Minimal disc bulge is present. The spinal canal and neural foramina are normal.
1) Mild degenerative disc disease, most pronounced at L4-5 with protrusion and annular fissure.
2) Bilateral neural foraminal narrowing and lateral recess stenosis at L4-5.
3) Mild spinal canal stenosis at L3-4 and L4-5
4) Severe facet arthopathy throughout the lumbar spine.
From a CT Myelogram that I had late last year, I have the following info available. I do not have the full report on hand that would say how it was done etc. I had only typed up this info as a comparison with the Thoracic MRI:
At T6-7: 2 mm right paracentral disc protrusion creates a mild impression on the right ventral cord. However, overall the spinal canal remains of adequate caliber. There is no associated foraminal stenosis.
T7-8 A central disc/osteophyte complex measures 4 mm in AP dimension resulting in a flattening of the ventral cord with reduction of caliber of approximately 20%. The spinal cord measures approximately 4 mm in AP dimension. A small rim of contrast remains surrounding the dorsal cord. The spinal canal measures 5 mm AP. The neural foramina remain normally patent.
T9-10: There is a 1-2 mm right paracentral disc protrusion resulting in a minimal flattening of the right cord. No significant central or foraminal stenosis is present.
The remaining disc levels demonstrate no evidence of significant disc protrusion or foraminal or central stenosis.