T11-12 Herniation Question

[Shanti]

I was dx'd with a T11-12 herniation about 8 years ago. I have recently been having increased pain in that area along with different areas and feelings. Can someone tell me what areas of the body T11-12 frequently causes pain/weakness, etc. at?

I also have a herniation at L4-5 (9 yrs now) which I had surgery on 2x...pain is worse than before surgery. So I'm not sure which area may be causing this increase and changes. I will be seeing my Dr. soon, but wanted to get some feedback prior to have a bit more understanding of what I am feeling before my appt.

Thanks!
Tina

[Mark N]

Here is a link for a dermatone map that shows you the areas effected.

http://www.apparelyzed.com/dermatone.html

You should be having problems with bowel and bladders, gall bladder, and other organs in your lower abdomen.

[suede]

This is a really good chart I use too.
Linda

http://www.chiromatrix.com/Chiropractic_Website_Spine_Simulator/nerve_chart/index.htm

[Shanti]

Thanks so much for the replies :) I have seen and used both of those sites before, however, I was told by my surgeon back in 99-2000 (who is now retired military) along with my primary care doc at the time that the lower thoracic herniations can cause/mimic issues in the lower back and extremities as well (which could cause confusion, in my case, as to what may be causing what) along with the wrap around pain I was already experiencing...but he did not get specific and I didn't think to ask at the time since I was dealing with all the surgeries and such with the L4-5.

I was searching online last night and did find a few pages that said the same, although kinda vague. They did mention something about it affecting the inner aspect of the thighs, along with the very inner part of the buttocks, the groin, etc. So I was hoping someone here might be able to confirm or add to that.

I get MRI's every couple years to keep on top of things (due to additional spinal issues as well) so I'll likely find out which area is causing me these new issues, but my guess is that it is indeed the thoracic just based on how I feel things. My number one being that I feel pain from the T11-12 area shoot down, inside my spinal column (so it feels anyway), to the lower back/legs and such..along with increase wrap around pain in the lower ribs.

Here is a quote from one page I found and the link:

"A lower thoracic disc herniation can cause pain in the groin or lower limbs and can mimic kidney pain." http://www.spineuniversity.com/topics.aspx?t=e2017d1a959a7159fc3514414c705aa3

If anyone has more info on this or a page that is more specific, I'd appreciate it :) I like to be very informed before, during and after my appt.'s and such. :) Thanks so very much for your help!

Tina

[suede]

Tina,
Sorry I can't really be of more help.
I have had spine problems now for 8 years.
I have serious problems through-out my spine and nerve damage only I have had no surgeries as the Dr's have said that surgery would not help at this point.
I spent the first many years on line and going from Dr to Dr trying to figure out what was causing what and have finally just accepted that I hurt every where and always will, not really a bad attitude just acceptance..
I hope you are able to get the answers you need and the help..
Best of luck.
Linda

[Mark N]

Tina, it is true that it can mimic lumbar problems and I think it is because of referred pain down the spine. Our spine can effect any level from the bad level down although most of the symptoms will be associated with a particular area of our body. I think your wrap around pain and kidney pain is indicative that your thoracic spine is the problem.

[Shanti]

Tina,
Sorry I can't really be of more help.
I have had spine problems now for 8 years.
I have serious problems through-out my spine and nerve damage only I have had no surgeries as the Dr's have said that surgery would not help at this point.
I spent the first many years on line and going from Dr to Dr trying to figure out what was causing what and have finally just accepted that I hurt every where and always will, not really a bad attitude just acceptance..
I hope you are able to get the answers you need and the help..
Best of luck.
Linda

Hi Linda!

I'm sorry to hear about your struggles. I've been dealing with my issues for 9 years now. Mine started at age 25 and for the first year I kept being told I was too young, just had a baby and do situps because there was nothing textbook wrong with me. Turned out I had the 2 herniations, severe DDD & DJD (joint) and cervical spondy. I hurt everywhere as well. I fortunately have had great Dr.'s once I switched military clinics 18 months after I first started having pain. I've only recently found out that all my problems were "hand-me-downs"...LOL I've been blessed/lucky the last 6 years in that I haven't had to increase my OxyContin dose, but I think it may be time. It's a scarey thought for me because the clinic we are at now is a military resident program through St Louis University...which is good in many ways, but I get a new Dr. every 3 years and some are very scared of me...LOL I'm already at what most consider a high dose (80mg OxyContin 4x/day) due to not being treated soon enough in the beginning. It took them nearly 3 years to start treating me and (through tons of trial and error) we finally found the magic number and combination to give me my life back (90% of it anyway). Not only am I on the OxyContin, but Percocet for break-through, Klonopin 3x/day for muscle spasms, etc., and Ambien for sleep which also helps with my hip pain at night. I can't help but wonder how much less meds I'd be on if I'd been taken seriously in the beginning. And now I cringe every few years when a new Dr. comes along because I always get "the look". Fortunately, they finally got a civilian PharmD on staff and he has "OK'd" and approved my regimen and said he would be there support me and be my advocate in case I have any problems in the future.

