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Question: Long thin wood foreign body in neck/shoulders

wibblypig - Sun Jun 03, 2007 8:28 am

I am 31 yrs old, female. A long, thin, sharp wooden foreign body under the skin / in the soft tissues of the head/neck/shoulders region retained for several years. Apologise for the lengthy description, but please bear with me to get the whole picture. Nov 1994: While sitting on an old wooden bench, I felt a sharp pain under the upper thigh. Stood up and felt (with hand) a sharp, thin stick protruding slightly out of back of thigh and pushing onto the underside of my (short) skirt. However, as there were many people around, I did not pull it out. Subsequently over the next few days, I felt a long, thin, sharp foreign body under the skin down the length of the back of the thigh and upper calf, even while walking. Estimated length: abt 1 foot in length, quite near skin surface. Whenever I squatted (we had a squatting type of toilet), I could feel the foreign body being pushed higher up under the skin due to the squatting. After abt 1 week, it had been pushed up to the buttocks area and whenever I sat down, I could feel distinct sharp pain in that area. Over a few mths, felt the object slowly shift/slide upwards under skin into lower back area. Whenever I sat down, felt upward pressure under the skin caused by the foreign body. However, there was no pain, only discomfort, pressure and the feeling of something under the skin/in the tissues, which was not supposed to be part of the body. (One cannot feel one’s own bones and muscles.) The object felt like a long, thin and sharp stick consistent with the wooden stick/shaving from the edge of the bench I had sat down on. I consulted a doctor. As she pressed my back, I could vividly feel a long coiled up and thin object being pressed and pushed higher up my back. It felt quite near the skin surface. Over the next few mths, felt the upward pressure of the foreign body under the skin at my back whenever I sat down, but there was no pain. Slowly, it settled into an area under the shoulder blades and was stable/did not move for some time. As such, I thought perhaps there wasn’t any foreign body in the first place. So proceeded to do more physical actions like bending e. g. sideways from a chair to pick up things, or carrying bags on one shoulder etc. However, these led to the feeling of the foreign body loosening up/sliding out of position, causing greater discomfort. I could feel the length of the object sliding slightly under the skin. Over time, sitting caused the foreign body to be pushed higher up to collarbone area. The upward pressure of the object felt worse whenever I sat down. I consulted another doctor, who sent me for an X-ray, which didn't show anything. (Wooden material can’t be imaged by X-ray). Subsequently, I also saw another doctor, who sent for a CT scan, but it also didn't show anything. Over time, the foreign body slowly shifted into a position around back of the neck, collarbone and shoulder area. As the neck and throat area is a very mobile region, where muscles move a lot, esp when eating and talking, I could also feel more vividly the sliding of the foreign body in the tissues, esp after swallowing or talking for some time. Mid-2003: At a salon hair wash, I felt my head/neck position was slightly lower than my back. Over next few days, felt the foreign body slowly loosen up (likely to have been dislodged by lowered head/neck position). Part of it shifted upwards from the shoulder higher into the neck, causing more discomfort. Current situation: Due to circumstances over the years, the whole length of the foreign body had slowly shifted/been pushed up along under the skin/fat layer in the back to the current position. Portions of it had reached the same height as the jaw region/base of the neck/below the hairline at the back of the neck. It feels like it’s entwined/lodged around back of the neck, with some parts in the shoulders and the ends of it at the sides of the neck. It feels long and extends to the upper shoulder area. The pressure of the object under the skin can be felt all the time, except when sleeping. The discomfort is generally worse towards later part of the day (waking hours) or when sitting too long. I usually feel least pressure or discomfort when in lying down position on the back (e. g. after a night’s sleep). As it's of substantial length, I can often feel it shift position/slide slightly in the tissues as a result of activities involving movement of the area such as swallowing, talking, moving etc. (But there's no pain). If it shifts too near the mouth (e. g. sharp end pierces near side of jaw/gum), then it would cause discomfort there. On a few occasions, I could actually feel (with my finger) the tangible sharp, thin (not more than 1 mm thickness) and slightly flexible tip of the object pushing very slightly out from inside the gum. If part of it shifts into a position near the throat, then it would cause some discomfort after swallowing for some time, especially towards end of a meal, or last meal of the day (dinner). Once the object moves into a position that irritates the throat or mouth, the muscles usually automatically pull to try to dislodge/move the object away from the throat/mouth area. I can then feel the long thin stick sliding/pulling away in the tissues. If I step too hard on the floor, I. e. the step is more forceful than usual, I can sometimes feel the impact/vibration of a long horizontal thin thing around the back of the neck under the skin (near the base of the bottom hairline). During a holiday to Universal Studios USA, I sat on an “earthquake” ride, which involved our carriage jerking and tilting. After the ride, the feeling of discomfort caused by the foreign body became worse, as I felt it loosen up and slide slightly in the tissues/under the skin, caused by the jerking physical motions during the ride. As the foreign body shifted nearer the throat, swallowing was affected for some days. I know wooden foreign bodies are very difficult to image, especially very thin ones, which is probably why it couldn’t be detected by X-ray and CT. Unless it can be detected by diagnostic imaging techniques, it’s difficult to get medical help, from my experience with previous doctors. I understand my situation sounds very unusual. However, the above account are the facts of the matter. The pressure and feeling is vivid and consistent with the long thin foreign body described and has been constantly felt all these years. It generally worsens with external pressure on the skin, sitting too long and physical activities affecting the neck/shoulders. Pls. advise what kind of imaging technique would have a higher chance of detecting such a thin wooden foreign body. I would appreciate any advice and hope for a reply. Thank you very much for your patience.

Dr. Chan Lowe - Mon Jun 04, 2007 4:02 am

For wooden foreign bodies such as you are describing ultrasound is best. If you can feel the wood through the skin the ultrasound should show it quite well. Even if it can't be felt by direct palpation, the ultrasound should still show it. If it is seen by the ultrasound I would recommend you talk with a surgeon about having it removed since it appears to have moved quite extensively. This is quite unusual for a sliver to do. Best wishes.

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