Dr Steve...question about hemangioma

[krashleen]

we have chatted before about about chiari malformation, cranial cervical instability which I have had surgery for.

I have had problems since a MVA in 1987 which I was rear-ended with me being the recipient of a whiplash. I have MRI's which reflect a hemangioma in the t9 vertabrae space. I have much pain in that area, significant enough that I cannot stand upright at times. I try yoga, pilates, gentle stretching nothing really works without causing additional flare ups in my pain levels.

All my protestations of this possibly causing me additional pain in that area..which btw there is nothing else in that area that could be causing me pain.
What should I do next? Does hemangiomas cause pain? The size of the hemangioma, I am not sure..I tried to find the MRI report, but I have sooo much paperwork...well its buried pretty well. I want to say its around 4mm but not sure, it could be more or less. Could it cause problems?

[tenesma]

hemangiomas are not painful...

most people have them to one degree or another

[Maggie]

I'm not Dr. Steve, but, if the hemangioma is large enough that it causes a displacement of tissues there seems to be a likely possibility that this could cause pain. I've not run across any studies regarding this, but, I don't read a lot lately.
Maybe the Dr. will come along later and enlighten us.
Maggie

[BrokenBladder]

Good question and I hope Dr. Steve will give us an answer. I'm sorry that you're having to endure this pain.

[lobelsteve]

Sorry I've been away so long. Too much work, not enough free time.

Hemangiomas are generally not painful. They cannot displace tissues if they are in the body of a vertebrae.

Thoracic pain is difficult to adequately diagnose and more so difficult to treat.
see ISIS newsletter 1997 (Dreyfuss).

I'd have your doctor perform medial branch blocks over the corresponding T8-T11 vertebrae on the more painful side to see if there can be an effective treatment as RF neurotomy. This is an unusual area for facet mediated pain and results are not as well known as compared to the lumbar and cervical spine. Should this not work, an ESI at T12-L1 entry with a catheter upto T9 could be tried for 3-6 months symptomatic relief. Failing that, I'd consider vertebroplasty to destroy the hemangioma (replace it with cement).

Just some things to discuss with your doctor. The standard of care varies, you may not be interested in doing any procedures, your doc might not do these procedures, vertebroplasty to a hemangioma could result in bleeding and spinal cord compression (a risk, but not likely), and a doctor patient relationship with a complete history.physical/imaging is needed for any of what I say to actually apply. I just got a tidbit of info and ran with it. You may have a simple unrelated problem in the same area that is causing your pain.

Best example of that is a lady I was treating for back and leg pain. I put a stimualtor in her and got her leg pain much better. During the procedure I asked her if she had any pain in her upper right quadrant of her abdomen. She replied yes, been there since gall bladder surgery, they say it is a stone or something like scar.

I showed her my Xray of the needle that they left in her about an inch deep under her skin. Not in her belly, not in her skin, so it was not going to do any harm, but it did not need to be in there and it was irritating to her.

[lobelsteve]

Bump for Krashleen.

[krashleen]

Thanks for answering..everyone. I have had some kind of injection in the thoracic area and I can tell you that is the most excruciating kind of pain! I shiver just to think of it, and its been a few years.

I just don't know. I am soooo tired of this pain!

Dr Steve? thanks for taking time out to answer, I appreciate the time you took. I will look a little further into it.