Sorry to ramble on... I will pray that you are able to get relief in some form or matter. You deserve it! :)

Tina

[Shanti]

Tina, it is true that it can mimic lumbar problems and I think it is because of referred pain down the spine. Our spine can effect any level from the bad level down although most of the symptoms will be associated with a particular area of our body. I think your wrap around pain and kidney pain is indicative that your thoracic spine is the problem.

Thank you Mark for your reply! That's my thought as well. But I am also having leg problems...not just pain but sporadic feelings of weakness. My L4-5 has always been left sided (and so is the leg problem) but my T11-12 at last check was mid and right, whereas before it was just right...so I don't know if that is again getting worse as far as the position or if the lumbar is also getting worse. I know the T11-12 is getting worse in general, but I guess we'll see if it has spread over to the left. Argh! LOL

Tina

[Mark N]

Tina, it is entirely possible to have both of them acting up and causing problems. I ha my lumbar fusion while my thoracic spine was causing problems. My lumbar fusion came first because the majority of my symptoms were caused by my lumbar spine [discogram test]. Later I had my thoracic fusion as it got worse instead of improving. So you can see it is possible that both areas are giving you trouble.

[Shanti]

Tina, it is entirely possible to have both of them acting up and causing problems. I ha my lumbar fusion while my thoracic spine was causing problems. My lumbar fusion came first because the majority of my symptoms were caused by my lumbar spine [discogram test]. Later I had my thoracic fusion as it got worse instead of improving. So you can see it is possible that both areas are giving you trouble.

Hi Mark:)

I absolutely agree with you, and that is something I've been thinking also. I guess we'll see what happens with the next MRI. Problem is getting into the Dr. The military clinic here is so hard to get into with the residents only being in a few days a week.

Thanks!
Tina

[lucidmaster]

Shanti,

Dermatome maps explain so little when it comes to spinal cord compression in the thoracic cord as opposed to the nerve root compression herniated discs cause in the lumbar spine. I recently had surgery for a slightly left-sided T7-T8 herniation, and had all sorts of weird symptoms--all below that area. It all started with minor tingling underneath the left foot, but quickly spread to both feet, then to both legs, then to the groin, and then to the chest and the upper back. I've had doctors tell me the thoracic disc could very well be causing the problem, and others saying no way, there is something else wrong with you. My entire CNS was imaged and they could not find anything else wrong with me. After the surgery, I've experienced improvement, if not complete resolution, in ALL of the symptoms I mentioned above. In other words, it is a crap shoot, and in some cases, there is no way of knowing for sure without having the surgery. I know that doesn't sound right, but that's the way it is. There are no well established patterns that people fit into with thoracic cord compression. Some people have severe compression and no symptoms. There really aren't a whole lot of tests they can do to pinpoint the problem. Regardless, you should definitely have an EMG done on your legs to rule out peripheral nervous system issues. I am assuming they did extensive bloodwork on you to check for metabolic issues? It would also help to have an EMG done in your arms as well even if you don't have symptoms there to rule a polyneuropathy. Good luck!

-Ozgur.

[Mark N]

Tina, I have to back up what Ozgur has said about the thoracic spine but in your case you can have test to see what the lumbar spine is responsible for.

My thoracic symptoms were many and varied from my T8-9 on down. I had all the 'thoracic' pains - wraparound, mimic heart attack, tight band around abdomen, etc but also had no reflexes in my left leg, no feeling in either foot, drop foot with my left foot. Thoracic issues can be odd and many doctors suspect other problems. There have been many gall bladders removed when it was really a thoracic spine issue. You could be diagnosed as intestinal problems.

[lucidmaster]

Mark's right. There are tests that can help you with determining the involvement of the lumbar issues. Also, dermatome's are more applicable to thoracic issues when the herniation is lateral (to either side), where a specific nerve root exiting the spinal cord is clearly been compressed rather than the spinal cord itself. Then, there should be mapping between the compressed nerve root level and the corresponding dermatome. If the herniation is close to the center or midline, the cord is directly compressed and what I've said in my previous post applies.

Finally, it wouldn't hurt to get your brain and cervical MRI'ed as well if your insurance would cover those. Doctors are reluctant to order such extensive MRIs, but it's better to be safe than sorry in case there is something else wrong with you, or if you reach a point where you are considering surgery, you need to eliminate all other conditions that can be diagnosed through such scans before making a decision. I was initially kind of diognosed with possible MS, and wanted proof. They were first reluctant, but I pressed on, and the thoracic herniation was discovered.

-Ozgur.

P.S. I remember reading an article that published some distributions for what kind symptoms thoracic herniations are known to cause with what % of the patients. I'll try to dig that up.

