Viewing 6 posts - 1 through 6 (of 18 total)
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  • MikeMorris18
    Member
    Post count: 11

    Hi Dr Corenman,

    First off many thanks for your great site and forum. You are providing a wonderful service for us.

    I am a 39 year old male. I recently had a series of neck xrays and mri completed.

    This was due to my orthopedic wanting to check my neck for the pain that I currently endure between my right shoulder and neck. It is a constant burning, aching pain. Not a the back of the shoulder but along the path from neck to A/c joint.

    I have a partially torn rotator cuff (supra) and arthritis in the A/c joint and impingement. They will go in shave some clavicle, clean up the A/c Joint and stitch the tear. Pretty standard stuff.

    I tried over 30 sessions of physio for the shoulder and two cortisone injections. The sessions did nothing and the cortisone provide relief for about 3 weeks at a time. The whole process has been over 15 months.

    The conclusions of the neck MRI are as follows (excuse the layman’s translation as the MRI result is in Spanish) straightening of the lordosis cervical, degenerative changes of uncovertebal C5-C6 (uncoartrosis), associated with a posterior/medial disk protrusion of a large area, that causes decrease in size between lateral recesses.

    As I explained before, my pain is between the neck and right shoulder, nowhere else.

    Having read a large number of people’s comments here I do not feel I have anything to worry about as I have no pain like my fellow contributors seem to have.

    That being said I just thought I would ask you for your general thoughts about these results.

    One last thing have looked around on Google and your webpage and YouTube videos. My frontal X-ray shows my neck and it is a bit like straightening out letter S, I repeat not the sagittal plane view, the frontal plane. There are also no visible spaces between the clavicles.

    I can’t find a similar anywhere on Google or your webpage. Not sure if that is also relevant.

    Thanks again for your time and for the extremely long-winded message which is probably a lot to do about nothing!!

    Best wishes and have a great day!

    Mike

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The pain you experience could be from either the rotator cuff or the cervical nerve root compression. You do not note on the MRI report what side the uncovertebral joint spur and herniation are on so I will assume it is on the side of your pain.

    The best way to determine which disorder is causing your symptoms is with nerve and joint blocks while keeping a pain diary (see website). These injections are just like a gum injection at a dentist office that numbs the nerve in the jaw. After this dentist’s injection, the jaw goes numb for about three hours and the dentist can happily drill away without causing any pain to you. He or she has successfully blocked the sensory nerve to the jaw so pain transmission stops.

    The same process occurs with a selective nerve root block (SNRB) in the neck and with a sub-bursal injection in your shoulder. Keep a pain diary to determine which block relieves what pain. Only be concerned for the first three hours after the injection and nothing further (the steroid injected can have pain relieving effects that are not specific).

    The “straightened S curve” in the front to back X-ray of your neck demonstrates asymmetric wear of the discs. This is not uncommon and by itself is not cause for concern.

    Dr. Corenman

    MikeMorris18
    Member
    Post count: 11

    Many thanks Dr Corenman for your very fast reply. It is greatly appreciated.

    Unfortunately in my MRI it did not stipulate which side the uncoartrosis was on either. Was presuming both.

    Have previously had two cortisone type injections for the right shoulder, six months apart. Both times, the burning pain disappeared for about 15 days. As you point out on your article about SNRB, the nerves do love steroids!!

    I will ask my orthopedic, when I see him on the 5th of April, for the SNRB diagnostic. When I have these results I will let you know their findings.

    Sincerely hoping it is just the shoulder!!

    In the meantime I presume that I continue with my day to day life normally, a friend suggested I visit an osteopath. I personally am not so sure on that as I think would like to wait until I have the return visit with the orthopedic.

    Thanks again for your time and efforts, you are most generous to offer your time and incredible expertise for us in this manner!

    Have a great day!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    An osteopath uses manipulation along with medications and injections. You can try treatment guided by an osteopath but I think it would be in your best interest to have a diagnosis first. Your response that shoulder injections gave you relief is an indication of the shoulder as the pain generator. Did you get complete relief for a short period of time?

    Dr. Corenman

    MikeMorris18
    Member
    Post count: 11

    Once again Dr. Corenman I sincerely indebted to you for your replies.

    I am holding off on the osteopath until the 5th of April, when I see my orthopedic. From there we will make some decisions.

    In response to your question about complete pain relief from the injections, the relief would have about 90% for approx. 15 days. After that period the pain returned completely within about 48-72 hours.

    As said previously I believe and sincerely hope that is the shoulder!!

    On a side note, I showed my cervical Xrays and MRI to my neighbour who is a GP (not sure if in America you use that term, sorry, General Practioner) He said he has seen worse and he has seen better!

    He sent me to get a Lumbar Xray, after he inspected the images and did a quick physical study of my back and neck, which I did on Friday past.

    From my layman’s eyes the Lumbar seems fine if not fantastic. I have flat-back syndrome, in the lateral view my lumbar is completely perpendicular (I presume that is why my neighbour sent me) and some significant disc degeneration at T11-T12, T12-L1. Am basing the significant comment on comparing to other Lumbar Xrays that I have found on Mr Google! So it could very well be moderate in some people’s eyes. But I am 39 so degeneration is too be expected.

    I have no real significant pain in the lower back. I feel I am just like everybody else, getting older!!

    I will take those Lumber Xrays with me as well when I see the orthopedic.

    Just to give an outline of my pain levels. I have FAI cam/pincer in both hips. I have both labrums torn with articular damage. Have seen 3 orthopedics (all three have worked and presented with your colleague Dr Phillipon) and they all want to operate. I am holding off as that pain is about 2 out of 10. My shoulder/neck pain is a 7. Lower back I would put at 3.

    Sorry for the extremely long-winded message.

    Hope that it makes some sense!

    Once again my sincerest thanks for taking the time to provide this wonderful service.

    We are so very fortunate to have a doctor of your standing provide this for us. Please know that we greatly appreciate it.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    If you received 90% pain relief in the first three hours, then you could blame 90% of your pain on the shoulder. If the pain relief took one to two days before you noticed it, this might be from the steroid effect of the injections. Only the first three hours is diagnostic to determine if the injected structure is causing pain.

    Many people have CNS (crappy neck syndrome) and have no to minimal pain only.

    Dr. Corenman

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