enlarged vertebrae
 

Pt is now saying I do have tos not due to ribs but enlarged vertebrae in my neck. Has anyone heard of this

when i look up enlarged vertebrae all i see is spondylosis and stenosis. i had an mri! you'd think it would show up on that

another thought, maybe my vertebrae feels larger because it is inflamed and it wasn't during mri

Other congenital causes

Some people are born with an extra band of tissue underneath their skin around the thoracic outlet area called a fibrous band. This can act a bit like an extra rib and cause compression of the thoracic outlet in some people. Anomalous (or extra) muscles around the thoracic outlet that you may be born with can also cause narrowing and compression. Also, some people are born with an enlarged or elongated part of a vertebra in their neck which can cause compression in their thoracic outlet.

If the MRI was fairly recent, you might have it reviewed by a dc- if you have a copy of it, or ask the md that rx'd to have it looked at again to see it vertebra size might be an issue or not.
Might be good to know if it is an issue.

maybe she was saying tho it sticks out too much at the sides? it seems like to show that you'd have to do it from a frontal view.


i actually had a chiro who worked on my neck a lot. he shouldve mentioned something. he did at least 8 adjustements tho and my hands were still numb so maybe he just wanted my money.

i think the tx is still the same, i need to unload my neck and increase circulation. my hands became less numb when i strengthened my shoulders. i had a bad flare up and my pt said that my left scapula (tosish side) was 2 inches off my back. that's GOT to effect my circulation somehow.

maybe i have bone spurs

they usually mention those in the report if you have them.
Osteo-- something I think..I forgot the official name
I have some anterior at c4/5/6 mild - at least per my 04 MRI.

Osteophytes?

yeah i really dont think i have them then. i went to emory for my mri and theyre pretty reputable.

"c-spine presents normal alignment. vertebral bodies are normal in height (unless she means they're FAT????). there is a normal marrow signal pattern. intervertebral discs are normal in height and signal intensity. the cspine cord is normal in size, contour, and signal intensity. the craniocervical junction is normal. the included intracranial structures are grossly normal ((i know, i'm overanalytical but he only used GROSSLY in this part what about the rest!)). the paraspinal soft tissues are normal.

c2-t1 normal normal normal normal..........

normal unenhanced mri of the cspine. "

i think my pt is just trying to understand something that's over her head but i can't blame her. she actually didn't think i had any tos until another doctor said she thought i had tos.

i can type a lot better today and it's only because my shoulders are taped to my spine. otherwise i'd be a mess. had an awful awful flare up. my bp feels inflamed to me.

i am soooooooooo glad i didnt mess up my neck with my eds, sure i might've messed it up some but not to the point of being obvious on an mri. considering the insane pain ive been in i thought for sure something would be glaring on there

Your c-spine MRI report reads beautifully, congrats that you have no issues there! If you had abnormally sized vertebra it should have been noted in the report.

I think your PT is over her head in regards to the comment.

PT actually started making me worse, so be careful. I am only getting therapeutic massage now (no exercise) and my symptoms are more manageable at the moment.

Since the kinesiotaping helps you, I wish you could get a free trial of the IntelliSkin. Maybe your PT can request a sample? The IntelliSkin is more effective that kinesiotaping with me.

hey nospam, does the intelliskin constrict your tos area at all..like the upper trap?

if i have a strap pushing down on there at all it actually makes me want to puke and gets my nerves firing off.

i agree about pt. my pt's been pretty good considering. i actually did this to myself, i am my own worst enemy!! on the stupid foam roller.

thanks for your feedback about the mri. i've asked a handful of people and that seems to be the general consensus. i also had the duplex ultrasound to analyze blood flow to my arms with turning my head to the side. it only had reduced flow when i was in the military position and i think turning my neck way way to the side which is normal. but i dunno how reliable of a test that is.

my new crazy theory is i have tos but it's some awful interaction of subclinical hypothyroidism/EDS/RSI aka trauma that's giving me like the worst fibro ever. none of my muscles feel normal. they all feel heavy and have poor circulation. even in my legs. the heaviness started before i had nerve pain i just didnt know what it was. any time i've overstretched i'm basically irritating (not to the point of damaging) the myelin sheaths and they never fully recover and they're constantly pressed on my heavy muscles/poor circulation. when the nerves get irritated all of the surrounding muscles clamp down. so the vicious cycle continues!!

you guys with abnormal cspine mris..

does your neck vertebrae (???) discs or whatever, do they crunch? mine crunch and sometimes then i'm flared up they crunch AND itch which i figure is really bad adn means i'm irritating the nerves

I get the "rice krispies sounds" in my neck esp when I get flared up or irritate things in my neck /upper back areas.

Personally I think it is the muscles pulling/tweaking on the vertebra , not actually the verts themselves.

