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What Causes Pain In Chest Radiating To Arms And Shoulder Post Spinal Contusion?

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Posted on Fri, 18 Sep 2015
Question: Just trying to figure out a potential diagnosis here. I was in a motor vehicle accident with a semi truck 10 months ago. Suffered a spinal contusion C-2 level, TBI, and several orthropedic injuries. Immediately after the accident I had chest pain and the ER told me it was Costochondritis. Anyways, the chest pain resolved after about 2 months. It has recently resurfaced and has caused a variety of symptoms. Sleeping on either side hurts the center of my chest and sends pains under my arm, shooting pain to forearm and shoulder blade pain/burning. If it gets bad valium helps me get to sleep

I just started working again, but on a very limited basis (The chest pain started up before I even got back to work). Today as I was performing very basic activities (Thats all I am allowed to do. folding clothes, hanging clothes, breaking down boxes, taking out trash) I got some pains that felt like I was stung by a bee, but on my lower groin and then a couple times in the abdomen. Happened about 8 times total, and was kinda scary. Up till now I was able to cope with the pain. I would get some chest pain and stabbing pains in the neck and arms during my shifts, but nothing debilitating. I would also make sure I ate a good breakfast, stretch, and take my pain meds before work.

Just trying to figure out what to do here. I am seeing a trauma specialist next week, but I always like to hear opinions on this site.
doctor
Answered by Dr. Dr. Erion Spaho (6 hours later)
Brief Answer:
New evaluation by imaging too, should be done.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Symptoms you describe, could be explained by spinal cord contusion, but also can be related to vertebral disc disease, this related to damages done to the vertebral column and its structures (discs, bones, ligaments and nerves) at the time of the accident and worsening due to physical activity with time.

Again, electric-like pain is more probably related to contused spinal cord ( or hemorrhage into it ), those sensations are encountered often after trauma as the healing process continues.

If you had a spinal cord MRI at any time after the trauma, if you could upload pictures of it, or its results, it will help me to have a better understanding of your condition.

Costochondritis may be a separate condition, or could result after trauma as well.

In my opinion, those new symptoms should be evaluated by imaging studies (MRI of column), and EMG ( nerve conduction study ) of your arms.

Awaiting for imaging studies reports....

Hope you found the answer helpful.

Take care.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (5 hours later)
Yeah, I forgot to mention I had an MRI a month after the accident in November 2014. They considered it to be a mild spinal contusion, and then another 3 months after that it was still there on mri. I've had injections for pain and muscle spasms that traveled down my shoulder also.

I also had a negative ct scan 2 weeks ago of my sternum area.
doctor
Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
Symptoms most probably related to spinal cord dysfunction.

Detailed Answer:
Welcome back and thanks for the additional info.

In this case then, symptoms you describe are more probably related to misdirected electrical neurological impulses in a healing spinal cord.

However, in my opinion, new MRI of the spinal cord needed to evaluate contusion healing process and to evaluate/exclude spinal disc disease as another possible explanation of your symptoms.

Negative CT scan of the sternum and ribs doesn't exclude completely osteochondritis as a diagnosis.

Hope I helped you.

Best regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (17 hours later)
One more symptom id like to add. I only work 2-3 days a week, 4 hour shifts. Today I experienced another symptom I've never had before. My fingers began to get stabbing pains both on the tips and by the knuckle area. Could this be related to any chest issues. My neurologist threw out a term thoracic outlet syndrome, but didnt say I necessarily had it. He wants me to see the specialist first. What are your thoughts, with what you know?
doctor
Answered by Dr. Dr. Erion Spaho (6 hours later)
Brief Answer:
Thoracic outlet syndrome is a possibility.

Detailed Answer:
Welcome back.

Thoracic outlet syndrome is possible to happen after car accidents, or when there are rib anomalies such an extra rib.

Symptoms are related to nerves and/or vessels being compressed between your collarbone and first rib.

Symptoms are unilateral ie. are felt in one arm, hand and shoulder and include numbness in your arm and fingers, wasting of hand muscles, pain in shoulder and hand, if the vessels are compressed too swelling of the arm, discoloration, fatigue of that arm, cold fingers.

Just an episode of fingers pain is not typically related to thoracic outlet syndrome, but cannot excluded entirely until otherwise proven.

So, let's see what will be the evaluation of your pain Doctor after examining you (clinically and by imaging).

I still think these atypical symptoms are related to misdirected spinal cord impulses.

Hope I helped you understand better your condition.

Take care.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Dr. Erion Spaho (3 hours later)
What kind of prognosis are you looking at with a spinal cord contusion in C-2/3 level. I mean its been 10 months, and the symptoms definitely have gotten worse within the last 2 months.
doctor
Answered by Dr. Dr. Erion Spaho (8 hours later)
Brief Answer:
Instability of neck should be evaluated.

Detailed Answer:
Hi again.

Contused spinal cord symptoms should have subsided by now and prognosis is favorable in cases of small contusions.

Since you referring worsening of symptoms, in my opinion, there is need to evaluate stability of ligamentous and articular complexes at craniocervical junction.

If there is instability, there is a possibility of minor repeated spinal cord injuries or contusions that may be responsible about worsening of symptoms.

Stability/instability is evaluated by having done plain radiographs in flexed and extended positions of the neck ( dynamic radiographs ), open mouth plain radiographs of the C2 vertebra and MRI with thin cuts to evaluate ligamentous complexes.

If instability is noted, stabilization surgery is needed.

You should discuss with your Doctor about these issues.

Hope I helped you. Take care.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4492 Questions

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What Causes Pain In Chest Radiating To Arms And Shoulder Post Spinal Contusion?

Brief Answer: New evaluation by imaging too, should be done. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. Symptoms you describe, could be explained by spinal cord contusion, but also can be related to vertebral disc disease, this related to damages done to the vertebral column and its structures (discs, bones, ligaments and nerves) at the time of the accident and worsening due to physical activity with time. Again, electric-like pain is more probably related to contused spinal cord ( or hemorrhage into it ), those sensations are encountered often after trauma as the healing process continues. If you had a spinal cord MRI at any time after the trauma, if you could upload pictures of it, or its results, it will help me to have a better understanding of your condition. Costochondritis may be a separate condition, or could result after trauma as well. In my opinion, those new symptoms should be evaluated by imaging studies (MRI of column), and EMG ( nerve conduction study ) of your arms. Awaiting for imaging studies reports.... Hope you found the answer helpful. Take care.