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Dr. Corenman
Hi my husband was sliding a steel plate off a truck at work but wasn’t expecting it to drop suddenly off the edge of the truck. When it did he said it felt like he got shot in the back in the shoulder blade with a bow and arrow. He could not stand up and had a hard time breathing at the time of the accident. He went to the doctor and they thought it was a muscle so he went to physical therapy for 3 weeks 3 times a week. He then started having neck/shoulder pain with it radiating to his arm and down to his hand where his pinky and ring finger goes numb. He went back to doctor and he decided to do a myelogram because he can not have an Mri due to having a bb next to his heart. He said the myelogram showed a nerve being pinched but he said it was the wrong nerve and that we are dealing with something else. This is all he said so he did a steriod injection in the shoulder to see if that helps and wants to start physical therapy 3 times a week again for 4 weeks. On my way home I was reading what the doctor wrote to the phyiscal therapist and his diagonsis on the paper is c6 left mild foraminal stenosis, left rhomboid muscle and left shoulder impingmene. I was wondering if you can tell me what the c6 left mild foraminal stenosis means. Also what do you think we should do? Should we get a second opinion or what?
Your husband’s presentation is commonly associated with a cervical disc herniation. Pain typically starts next to or behind a shoulder blade and some time after develops in the arm.
Apparently, your husband cannot have an MRI due to this BB but I would still check with a knowledgable radiologist to see if an MRI can be performed. I do not recommend any specific names on this website but if you call the office at our 888 number, I can give you the name and contact information of a respected radiologist who can give you more information.
You husband received a steroid injection into the suspected painful shoulder. I assume that a numbing agent (lidocaine) was also injected at the same time. If so and assuming the injection was placed in the correct compartment, this was an opportunity to find out if the shoulder played some role in generation of pain. For the first three hours after the injection, did the pain in the shoulder and arm significantly diminish? If so, did all the pain subside or only a portion of the pain. See “pain diary” on this website to understand how to report these findings.
C6 foraminal stenosis is well described under “Conditions”/”Neck-Cervical”/”Radiculopathy-pinched nerve”. This is a condition where bone spurs fill the exit hole of the nerve causing a pinch of the nerve. This condition is possible but I would suspect a herniated disc causing the problem (see same section under herniated disc). The symptoms would be the same but a herniated disc is harder to see on a CT myelogram and is sometimes missed.
It would not hurt to gain a second opinion if you don’t have enough information.
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.My husband had the shot at about 430 pm and yes there was a numbing agent in the shot. He said that the pain went away but not completely but then he went and took a shower and reached to wash his back but nothing strenous this was about 9:00 pm and then it came back full force. His neck was stiff and very sore and his shoulder hurt so bad that he couldn’t even move it.
The numbing agent works for about three hours. The relief that your husband received is most likely proportional to the pain generation that the shoulder generates. Since the block was performed at 4:30PM and his pain returned at 9PM, the block had worn off by then. His shoulder is at least part of the problem.
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.We are going to seek a second opinion what type of doctor should we see considering he is having neck,shoulder and nerve issues should we see a spine specialist or a neurology doctor or someone else?
I was wondering after therapy for 4 weeks if it does not help his neck what is normally the next step. Remember right now he is under the care of an ortho doctor. he has been to about 4 sessions of therapy and neck is not any better. He says he is miserable and ready to go somewhere else because it is not helping and the therapist says it should be helping by now. we don’t know what to do because it is a work comp issue and can not get a second opinion without work comps permission other than through an attorney that has checked with a doctor she uses and he can’t get him in until the 1st of may. Any suggestions would be appreciated.
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