[lucidmaster]

Found the article:

American Family Physician, May, 1992 by Thomas A. Wilson, Charles L. Branch, Jr.

http://findarticles.com/p/articles/mi_m3225/is_n5_v45/ai_12199654

Actually, the author is quoting the following info from a review article:

Axial and radicular pain: 60%
B/B issues: 30%
Sensory only: 15%
Motor only: 6%
Sensory & motor: not quantified, but stated as "at the time of diagnosis, majority of patients"

[jena1225]

Mark's right. There are tests that can help you with determining the involvement of the lumbar issues.

I have absolutely no help to offer, as I am a dummy when it comes to all this, sorry. But you have all the help you need with these guys :p

But I wanted to jump in and ask about the above... Ludicmaster, do you mean there are tests to determine what each problem that each of the Lumbar issues are causing? Also, would a Hemangioma have anything at all to do with T-Spine pain, spasms, etc...? Being that I have MS with serious T-spine pain along with the "L" issues, this is a dangerous question for me to ask, but I am a glutton for punishment I guess :rolleyes: Thanks!

[lucidmaster]

Jena,

Sorry, I don't anything about Hemangioma, so I can't offer a perspective on that.

As for lumbar issues: there are 2 tests that can be done.

1) An EMG. Nerve conduction tests can determine if signals are being disturbed as they travel up your limbs and up the nerve roots in your lumbar spine before they reach your spinal cord.

2) Discograms can be somewhat helpful in determining if a degenerating but not herniated disc is referring pain down your legs and so on, but I've read that they don't work for everyone. To the best of my knowledge, they are not effective in determining if a herniated lumbar disc that might be putting pressure on a nerve root is causing symptoms though.

Mark probably knows more about these tests though since he's had lumbar surgery as well.

Also, check out Chirogeek's webpage for more info on lumbar issues and tests:

http://www.chirogeek.com/

-Ozgur.

[Mark N]

I can only tell you what I went through with determining my lumbar issues. I had an EMG that showed I had some nerve impairment and then the discogram, after a fusion was decided on, was done to determine which disk were responsible and how much each one accounted for the pain and symptoms. Since my problems were IDD the discogram determined that two of the four bad disk accounted for 90% of my problems so the fusion went from a four level to a two level fusion.

The main thing is to not jump into surgery and have the test needed to pin down your real spinal problem. As Ozgur's said there comes a point that after you get all the info you can it will be time to make a decision and hope for the best.

[Shanti]

Thank you so much to all who have replied!! It helps me out a lot :)

Yes, Ozgur, I have had a complete scan. Just had a brain scan done a couple years ago along with blood work and all the other uncomfortable tests. But every 18-24 months I have a routine MRI to include the cervical spine all the way down to sacral simply due to the genetic aspect of everything, having issues in every section, steady deterioration, and the docs wanting to keep an eye on the T11-12 due to it being a critical area in the spine. They add extra tests after each scan depending on the results (how much has changed and my complaints).

This is where I feel very blessed with my husband being military. I feel I get much better care in general, even though sometimes there is a struggle to get things done and the stress of having new docs every 3 years. But overall, once I got a Dr. to believe me, I've gotten great care. I just wish everyone had the care I have gotten. This is one reason I actually choose to have a 1st year family practice resident everytime my docs leave. I want them to experience someone like me so that, epecially, when they get into the civilian sector there will be one less Dr. who doesn't understand "us" and feels more comfortable dealing with chronic pain patients.

Tina

[jena1225]

I can only tell you what I went through with determining my lumbar issues. I had an EMG that showed I had some nerve impairment and then the discogram, after a fusion was decided on, was done to determine which disk were responsible and how much each one accounted for the pain and symptoms. Since my problems were IDD the discogram determined that two of the four bad disk accounted for 90% of my problems so the fusion went from a four level to a two level fusion.

The main thing is to not jump into surgery and have the test needed to pin down your real spinal problem. As Ozgur's said there comes a point that after you get all the info you can it will be time to make a decision and hope for the best.

Mark, I had asked a while back if there was any way I could determine where most of my pain was coming from (bulge/herniation, DDD, IDD, Arthritus, Stenonis) but I think you had said there wasn't :confused:

But, are you saying that these tests are able to do that? Sorry, I am still not up on all this :o

[Mark N]

Jena, no I was saying there was no way to tell. Discograms are under suspicion about the value they have and the damage they can cause but if you have already determined to have surgery it can help determine the levels that are responsible for your symptoms. In my case, I had decided on a 360 fusion and my OSS used the discogram to determine which levels were needed to be fused because he didn't want to do the 4 level fusion that was indicated. The test showed 90% of my problems came from 2 disk and I haven't had much trouble from the other two during the past 11 years.

There are other test that can be used, with varying levels of success, to determine nerve impairment and other impacts from your spine.

I don't know of all the options out there, only the ones I have gone through and how well they worked for me.