MarkLMemberFebruary 14, 2012 at 10:11 amPost count: 3
Hi. I was a passenger in a 1995 car accident where a driver drove into the passenger door at 40mph. After 6 months of neck PT, symptoms disappeared for 12 years. Neck pain in 2007 led me to get an MRI which showed some C5-C6 degeneration, spur formation, narrowing, slight bulging. Yoga and home traction relieved the pain and brought more movement to the joints but it’s still generally on the sore side. I’m early 40s, in good shape, live healthy lifestyle (despite working at a computer).
A nerve conduction study was done in 2008 before a rotator cuff repair. The surgeon wanted to be sure the pain was coming from my shoulder and not my neck. Although the neurologist concluded the shoulder was the cause of the shoulder pain, he told me there was bilateral nerve weakness consistent with a C5-C6 injury. Although I barely felt anything at the time, I have been getting progressively weaker from the lower bicep through my forearms and into my wrists since 08. I lift weights to avoid muscle wasting and keep trying to ignore it but I am noticing fine motor skill issues and very early fatigue. Gripping things for a while and even typing can be a challenge after a few minutes. It’s all still livable (though annoying) but at the pace it’s moving, I fear whether I’ll have use of my arms/hands by age 55 or 60.
My Question: Is this type of damage generally permanent? Is time of the essence to get it treated? Should I not be fighting through it but instead be having something done about it? What would typically be done for this? Back in 07 when the MRI was done, they said they don’t like to do surgery for stuff like what they saw because the risks of neck surgery are so great. Thanks for your help!Donald Corenman, MD, DCModeratorFebruary 14, 2012 at 1:16 pmPost count: 8468
You had a motor vehicle accident about 16 years ago and recovered after 6 months. About 5 years ago, you developed neck pain and an MRI demonstrated degeneration of the C5-6 disc. You have been able to manage the pain and live a relatively normal life.
You underwent an EMG which indicated involvement of the C6 nerve (C5-6 level). You have been developing progressive weakness of your biceps to wrists bilaterally.
Normally, foraminal stenosis (see website) is not normally bilaterally symmetrical. Also, there typically are paresthesias (pins and needles) and pain associated with foraminal stenosis and the symptoms typically become worse with neck extension (bending the head backwards) and improve with the chin on chest maneuver. Does that fit with your current complaints?
If you have only weakness without any radiating symptoms, you need to see a neurologist again. If you have the above noted symptoms, you need to see a spine surgeon for a consultation.
Dr. CorenmanMarkLMemberFebruary 14, 2012 at 4:04 pmPost count: 3
Thanks doc. I just found the MRI report from 07. I’ll type it up in case that’s helpful. At C5-6 disc space, a 3.8mm broad-based bridging osteophyte creates minimal spinal stenosis with attenuation in the anterior subarachnoid space. A 2.5mm far right lateral protrusion superimposed on hypertrophic change to the right uncovertebral joint contributes to severe right C6 lateral recess and proximal foraminal stenosis. There is additionally severe compromise to the left C6 foramen due to hypertrophic change to the uncovertebral joint and lateral spondylosis. At the C6-7 disc space, a 2.5 mm diffuse bulging annulus and minimal spondylosis is present. At the C7-T1 disc space, a 1mm far right lateral protrusion is not excluded. The resolution and definition of the lateral recess and proximal foramen is somewhat limited. The signal intensity of the cervical chord is normal. The facet articulations are maintained bilaterally. There is no compression fracture deformity of the cervical vertebrae. There is no evidence of cerebellar tonsillar ectopia. Normal flow is demonstrated from both vertebral arteries.
I can’t find the EMG report from 08 but I remember that only 1 side was tested. They had found some weakness that they said was consistent with the neck condition, from the bicep to the wrist flexors. Today I feel weakness in those areas in both arms. At the time of the tests, I was having the paresthesias with head bent back. Flexibility has improved with traction and yoga and I don’t notice paresthesias when bending head back (just stiffness). I get some pain in low bicep/forearm area when sitting with bad posture for extended periods today.
Given this more detailed information, does it sound like I should be seeing a spinal surgeon or neurologist? OR just tough it out? If nerve damage is being done, is time of the essence that I deal with this so as to prevent further damage or bring back any strength that has been lost? Or would that be permanent loss? Thanks so much.Donald Corenman, MD, DCModeratorFebruary 15, 2012 at 10:37 amPost count: 8468
Based upon the radiologist noting “severe” foraminal stenosis bilaterally at C5-6 and increased symptoms with head extension, you might be better off with a spine surgeon. Motor weakness needs to be addressed and if from severe foraminal stenosis, a spine surgery consult would make more sense.
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