Question
Hello Dr. Biggs,
I've recently started feeling various pains in my middle back along my spine (just below shoulder blades).  I do not feel this pain while laying down or while standing, but if I sit for awhile I can feel this pain and it makes me have to stand up right away for it to go away.  The pain is usually a "pins and needles" feeling, but sometimes can feel like a sharp pain, too.  

If my lower back is well supported in the chair I can sit for quite a while without pain, but any position where I begin to slouch, etc will quickly trigger the pain.  I don't feel the pain radiating outside of the mid back area at this point.

Does this sound like I could have a pinched nerve or disc problem?  Would I need an MRI to see what is happening?

Thank you very much for your time!

Answer
Dear Sarah,

This does sound like a mechanical, joint, and nerve pain since it appears to come and go based on your position and posture.  Pain related to an internal organ problem would instead be painful regardless of position.

The mid back, or thoracic spine region, is an area of the spine in which a person might suffer from disc bulging, but it is much less common than in the lower back or in the neck region.

A simple x-ray of the thoracic spine would help to rule out some pathologies of the spine, but it is quite limited as a study. An MRI is going to improve the ability to look at the discs and ligaments. It is also better in ruling out any other space occupying lesions on or near the spine.  Since the symptoms are described as "pins and needles", this is the study that I believe would be most appropriate for you.  "Pins and needles" sensations are typical nerve symptoms.

If I were you, I would ask my primary care physician to either order any MRI or to refer you to a neurologist/neurosurgeon that can evaluate you and, if needed, order an MRI or other appropriate tests.

Sarah, I hope that this helps you a little bit. Good luck with your back symptoms... and Merry Christmas!

Keith Biggs, DC
http://www.eastmesachiropractor.com
http://www.biggschiropractic.blogspot.com
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