I Finally Know What's Causing My Chest Pain.

I finally found out for sure what’s causing my chest pain, and it wasn’t good news.

When I saw an orthopedist at Tria last Thursday, it was hard to localize the pain.  That led her to believe it was a pinched nerve, rather than a strained muscle.  No one muscle could explain all the places where I was feeling pain, but a nerve could.  On my chest X-ray, she noticed some smaller than normal gaps between some of the vertebrae in my upper back.  That could mean a bulging disk, but the only way to be sure was to do an MRI.  I went in on Friday to get MRIs on my neck and my upper back.  I had to wait until today, to see the doctor for the results.

She knew I still needed to decide whether I was going to run the Bighorn Trail 100, so she suggested that I do another short run to see how I feel.  If I was in pain after a four mile run, I probably shouldn’t try to run 100 with this injury.

On Friday, I did an easy 3.5 mile run, while doing my best to minimize the movement of my left arm.  On level ground, that wasn’t too difficult, and it enabled me run without any discomfort.  When I got to a small hill, it was harder to keep my left arm from moving.  I had a small amount of discomfort, but it wasn’t too bad.

Previously, the pain seemed to come from all over the left side of my chest.  Now it was more consistent.  Certain movements of my left arm caused pain in one of the pectoral muscles.  Over the weekend, I learned to avoid most of the movements that caused pain.  If I kept my left elbow pinned to my side, I could move my left hand and forearm without any discomfort.

That made me wonder if I could run without discomfort if my left arm was in a sling.  I gave that a try on Sunday.  I ran on the treadmill, which made it easy to experiment with different grades.  Running slowly on level ground, I felt OK.  It was similar to the run I did on Friday, but I didn’t need to make a conscious effort to control my arm motion.

After about a mile, I started to run uphill.  As I put more effort into the run, I would occasionally notice momentary discomfort in my left pec, but it wasn’t a big deal.  Eventually, I set the grade steep enough that I had to walk.  I was still working hard, but I was much more comfortable.  Walking is far less jarring than running, which makes it easier for me to keep my arm relaxed.  That part of my workout was promising.

As I turned the grade back down and resumed running, I once again noticed some temporary discomfort.  Overall, doing a mostly uphill workout wearing a sling felt about the same as doing an easy level ground workout without the sling.  I still had big concerns about running with a sling.  I didn’t know if it would cause muscles in my upper back to get sore.  I also didn’t know how much the strap would make me chafe after running with it for several hours.  I wasn’t convinced that I could do the race this way, but I also wasn’t convinced that I couldn’t.

I still had to make a decision about Bighorn.  I booked my flight with miles, so I had until this morning to cancel the flight without penalty.  As recently as Saturday, I desperately wanted to do the race, but it seemed like a bad idea.  I felt surprisingly good yesterday and better this morning.  I felt like I was turning the corner.  It may help that I’ve been getting better at avoiding motions that cause discomfort.

This morning, I had my follow-up with the orthopedist.  Going in, I was optimistic.  I felt much better this morning than I did last Thursday.  With four more days to recover, I was leaning toward doing the race.

I told the doctor how I felt over the weekend and how my runs went.  She was encouraged by my progress, but didn’t want me to do any more running with a sling.  She shared my concerns, but was also worried that it would alter my stride in ways that could cause other problems.

Then she gave me the results of my MRIs.  I have a couple issues in my cervical spine, but the big issue was in the thoracic spine.  I have a large disk extrusion between my T8 and T9 vertebrae.  The disk is filling most of the space where my spinal cord should be.  That’s pushing my spinal cord way to the left.

She was expecting to see a disk impinging on one of the thoracic nerves.  That would explain my chest pain.  This disk was impinging on the spinal cord itself, which could potentially cause a multitude of problems in my lower body as well.  She was a little surprised that I wasn’t having more symptoms.

She couldn’t tell me it was OK to run Bighorn, but she also wasn’t willing to tell me I couldn’t do it.  Then she decided to do some tests of nerve function in my legs and feet.  One of the tests revealed a neurological symptom in my right foot.  After doing that test, she told me she didn’t want me to do the race.

Her concern was that all the jarring of a long trail race could cause me to develop worse symptoms in my legs.  That in turn, could cause me to fall.  She was worried I would not only be setting myself up for failure, but I could develop symptoms that are much worse than what I have now.

She referred me to a neurosurgeon at another clinic for a consultation.  That doesn’t mean I need surgery.  It just means I need the opinion of a specialist.  I’m still cautiously optimistic that this injury can resolve itself over time.

I see the neurosurgeon tomorrow morning.  In the meantime, I’m not supposed to run or do any activity that’s jarring to my spine.  I’m also supposed to avoid activities that twist my back or create pressure in my chest.  I can resume some strength training exercises, but something like a bench press is still out of the question.  To maintain some of my aerobic fitness, I can ride a stationary bike.

After today’s appointment, I cancelled my flight.  I won’t be running Bighorn this year.  That was disappointing.  I’ve worked so hard to get in shape for it.  Until two weeks ago, I like my chances of finishing it this year.

My other summer races are also in question, but I’m taking it one race at a time.  For now, I’m waiting to see what the neurosurgeon says.