GingerMemberJuly 11, 2012 at 4:55 amPost count: 2
Dear Dr. Corenman,
I have on and off neck pain and headaches since we hit a deer with our car in 2008, able have it quite under control with chiropractic care till December 2011. Then the pain suddenly got much worse. Now I feel dizzy most of the time, have daily neck and back pain and headaches, the pain radiates down the right arm, I have tingling in right hand and foot, cannot stay upright for a long time without resting my head, have a very limited range of movement.
I discontinued seeing the chiropractor because every treatment just seemed to make everything worse. I started doing physiotherapy exercises but don’t get relief. Because of rheumatoid arthritis, I am already taking anti inflammatories, and the RA is pretty much under control with Remicade and Methotrexate.
My family doctor wants to refer me to a specialist and ordered an MRI. Today I got the report:
There is moderate disc space narrowing at the C5-6 level with associated retrolisthesis measuring 3 mm. Alignment is otherwise unremarkable. No cord signal abnormalities are visualized.
I got a CD from the MRI and copied some pictures out of it to show them to my family doctor. She thinks that it looks worse than stated in the report and still tries to refer me to a specialist (which is not easy in Manitoba, Canada). I would be glad if you could have a look at the pictures and tell me your opinion. The symptoms are so bad now that they are effecting my every day life. You find some of the pictures here:
Thank you in advance,
JuttaDonald Corenman, MD, DCModeratorJuly 11, 2012 at 12:08 pmPost count: 8455
Your C5-6 level is quite degenerative with bilateral foraminal stenosis. This can cause lower neck pain and pain in the shoulder that would radiate down to the thumb and index finger. This level will generally not cause headaches.
Headaches can be caused by the facets at C2-3 and C3-4. This facet disorder generally does not show up on an MRI. The only way to determine if these facets are causing headaches is to use diagnostic facet blocks (see website).
To determine if the C6 root is causing the neck and shoulder pain, a selective nerve root block would be required (see website).
I deleted the address for the images to have you remain anonymous.
Dr. CorenmanGingerMemberJuly 12, 2012 at 2:42 amPost count: 2
Thanks for responding so fast and the detailed explanation. I just don’t quite understand that the MRI report stated: “There is no significant foraminal narrowing.”
My husband said recently that he noticed that I quite often drop things from my right hand. I had thought it might come from the pain and do more with my left now, but my handwriting has changed as well. I used to draw but I have difficulty doing this now. Sometimes, the pain in the hand is dull but the skin seems to be burning, sometimes the pain is sharp. The left arm and hand has some tingling too, but nothing compared to the right one.
The headaches and some of the dizziness seem to get a bit better when I put my hands round the back of my neck and do a very mild stretch upwards. But this relief doesn’t last. Sometimes I have less pain but a tingling on the skin of the back of my head.
The pain and dizziness are keeping me from sitting through a movie with my family, driving in a car for more than an hour results in hours of worst pain. What can I do to get some relief while I am waiting for my appointment with the specialist? Are the problems urgent enough to ask for an earlier appointment? According to my pain and discomfort it is urgent to me, but what from a neutral point of view?Donald Corenman, MD, DCModeratorJuly 14, 2012 at 8:25 amPost count: 8455
If the radiologist reported “There is no significant foraminal narrowing”, I would disagree with him. You appear to have narrowing at C5-6 based upon the image I reviewed. With C5-6 foraminal stenosis, you cna have pain radiate down your arm into your thumb. Nerve compression can also cause you to drop items.
Without a full history and physical examination, I cannot tell you if you have an urgent problem or not.
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