[biltaylo]

#7492

For the past 6 months I have had neck pain, shoulder (blade) pain, numbness in my left arm down through my left thumb. I had an MRI and this was the findings:

C5 to C6: Disc degeneration with moderate to moderately sever disc height decrease with endplate irregularity and sclerosis and underlying marrow signal change which be reactive discogenic. Prominate anterior endplate osseous ridging is seen. Prominate posterior endplate ridging and disc osteophyte complex extending posteriorly by about 3mm is noted, flattening of the anterior thecal margin and narrowing of the anterior and posterior subarachnoid spaces, with mild thecal sac narrowing. Mild to moderate facet degenerative change. Moderate to moderately severe foraminal narrowing bilaterally.

C6 to C7: Disc degeneration with moderate disc height decrease with endplate sclerosis and underlying marrow signal change which be reactive discogenic. Prominant anterior endplate osseous ridging. Prominent posterior endplate ridging and disc osteophyte complex, left greater than right, with possible small left paracentral to posterolateral disc protrusion, with the endplate ridging and disc protusion extending posteriorly about 3 to 4mm, flattening the left anterior thecal margin, effacing the anterior and posterior subarachnoid spaces with mild to moderate thecal sac narrowing and with mild flattening of the anterior cord margin in the imaged position. Mild to moderate facet degenerative change. Moderate to moderately severe foraminal narrowing bilaterally.

Impression:

C5 to C6: Prominent posterior endplate ridging and disc osteophyte complex with narrowing of the anterior and posterior subarachnoid spaces. Moderate to moderatley severe foraminal narrowing bilaterely.

C6 to C7: Prominent posterior endplate ridging and disc osteophyte complex left greater than right and possible small left paracentral to posterolateral disc protrusion, flattening the left anterior thecal margin and effacing the subarachnoid spaces with mild to moderate thecal sac narrowing and possible slight flattening of the left anterior cord margin in the imaged position. Moderate to moderately severe foraminal narrowing.

I am seeing a neck pain specialist who has me in physical therapy as well as oral steroids. After 4 weeks of therapy there is no improvement in my symptoms. The next option is for injections.

My question is, is this the proper treatment to resolve my neck and arm pain, and can the injections cure the problem, or am I looking at surgery at some point in the future?

Thank you!

[Donald Corenman, MD, DC]

#8161

You have substantial degenerative changes to the C5-7 levels with foraminal stenosis (see cervical radiculopathy on the website). More likely than not, your arm pain is caused by this condition.

If there is not profound motor weakness present, you can start treatment conservatively including physical therapy, injections and medications. Traction might be useful for temporary relief. I do have patients with your findings that go for a long time before surgery is contemplated. Based upon this imaging report however, you will probably at some time in the future need to consider surgical intervention.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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