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Thoracic pain, back pain, MRI suggests hemangioma and spondylosis. Taking Ibuprofen. Should I consider surgery?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10445 Questions
I have been experiencing thoracic pain now for about six weeks. It started when I began doing some work on a weight training machine that involved pulling my arms from above my head. I have pain mid-back just below shoulder blades, a sharp poker-type pain just to the right of the spine, then also around right ribs, with pain, pulling sensation, and tingling just below rib cage in front. My recent MRI suggests a hemangioma in the T7 vetebral body, moderate degree of disc-spur complex at Y7-T8, and mild efacement of thecal sac. Also, diffuse spondylosis in lower thoracic spine is noted. I have tried PT with little success; they thought it was muscular. I do take ibuprofin, which seems to help, but pain is getting worse especially when I am sitting. I had lower back surgery about 12 years ago with great success. No one has suggested any kind of epidural or cortisone treatment. Should I be considering surgery on the thoracic spine? Everyone tells me it is not often done!
Posted Wed, 23 May 2012 in Brain and Spine
Answered by Dr. Praveen Tayal 6 hours later
Thanks for posting your query.
The symptoms you are having are likely to be related to the diffuse spondylottic changes in the lower thoracic spine. A hemangioma in the vertebral body is mostly asymptomatic. The disc spur complex might cause nerve root compression aggravating your symptoms. If your pain is adequately controlled with carefully chosen pain killers and mild muscle relaxants then surgery is not immediately needed.
Such symptoms though are slow to resolve but can be adequately controlled with medicines, epidural steroid injections and methylcobalamin supplements.
Physiotherapy helps in preventing further progression of spondylottic changes.
I do feel you can have a better health with the help of your orthopedician and physiotherapist together. Surgery is not immediately required as the risks involved in the surgery must outweigh the benefits.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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