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Constant pain from spine injury.

The injury took place on Jan. 31/12

T12 burst fracture

FINDINGS

There is a compression fracture of T12 vertebral body, the anterior height reduced to 40% of normal, this resulting in a mild kyphosis centered at this level. The posterior aspect of the vertebral body is minimally compressed.

IMPRESSIONS

Anterior compression deformity involving T12 vertebral body with significant height loss anteriorly. No posterior displacement of fracture s are identified.

There is an anteriorly displacement fracture fragment measuring  11 X 7 mm, this adjacent to the anterior superior margin of T12

I had a car accident and my car flipped several times. I found myself in the rear of the car from the driver seat. I had no seat belt. I was four weeks steady in bed except for going to the washroom and eating a little. I started walking a lot after six weeks.

I have pain getting out of bad every morning.  My pain is constant from mild to strong as the day progresses. I can be sitting or standing and need to support myself by leaning on something. My pain is in and around my waist and upwards, some time the pain goes down to my groin on my right side. Many times my back is mum and feels cold.

I try not to take pain medication, is this OK? What should I be doing? Is my pain going to go away?

  
5 Responses
1271743 tn?1320892461
The pain meds are a live saver for me, but everyone has different views about them, I have been on them for 12 years and its a part of my life, I wouldn't be able to walk without them, if you are not comfortable taking pills all the time, they have a pain patch called fentanyl that you change every 3 days that provides constant relief... maybe ask your doc about this pain management option.  I am thinking the pain may have developed into Chronic Regional Pain Syndrome.... Google it and check it and ask about it... b/c I am not a doc, only speaking from 12 years of chronic pain experience and research and a million questions to my doctor.... lol
1331804 tn?1336867358
Hi karmalyta and welcome to the pain management community!

The pain that you have been experiencing from the car accident may have progressed into chronic pain as you have had this pain for almost 6 months.  I am not very knowledgeable with regard to spinal fractures but your MRI indicates that you also have loss some disc height at the T12 level.  This finding alone does not necessarily cause pain.  It simply indicates that the disc at the T12 level has loss fluid.  This happens over time to many of us as part of the natural aging process.  Your MRI also doesn't indicate that you have any nerve impingement from herniated discs.

What I would recommend is having your doctor order another MRI of your thoracic spine to see if the spinal fracture is healing or has healed.  The pain you are experiencing around your waist and also near the groin area could indicate that there may be spine problems in the lumbar spine region (low back).  If you haven't received an MRI of your lumbar spine yet, I highly recommend that you get that completed.  Many times the lumbar MRI does also image the T12 vertebrae level so your MRI results from January could be from imaging your lumbar spine.  Typically, the MRI results indicate the findings at ALL levels that were imaged in the particular spine region assessed.  Do you have any MRI findings regarding levels L1 through S1?  If so, please consider sharing that information as well so that we can provide more information that may better assist you with getting the right treatments.  

I recommend that you consider seeking out an orthopedic spine specialist or physiatrist at a teaching hospital as they are specialized in spine related treatments and therapies.  These types of physicians most likely have some options that may be helpful to you that physicians whom are not spine specialists do not.  

Lastly, if you have not been taking at least 60 mg of morphine or the equivalent on a daily basis for a couple of weeks or more, you are not opioid tolerant enough for the Fentanyl patch, which can result in severe respiratory depression that can be fatal.  I recommend talking with your doctor about trying occassional short-acting opioids first and if those do not control your pain and keep it at a tolerable level, then at that point an extended release opioid can be considered but Fentanyl is NOT a first line long-acting opioid.  Instead, MS Contin (extended release morphine) or Oxycontin (extended release oxycodone) are good choices.  You want to start out on the lowest dose that effectively controls your pain due to tolerance issues that develop over time if the use of opioids become a required long term treatment for effective management of your pain.

Lastly, your pain could also be caused by what is called myofascial pain syndrome (severe muscle pain) in conjunction with spinal problems.  Adding adjuvant medications such as a muscle relaxer, anti-depressant, and anti-convulsant can add to the analgesic properties of opioid medications to treat muscular and/or nerve pain.  

Please keep us updated on how you are feeling and whether or not you're getting your questions answered from your medical team.  Pain can be that much more frustrating when it is not clear on where it is coming from.

femmy
Avatar universal
Thank you so much for both of the responses above. I am posting this for a good friend of mine and I have just sent the link so she can read the replies. Again thank you very much for taking the time to try and help.

:-)
1331804 tn?1336867358
You are very welcome.  I hope that she gets the answers and the treatments that she needs.  Please do keep us updated if you can.  Take care.

femmy :)
Avatar universal
Hi I just want to know if losing bladder control is normal after a car accident? I have whiplash and disk loss at t12 and Loss of cervical lordosis with straightening I am so lost as my doctor didn't even take the time to explain this to me... Its like he just wanted me out the room, I am wearing a soft cover neck brase as the hard brase left me with bruises and I have a lot of pounding pain in my head, get sore when I get out of bed and neck, shoulder and back aches like 60% of the day I also experience pins and needles in my legs and I just discovered that I'm not as incontrol of my bladder as I used to be... I'm a 23 year old female.

Please any advise welcome.
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