[Jose]

#10918

I recently had an MRI for my cervical spine. I had numbess and tingling in the fingers of my left hand, and scapular pain that seemed to originate from the neck. After focusing on my posture and doing some excerices, the tingling and numbness have gone away, but some grinding, stiffness, and a feeling that something is stuck in my neck persists and it always pops when I turn it. Here are my results:

c1-c2 mild arthrosis with normal alignment
c2-c3 no stenosis
c3-c4 disc space narrowing with decreased T2 nuclear signal but no central stenosis and the neural foramen are patent
c4-c5 decrease T2 nuclear signal with a mild bulge but no central stenosis. Slight left uncovertebral joint osteophyte change. Mild ligamentum flavum heperthrophy mildly indents the dorsal thecal sac.
c5-c6 degenerative central protrusion with mild flattening of the ventral thecal sac. Mild ligamentum flavum hypertrophy, greater on left with flattening of the dorsolateral thecal sac. Neural foramen are patent.
c6-c7 decreased T2 nuclear signal with a small right parcentral protusion. Mild right c7 foraminal stenosis.

Cervical spine demonstrates dextrocurvature whose apex is at c6-c7.

There is no cord compression or abnormal internal cord signal.

Question – How bad is this, I am 56 years old. The dextrocurvature, can that be re-aligned somehow….not too keen on going to a chiropractor or neck issues. I am deathly afraid of having to get surgery on my neck.

Thanks

[Donald Corenman, MD, DC]

#10926

Your “numbness and tingling in the fingers of the left hand” could be from cervical radiculopathy (see website for explanation) but your MRI report only notes right nerve compression (“c6-c7 decreased T2 nuclear signal with a small right par central protrusion. Mild right c7 foraminal stenosis”). There are many other disorders that can cause numbness and tingling. Look under “Nerve entrapment/compression” to understand these other conditions.

Scapular pain commonly originates from the neck. This can develop from degenerative discs, facets and compressed nerves. This pain can also originate from the shoulder.

Your MRI report is not too bad. You should be able to manage these symptoms with therapy and medications. Injections can also be very effective. Chiropractic can also be effective for symptoms. The curve of your neck (“dextrocurvature whose apex is at c6-c7”) is by itself nothing to worry about. A chiropractor will not be able to “straighten” this curve out but should be able to help you manage with your symptoms.

Surgery is only indicated if you have spinal cord compression, nerve compression leading to motor weakness or intolerable pain. You have none of these according to your report.

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.

[Jose]

#10929

Thank you so much. I thought it wasent too bad, but wanted to know what you thought. I hope that it dosent turn into surgery at some point (would love to know what you think about this possibility for someone my age).

As I said, I no longer have the numbness and tingling, that seemed to have resolve with being conscious of the way I walk, sit, stand, sleep, work. What is puzzling me though is the only remaing pain that I have right now feels like a ligament or muscle or something that is caught tight. If I turn my neck up to the left, down to the left, and just about anywhere left, it pinches the area that seems to be to the left of C7. Can that be the ligamentum hypertrophy? Yet, as you said, everything points to the right side and I have not symptoms on my right side. I am a bit apprehensive about chiropractic manipulation on the neck given the bulges and protrusions.

As an aside, I starting taking 1,000mg of curcurium a day about 3 months ago to replace the NAISDs. I do yoga, and I do cervical traction at home on a device that I hang over my door. I use about 20 pounds for 10 minutes. I also read, and started to do post isometric release excercises around my neck and do McKenzie neck excercises. Lastly, I go to accupunture about 1x per month.

[Donald Corenman, MD, DC]

#10931

The findings on your MRI might not point to the structure that is causing your pain. By your description, the facet can be your pain generator. I understand how you feel regarding chiropractic but your symptoms might be well managed by manipulation. You need to find a good, experienced chiropractor who is gentile. Physical therapy is another alternative to manipulation.

The treatments you are currently involved with look to be beneficial although I am not clear how effective curcurium (tumeric)is.

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.

[Jose]

#10938

I think you are right. The more I think about it, the more I believe its not due to the MRI findings. It’s on my left side. It started about 4 years ago with pain in the scapular region up to my lower cervical area, it would hurt even when I sneezed. Over the past few years I’ve tried very hard to change everything – ergonomics, sitting, etc. I worked for over 30 years on a computer and I think it caused a muscle imbalance which led to pain in the joints and ligaments. I have recently started doing core excersices, yoga, and take frequent breaks at work to stand up and walk around for 5 minutes. Perhaps I can reverse some of the damage or at least stop it. I plan to go back and do Pilates which I did many years ago and felt great. Thank you so much for your prompt responses.

[Donald Corenman, MD, DC]

#10942

Please give us feedback regarding how you are doing in three months. I think the most valuable part of the forum is feedback on outcomes.

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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