My krunchies go away when all is calmed down.

I got too enthusiastic on the mini tramp and aggravated myself- hips and neck :( slowly resolving.

My neck has done the "snap, crackle, pop" thing for years and the severity doesn't always correspond to a flare. I've been told by every doctor I've asked that it is normal and nothing to worry about if all other testing is clear. I've never associated any itching with it though.

No, it feels to me that all the work of the garment is being done in the middle and lower trap and the rhomboids (my main areas of weakness according to PT). Once the shirt is on, it doesn't feel like its doing that much. There is a slight pull on the head of the bicep/shoulder with the sleeved shirt which the sleeveless tank doesn't do (or the bra I would guess). I believe this helps open up the thoracic outlet which is why the shirt is a bit more effective than the tank for me. Otherwise, it just feels like my weak back muscles are finally activating and not letting the upper trap and pecs override them. It doesn't feel like a brace, just a performance exercise shirt.

Has anything been able to break the cycle? Toradol or Medrol maybe? I had a similar experience prior to my cervical fusion. I had been diagnosed with both TOS and cervical stenosis at the time. My neurologist decided to get a lumbar MRI and found I had disc compression there as well. Prior to this finding, fibromyalgia was suspected. Medrol broke the cycle. I've found Toradol works better for me than the Medrol Dosepak. Have you had MRI of your lumbar spine, EMG of both upper and lower extremities? The EMGs are not fun, but should be done IMO.

Are you on Lyrica or Neurontin as well as Cymbalta or Pamelor? What are you taking?

I also have the rice crispies and sometimes a liquidy sound which I think is totally freaky. I disagree with the MDs that all is well:

I didn't have this when I was young and I didn't have all these problems either. :)

After I go to the chiro all those sounds go away and stay away for about 2 - 3 days, during which time I feel healthier. He says he's adjusting my skull; how it sits on the neck.

Also, I think forward head posture for many years and many hours in front of the computer is a leading contributor to my non-normal neck.

I'd love to know anything more about these strange neck noises.

thanks for the input you guys, sorry i cant type much today. not taped up :(

i am not on any meds, on the w/e i sometimes take flexiril but that's it.

does medrol actually help heal your nerves or is it more of a bandaid?

chroma, i get that liquidy feeling, not a sound though. unless you mean tinnitus.. it used to be worse i think when i would TRY to stretch and my muscles just would not budge


after taking too much magnesium, my muscle pain went down to like a 1 and all of my sx resolved except for the numb hands. so i think something is just not circulating right. doctors take this circulating stuff too literally. ive had a duplex ultrasound and passed it fine but i KNOW i have circulation problems

Medrol is a tapered steroid/anti-inflammatory (taken for 5 days). It will reduce inflammation (including your nerves). Toradol (taken 3-5 days) works better than medrol for me. It is a non-steroidal anti-inflammatory (NSAID). One of these two drugs would take away my flares for a couple months. That is no longer the case for me as my flares come right back shortly after the 5 days (which is why I've decided to move forward with surgery). I'm keeping things under control using Ibuprofen and Valium (before bed) right now...and keeping my elbows at my side at all times. The muscle relaxers (Valium or Zanaflex as Flexeril doesn't work for me anymore) don't really help my symptoms anymore...they just help me sleep through the night.

Magnesium helps reduce inflammation (not even close to the level of Toradol or Medrol though). Numb hands do not always equal a circulation problem. Numb hands/fingers are more likely a neurogenic symptom. Sounds like neurogenic TOS to me.

What specialists have you consulted so far?

Interesting information about magnesium. I got several bags of it intravenously while I was in the hospital after my TOS surgery and couldn't figure out why. I think of it as a muscle relaxant because I was also given magnesium during the delivery of my children.

well my pt actually gave me a posture shirt to try out, it's much tighter which is good

yup its awesome

but if you take too much magnesium you have to be careful because your diaphgram relaxes too much and you start hyperventilating

thanks ill look into medrol/taradol. i just assuemd it was like lyrica which i do NOT agree with taking.


so another question!! if i had a c-spine mri would it say if i have a big?? transverse process? because my pt said i have this. i need to read up more on bones. so far i've been obsessed with shoulder anatomy and nerves.

No, a c-spine MRI will not show an enlarged transverse process. Due to me showing significant arterial problems and having had an abnormal 1st rib removed already, my doctors ordered a specific x-ray to look at the transverse process. He said the test that will really show the size is a CT scan of the neck. I already had a CT scan done for another reason so the doctors reviewed the scan and x-ray. Yep, I've got a hypertrophed transverse process.

