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SEVERE PAIN IN THORACIC AREA AND THE PAIN RADIATES INTO THE…

HI MY NAME IS*****...

HI MY NAME IS***** HAVING SEVERE PAIN IN THORACIC AREA AND THE PAIN RADIATES INTO THE RIB CAGE. THE INJECTIONS AND PAIN MEDS ARENT TOUCHING THE PAIN AND IM AT MY WITS END IT HURTS SO BAD...ANY IDEAS?

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

YES I HAVE SOME IM ALLERGIC TO...I TAKE OXYCODONE, PAXIL, ECT I CANT THINK IM IN SO MUCH PAIN

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Answered in 9 minutes by:
12/7/2017
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,933
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified

Hi,

Welcome to JA and thanks for this question. Im sorry to hear bout your symptoms. Can i ask what tests have been done so far? A MRI? NCS/EMG test? Also have you tried using any neuropathic drugs like lyrica or neurontin?

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Customer reply replied 7 months ago
im on lyrica and working on an mri which was denied twice, no idea why but I need answers now the pain is so bad I cant take it much longer

Does the pain also occur in the back of the thorax? Or does it start in the front and then extend into the ribs?

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Customer reply replied 7 months ago
its all in the back

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins. If you get a phone call request, that is an automated site response. I DID NOT send it. Thanks!

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Customer reply replied 7 months ago
its ok to talk im desperate
Customer reply replied 7 months ago
IVE HAD SEVERAL EPIDURAL INJECTIONS AND HPOS AT THE ER AND NOTHING HELPS
Customer reply replied 7 months ago
COULD IT BE THROACIC NEURITIS OR A PINCHED NERVE...IVE HAD SEVERAL FUSIONS IN LOWER BACK AND ALSO CERVICAL AREA

Actually, this does sound like a severe back issue with the spine which is causing the problem. It could be a slipped disc or even inflammation in the joints of the spine or even compression of the nerves in the spine. This would cause pain which is severe in nature and would radiate down to the ribs. Now since you have already gotten steroid injections and painkillers, the next option here is definitely an MRI, I don't understand why they are denying you this, it SHOULD be done and an NCS/EMG test should be done as well. Once that is done there are several options which can be implemented here which include,

Diathermy therapy

Ultrasound therapy

Laser therapy (Cold laser therapy or Low-Level Laser Therapy)

Interferential therapy - a type electrotherapy

TENS (Transcutaneous Electrical Nerve Stimulation) – another type of electrotherapy

COOLIEF Cooled Radiofrequency treatment

Calmare Scrambler Pain therapy (medical device)

Iontophoresis

Lumbar traction therapy

SMT (Spinal Manipulative therapy)

IDD therapy (Intervertebral Differential Dynamics Therapy)

Special forms of spinal injection treatments - PRP (Platelet Rich Plasma) spinal injection, Prolotherapy spinal injections, Etanercept spinal injections, Botox spinal injections etc

Chiropractor spinal manipulations

Osteopathic spinal manipulations

Acupuncture etc

All of these options can be used to control the pain, I would ESPECIALLY recommend radiofrequency ablation in this situation. This would destroy the nerves causing the pain and would result in pain-free time period of several years. ALSO, i would recommend TENS therapy which can be done at home.

Do you have any more questions? Would you like to discuss this further?

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I would suspect pinched nerves FIRST and then consider neuralgia which would be due to the nerves being damaged in the intercoostal spaces on the back. That can also be treated with radiofrequency ablation.

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Customer reply replied 7 months ago
IVE HAD THERAPY WHICH MADE THE PAIN WORSE. I ALSO HAVE A TENS UNIT WHICH DOESNT WORK. IVE HAD THE RADIOFREQUENCY WHICH DOESNT WORK EITHER. IVE TRIED ACUPUNCTURE AND ONLY BENT THE NEEDLES IN HALF WHICH ALSO DIDNT WORK. COULD THIS PROBLEM MEAN SURGERY?

Was a spinal stimulator tried? What about spinal pain implant?

