[Browner53]

#30580

Dr. Corenman

I am trying to figure out what is going on with my neck and various symptoms I have been experiencing over the last 4.5 months. I am a 53 year old male that was diagnosed with Benign Fasciculation Syndrome 20 years ago. My muscle twitching had been happening only mildly for the last 15 years. At the end of January, 2019 I developed a burning pain in the back of my neck that stretched across the back of my shoulders. It also includes shooting pains into my shoulder blades and soreness in various parts of my shoulders and the bottom of my skull. The burning pain has subsided but I am still getting occasional numbness/burning in the back of my neck with muscle soreness coming and going in my should blades, shoulders and upper right arm. I am also experiencing soreness at the bottom of my chin on the left side and the back bottom of my skull on the left side. My muscle twitching has also come back with a vengeance especially in my hands causing my fingers to twitch. I am also experiencing twitching in my triceps, chest muscles, legs and feet. My muscle twitching is bi-lateral. Other symptoms that started in January are the following:

– Body overheating at night causing a damp collar most mornings
– Mild Dizziness that comes and goes
– Paresthesia on left side of head that comes and goes
– Diffuse joint pain that comes and goes (ankles, knees, thumbs, elbows)
– Stiff joints each morning
– Stiffness in my right hand that seems to impact my right forefinger the most
– Bowel issues – Less frequent bowel movement
– Bladder issues – A few days where I found myself needing to go every 1.5 hours.
– Over the last week I have been waking up each morning with pain in my lower back

I have had a full battery of blood work ordered by my internist which showed a very low Vitamin D level which I am taking 4,000iu daily of a D3 supplement to treat. My internist also ordered a CAT Scan of my neck to look for possible lymphoma and all was normal.

I saw a Neurologist who said because I am not experiencing weakness he does not know what it is but he did order a Cervical Neck MRI w/o contrast. Here are the results:

EXAM: MR CERVICAL SPINE WITHOUT CONTRAST
CLINICAL INDICATION: Cervicalgia for three weeks.
TECHNIQUE: A variety of MR imaging pulse sequences were performed in the sagittal and axial planes for evaluation of the cervical spine.

COMPARISON: No pertinent prior studies have been submitted for comparison.

FINDINGS: There is normal alignment and vertebral stature in the cervical spine.
Marrow signal intensity appears normal for patient age. Cervical spinal cord caliber and signal intensity appear normal. A
limited view of the posterior fossa structures appear normal.
At C2-C3, there is a tiny right paracentral disc protrusion without central canal or foraminal compromise.
At C3-C4, there is no evidence of disk disease, spinal stenosis or foraminal stenosis.
At C4-C5, there is no evidence of disk disease, spinal stenosis or foraminal stenosis.
At C5-C6, there is a minimal disc bulge without central canal or foraminal compromise.
At C6-C7, there is a mild disc bulge with a tiny central disc protrusion and facet arthrosis present without central canal or foraminal compromise.
At C7-T1, there is a minimal disc bulge without central or foraminal compromise.
IMPRESSION: C2-3 tiny right paracentral disc protrusion without stenosis. C5-6 minimal disc bulge without stenosis.

I can hear my neck lightly cracking when I turn my head and Advil does seem to help when the pain starts. Sometimes in the morning my spine feels like it is being compressed. It is an odd sensation.

My question is do these MRI findings strike you as a possible cause of my neck issues and these other symptoms I am experiencing?

The Neurologists I have seen do not think it is PD and I am seeing a Neuro next week that is a MND and MS specialist to try to rule out Lower MND and Autoimmune.

At this moment I find myself struggling trying to figure this out.

[Donald Corenman, MD, DC]

#30583

Your symptoms are diffuse but some could originate from your neck. Your “Mild Dizziness that comes and goes– Paresthesia on left side of head that comes and goes– Diffuse joint pain that comes and goes (ankles, knees, thumbs, elbows)– Stiff joints each morning– Stiffness in my right hand that seems to impact my right forefinger the most sound more to be a rheumatological condition and some lab tests would be in order to try and determine if you have an autoimmune problem.

Your neck might be simpler. Is is very common to develop neck pain that radiates into the shoulders from degenerative facet disease and you have that disorder at (at least) one level (“At C6-C7, there is a mild disc bulge with a tiny central disc protrusion and facet arthrosis present”).

My next step would be to consider an injection pain specialist and discuss facet blocks. See: https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/

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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