How Can I Tell if I have an Injury or Chronic Condition

Tagged: mri, Neck pain, tmj

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coco21
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October 7, 2019 at 10:25 pm

Post count: 2

#31255

Four years ago I was walking a dog when it yanked my arm.
I felt a strong sting in my shoulder all the way from my shoulder to my breast muscle.
I had trouble recovering and I did not go to a doctor and my physical fitness suffered.

Two years ago I tried to play soccer after not playing for awhile and I felt a strong knee stretching. A few nights later I got up fast after falling asleep on the floor and I had felt my knee somehow had shifted out of place and moved back in very quickly as I got up. After both of these injuries my physical fitness went downhill to almost non existent in terms of recreational fitness. I finally decided to go to a specialist because I was confused as to whether the lack of exercise was causing my pain or my pain was making me not want to exercise. The pain is a lot of neck tightness akin to someone making my neck into a corkscrew. The knee pain is a weakness type of feeling.

The neck mri came back as normal alignment of cervical spine, no fracture.
c2-c3 normal
c3 c4 normal 1 mm midline disc bulge
c4 c5 mild endlplate degenerative changes
c5-c6 mild endplate degenerative changes. broad 3 mm midline disc protrusion resulting in abutment/flattening cerivcal cord w moderate degree of central canal stenosis
c6-c7 2 midline disc bulge w effacement of the anterior thecal sac and milkd central canal narrowing

c7-t1 normal

***note it also said limited evaluation of the cervical cord due to patient motion.**

My dr put me on Celebrex 400 mg a day. This has really and about 80 percent helped my pain.

I forgot to mention I have had TMJ for at least 10 years seriously and I do wear protective gear.

The Celebrex has helped but not eliminated the TMJ.

The joint specialist told me I could deal with my issue by going to chiro and starting exercise again. He seems to claim that the pulling of the dog has not impacted my shoulder.

ONe question I have is – what does it mean that there was limited evaluation of the cervical cord due to motion? should I ask for a new mri considering most of my pain is in my neck?

Other questions – the Celebrex relaxes me and it also makes me feel more calm when I get upset about something. My therapist told me I should go see a rheumatologist as I might have lupus. I can feel when I get upset all of my muscles tightening up. And I can feel the Celebrex loosens them. Before I started taking Celebrex I was suffering from a type of gastritis that I was trying to manage by limiting stress which was impossible to eliminate when I became upset emotionally. I find the Celebrex helps me from getting emotionally too upset about things.

I am also considering a psychiatrist as I am possibly having a untreated case of PTSD from an incident four years ago.

I have treated TMJ w physical therapy and I can relax it to some extent on my own and I have never taken pain meds for it.

Also the MRI came back saying I had thickening of the sphenoid sinuses. NOt sure how much this contributes to all the pain I get in my ears and my face and my jaw. I see an Ear NOse and Throat DR because I was getting sinus infections all the time and I also was being treated for one when I got the MRI. He has me on Mucinex d and a nasal spray daily.

I would like to start exercising again and see if I can limit the Celebrex to at least one a day as I am concerned if it has side effects but I like its calming impact. I briefly went to the chiropractor when I first started seeing the joint dr but chiropractor was very time consuming and I noticed if I missed it my condition went back to where it started. I got a lot of benefit and body relaxation out of the cooling packs the electronic stimulus and the adjustment.

I am 37 year old female, was always active prior to the incident 4 years ago. Got a lot of benefit out of making sure my muscles were strong helped w my posture and not sure now I like to run not sure if running is okay for my spine.

coco21
Participant

October 7, 2019 at 10:27 pm

Post count: 2

#31256

im sorry I meant to say I might have fibromyalgia not lupus

Donald Corenman, MD, DC
Moderator

October 8, 2019 at 8:12 pm

Post count: 8660

#31265

Your MRI report notes “c5-c6 mild endplate degenerative changes. broad 3 mm midline disc protrusion resulting in abutment/flattening cerivcal cord w moderate degree of central canal stenosis
c6-c7 2 midline disc bulge w effacement of the anterior thecal sac and milkd central canal narrowing”.

“Two years ago I tried to play soccer after not playing for awhile and I felt a strong knee stretching. A few nights later I got up fast after falling asleep on the floor and I had felt my knee somehow had shifted out of place and moved back in very quickly as I got up”. This sounds like a knee problem such as an ACL tear or a subluxed patella, not a spine disorder.

“what does it mean that there was limited evaluation of the cervical cord due to motion?” The MRI requires you to stay perfectly still as motion will blur images like an old time civil war picture will blur the individual that moves (like a ghost).

“I am also considering a psychiatrist as I am possibly having a untreated case of PTSD from an incident four years ago”. I cannot comment but an evaluation could be helpful.

I cannot comment on your sinus findings.

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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