If the above have been tried and they dont work, then surgery is the only option left but the type of surgery would be determined after a repeat MRI and NCS/EMG test

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Customer reply replied 7 months ago
I HAVE NOT TRIED A SPINAL STIMULATOR THAT I KNOW OF BUT DOC WANTED TO PUT ME ON A MORPHINE PUMP. THE RIGHT SIDE OF MY BACK ALSO FEELS LIKE SOMEONE SCRUBBED IT WITH SANDPAPER AND FEELS SO RAW, ITS HARD TO LAY DOWN BECAUSE OF THE PAIN BUT IF I CAN GET COMFORTABLE IT DOES HELP SOME SO I SPEND EVERYDAY IN BED MOST THE TIME.THE LONGER IM UP THE MORE PAIN I HAVE.

An implanted spinal morphine pump may be effective in the short term until a MRI can be done, i would go for that until a plan for a spinal stimulator can be considered or atleast until a surgical plan can be formulated. This way at the very least your pain can be controlled as it is obvious right now that the drugs are not working, you should NOT be in this much and it is imeprative that emergency measures be taken to control it. Whether that requires fentanyl patches, ketamine infusions or even morphine, the pain should be controlled.

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Customer reply replied 7 months ago
THE PAIN STARTED A YEAR AGO AND HAS BEEN SEVERE ONLY THE LAST 3-4 MONTHS. MY PAIN DOC WAS SPOSE TO CALL MY INS CO TO FIGURE OUT WHY I WAS DENIED, HES BEING SLOW TO DO PEER TO PEER AND I AM AT MY WITS END. IS THERE SOMETHING I CAN DO MYSELF TO HELP
Customer reply replied 7 months ago
IVE TRIED EPIDURAL PATCHES AND IT DOES NOTHING, MY REG DOC CANT HELP ME SO I AM DESPERATELY WAITING ON MY PAIN DOC

You can try using combination of meds which are available OTC such as ibuprofen at the maximum of 800 mg thrice daily PLUS OTC tylenol 1 g thrice daily WITH the oxycodone that you are on and have your doctor atleast iuncrease the dose of lyrica to the maximum possible which is 150 mg twice daily. If necessary have him add amitriptyline to the mix as well. Additionally try the following supplements which MAY help with nerve pain,

Acetyl L Carnitine

ALA (Alpha Lipoic acid) etc

Also herbal medications like,

Limbrel (Flavocoxid)

Noni concentrate

Nettle Root extract

S adenosyl methionine etc

Fentanyl patches are not epidural patches they are a slow release skin patch which causes control of the pain. They are STRONG opioids and usually work where oxycodone etc have failed.

I am sorry that your pain doctor is delaying this, you should not be in this much pain, he should atleast start you on a bridging therapy like ketamine infusions which DO work wonders for many patients.

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Customer reply replied 7 months ago
I WILL TALK WITH MY PAIN DOC ABOUT THESE REMEDIES AND THANK YOU SO MUCH FOR TRYING TO HELP ME. AND THANKS FOR UNDERSTANDING THE PAIN ISSUE WHICH MOST DOCTORS DONT GET.MAY I COME BACK IF I NEED TO.ITS JUST NICE TO HAVE SOMEONE LISTEN AND WHO GETS IT. AGAIN THANK YOU SO MUCH.

You can ask questions anytime. I was happy to have helped you in some way. I just hope you feel better soon, if possible do let me know when your pain is controlled. Ill be happy to know that you are pain free at that time.

You're welcome, do remember to leave a POSITIVE rating by clicking on the stars above your screen as that is how we are compensated for helping you today. Any BONUSES would be well appreciated!

Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,933
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified
Dr. Muneeb Ali and 87 other Medical Specialists are ready to help you
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Customer reply replied 7 months ago
I LOVE DR. MUNEEB...HE LISTENED TO ME AND UNDERSTOOD MY PAIN. HE GAVE ME CHOICES I HAVE NEVER HEARD OF BEFORE. THANK U SO MUCH FOR HELPING ME. SUE WRIGHT
You are welcome once again and thank you for the kind words.
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