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Thread: Numb Patch Along Spine Correspoding with Indentation in Erector

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    Default Numb Patch Along Spine Correspoding with Indentation in Erector

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    I am a 27-year-old male. 6'1", 225. For about ten years, I've had a numb patch along the left side of my spine about halfway up my back. It's about the size of a quarter. According to no discernable pattern, it sometimes itches, burns, tingles, feels a little bigger, feels a little smaller, etc. But until now it's never hurt much, so I've let it go.

    Recently the left side of my middle back been aching a little more than is typical, and the other day I noticed that there is an indentation in the left erector under the numb patch. When I run my thumbnail down my otherwise thick and enviable left erector, I feel a little gap. Atrophied muscle from years of inadequate innervation is my guess. I'd like to remedy the problem in order to avail myself of all of my back muscles.

    Questions:
    1) Is there anything a chiro or rolfer can do for this, or do I skip straight to the MD?
    2) Ortho or neurosurgeon?
    3) Is there anything an MD can do for this? I'm not sure it's cut-worthy.
    4) I know you give people hell for gratuitous MRIs, but is an MRI justified here?

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    Very weird. Almost sounds like a superficial cutaneous nerve, but that would not cause a local atrophy. Was there a trauma associated with this thing? It doesn't sound chiropractic at all.

    Sully?

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    Quote Originally Posted by Mark Rippetoe View Post
    Was there a trauma associated with this thing?
    No single instance comes to mind. I recall first noticing it in high school, when I was playing a ton of lacrosse. This involved lots of rotational movement in the shooting motion as well as lots of banging around. Of course I was also working in restaurants, getting in car accidents, and otherwise living life with a spine so take the lacrosse theory for what it's worth.

    My wife verified that there is indeed a palpable indentation under the numb patch.

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    Did somebody hit you with a stick there?

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    Most likely yes. I played attack (forward) and was regularly subjected to inaccurate stick checks from the big boys playing defense. A big slap check across the back could have been the culprit I suppose, but I didn't make the connection at the time. Just noticed the numbness one day.

    I am getting impatient here and would like an accurate diagnosis over the internet please. I did buy your books you know.

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    Quote Originally Posted by Mark Rippetoe View Post
    Very weird. Almost sounds like a superficial cutaneous nerve, but that would not cause a local atrophy. Was there a trauma associated with this thing? It doesn't sound chiropractic at all.

    Sully?
    I can't do any better than your diagnosis, Rip, especially because I'm part of that ever-dwindling minority of docs who still believe in the awesome power of the physical exam. It sounds like a hunk of tissue got "cored out" in that area, with scar tissue replacing it. I agree that it sounds like a post-traumatic issue. Clearly, there's damage to the cutaneous twigs in that patch, but I have to wonder if the divot Bronan describes actually involves muscle tissue. Again, I can't see it, but I wouldn't be surprised if it were more superficial, from subdermal contraction of post-traumatic scar or idiopathic fibrosis, which can be deceptively impressive. If there were scarring or fibrosis in the muscle extensive enough to deform the belly, I would think it would hurt every time he locked his spine and would be prone to re-injury. I wondered about spasm--severe spasm can cause deformity in a muscle belly--but a spasm that caused that sort of deformity would be very painful, and that doesn't sound like what Bronan's describing.

    So I'll stop waving my hands and make a few of observations:

    1. If this is a tissue-loss or fibrosis issue, it's permanent (I guess that should be obvious, but still...).
    2. The problem is chronic. At worst it is indolent.
    3. If his log is any indication, this lesion has not, to date, interfered with Bronan's respectable progress in his lifts.
    4. Unless Rip and I are way off, the only thing a surgeon has to offer is to convert this little divot into a big divot, to no salutary effect.
    5. Having an MD, osteopath or chiro take a look will Do No Harm, except to Bronan's wallet. An MRI may show an enhancing lesion, but is unlikely to suggest an intervention. If, after examining you, a doctor suggests an MRI, ask him what he's looking for. If he's looking for something specific and amenable to correction, get it. If he's Just Fishin', don't.
    6. If the paresthesias become intolerable, it is possible as a last resort to ablate the nerve, although this will still leave you with numbness--probably over a greater area.

    Bottom line: If it were me, I'd let a doc peek at it. Make sure he's not holding a knife. I would be interested to know how this shakes out. Sorry I can't be more helfpul over the Internets.

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    And there you have it. Free even. "At No Cost To You."

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    Quote Originally Posted by Sullydog View Post
    If it were me, I'd let a doc peek at it. Make sure he's not holding a knife.
    Gents, many thanks for the help. Last question: If I go to see an MD, then what specialty? Thanks in advance.

    PS: Sully, I know you love it when people stroll into the ER for stuff like this.

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    An orthopod. Wait: maybe a gynecologist.

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    Quote Originally Posted by Mark Rippetoe View Post
    An orthopod. Wait: maybe a gynecologist.
    Devastating. Hurts more that any back pain ever could. I think we should all be proud that a thread about a tiny numb patch and a little divot is now at double digit posts. If I visit the doc about this, I'll report back to assuage your burning curiosity.

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