Personally, I wouldn't request a CT scan due to the radiation exposure unless there were other signs leaning towards a potential issue with C7.

thanks so much, ive been worrying about this quite a bit. so i will request an x-ray no ct scans.........


do you know if surgery (?) to fix an enlarged transverse process is as invasive as say...a rib ressection? i have ehlers danlos syndrome and im terrified of scar tissue.

i'm a worry wort after all the stress i've been through. i feel like mentally i have to juggle in my head each day how much my physical therapy for winged scapulas is working for me.

i dont see much info on transverse surgery, most of it's on fractures. i wonder if it's really that rare

so i'm going in for an appointment next week. ill ask about those drugs and if she thinks theyre appropriate, since my sx are more muscular i bet they'll hesitate to give me them.

i'm also wondering if i should just go ahead and get an mri of my bp. i never requested one because ive heard theyre usually pointless

AlignMed PostureShirt I presume. Give us a review when you get a chance.

Nerve pain can be at the root of myofacial pain, I think this is a large reason why it takes so long to reach a TOS diagnosis (and I'd bet TOS is largely under diagnosed).

It wasn't until I stopped PT, rested, and got aggressive with getting rid of myofacial trigger points (massage therapy, anti-inflammatory drugs and home ultrasound/TENS combo therapy) that the neurogenic and vascular TOS symptoms became obviously apparent. We have a pain bucket, and when that bucket is full and overflowing you really only feel the most noticeable pains (at least that is how I am).

I think the surgery is similar to removing the cervical rib.

i disagree about pt personally, i have been hooked up to a tens unit, massaged, etc and no spasms to speak of but my neck is collapsing because it's holding up my shoulders so i definitely need pt. anyone with a really bad rsi needs to strengthen imho. its just finding the right time to do it

http://img.medscape.com/pi/emed/ckb/...15811-34tn.jpg
this is actually what my shoulder looks like kind of from the side, and dont get me started on the back. it's a mess.

yeah i was rethinking that as i posted. my trigger points...i'm not even sure if they ARE trigger points? they feel like festering needles all over my levator and upper traps, so i guess so..they only appear when i stretch the wrong way which to me means im irritating a nerve. when i strengthen incorrectly i just get tight and dizzy but no needles.

I think I am inflamed. I took a muscle relaxer expecting it to do a little somethingn. Can't sleep and feel awful. Wouldn't inflammation be straight up brachial neuritis? I thought that was different than tos

I don't think so.

For me, anti-inflammatory drugs are much more effective than muscle relaxers (Toradol being the best). Have you tried even Advil or Alleve? Are you on a pain management drug regimen?

No. But I used to take a TON of ibuprofen every day. It didn't do much and was actually bad for me..if anything. But for a flare up maybe it does help. I have some etodolac I might try again.

I'm going to take liquid magnesium now. Maybe it'll absorb better while I'm on pills. That was a big problem for me. Malabsorption

I don't get it. So my nerves are irritated from

when I overstretched a good 1.5 years ago...seems unlikely

or they're inflammed bc compressed but. I do not have enough muscles to compress this area so wtf.

Scar tissue on both tos sides seems unlikely to me too.

I would say vascular compression but I passed the duplex ultrasound.

If my xray / MRI comes back normal I'm just going to assume its the eds. I've talked to a handful of girls with eds and they all seem to have some dx of tow.

What physician specialists are you seeing to manage your TOS/EDS? It sounds as if you are trying to self diagnose which is a bad idea.

Also, if you are not seeing a pain management specialist you may want to consider adding one. Their insight can be invaluable in dealing with flares without putting yourself in danger.

i have been to 12 or so doctors and none of them have helped me. i was under the impression pain management specialists just gave you bandaids and didnt actually treat the source of your pain. i would however be interested in getting a nerve block or something like that to find out exactly where the pain is..but i'm scared because my pt acts like i have rsd and rsd and needles are a bad combo

Pain management doctors will try to help alleviate the pain via medications, shots, etc. I've seen postings where it was the pain management person who figured out the source of the problem and referred the person to the appropriate doctor. If you think you're not a surgical candidate due to your EDS, then you should see a pain management doctor. If the PT is correct and you're developing RSD, then you need to get treatment sooner than later to try to prevent the spread.

For me, my physiatrist has done the shots that show exactly where my pain is coming from.

http://en.wikipedia.org/wiki/Pain_management

Thanks! I am curious about the shots. All The pain I've experienced is too close together to tell the source but my pt thinks my rsd or whatever has set off my nervous system is remissing. When I first went in my whole back/neck was on fire...about a year ago. I've never gotten half the symptoms of rsd like fat hands etc and my magnesium levels were dangerously low .5 (1.5-2.2 range) for who knows how long on ibuprofen. But yeah if I stretch it triggers an attack. Ill ask about the shots when I go in on Thursday.

I have some lidocaine patches and ice and I actually feel okay now.