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Hi. I found your site and am praying you can help me better understand what is happening to my body and if/how I can get better or even completely back to my previous self.
I read how to describe my injuries on your post so I will do my best and apologize in advance if I miss something or give information you don’t actually need.I had a horseback riding at work on 10/05/2013. I work on a cattle feedlot and we were out at the pasture checking on cows and fences. I was riding up a ravine going slowly and about halfway up my saddle strap broke from my saddle. I fell from the side of the horse with the saddle. I do not know anything about how I landed, what I hit or details. I was knocked unconscious for about a minute and my boss who was riding with me was in front and did not see how it happened he found me on the ground.
Neck/Arm/Hand:
Quality of pain is variable. Most of the time I have aching dull pain midline on back of neck. The pain deepens on the base of my skull on the right side. It feels like immense pressure. This can come or go and I have not deciphered anything in particular that precedes the changes in pain or intensity. I usually have some degree of headache everyday. 1-6 VAS. The pain extends down my right shoulder and upper arm. The pain there feels sharp, and stabbing, in the shoulder socket area. I get numbness with tingling down right arm. This I noticed is mostly onset by position such as driving. Changing positions and lowering my arm to my side usually helps to relieve the tingling and numbness feeling. Then the sharp pains will subside. At one point my first finger and thumb on my left hand were less sensitive to touch and feeling. I noticed this for about a week and it has since subsided and not returned. This was about a month ago. I have not noted any skin changes. My neck is sensitive to massage type touch. The percent of pain in neck vs shoulder/arm also varies. When I am not experiencing the pains down my arm it is 90/10. When the pain radiates down my shoulder and arm it is 50/50. The intensity of pain in neck usually is in the 2-6 range. But with driving, lifting things more than about 15 pounds, pushing, pulling, sweeping and action as such the pain will increase to 3-7. Usually ending up on the later end of the scale after doing such activities. I have not noticed significant weakness in any limbs but my PT did not decreased strength in my left grip of 20%. My handwriting has changed noticibly. It is much more sloppy and not as fluid. The pain was almost immediate after my accident and has progressively gotten worse over the last few months. Sitting increases my pain if I am reading and holding my head at an angle other than completely straight forward and my posture very erect. Standing does not seem to change pain. Laying down on my side is most comfortable and relieves the pressure feeling in my neck but usually increases arm pain radiation. So I find myself changing from side to side often to decrease pain. I can sit for about 20-30 minutes before it gets so uncomfortable that I have to get up and move. I have also noticed that lifting both arms directly over my head relieves the pressure and associated pain in the midline area of my neck and base of skull. The pain has completely changed my quality of life. I was a very active person who worked an extremely physical job daily. I also enjoyed many outdoor activities prior to my injury that I cannot do not due to my pain. Now just doing menial household chores causes my pain to increase and I find myself dreading seemingly simple tasks. My job is extremely physical and is different everyday. I have been off of work since my accident and work comp is handling my treatment.
Lower back/Legs:
The pain in my lower back is equal to and sometimes worse than my neck areas. It is low on my back and is persistent. It feels dull at times, sharp with movements that are sudden, sitting for longer than 20 minutes, pushing, pulling, driving, lifting, sweeping, etc. At times, mostly random it seems, I get sharp extremely painful shooting pains down my buttocks and back of my legs. This happens on both sides but more on my right side when I am driving for longer than 30 mins or so. I try moving around in my seat to ease the pai but it usually will not let up until I am able to get up and walk around. The pain intensity in my lower back varies as well. If I stay fairly inactive it is about 1-4 but with driving or increased activity and sometimes for no reason at all that I can pinpoint it changes to 4-7. The percent of pain from back to legs is usually 80/20. I have not noticed weakness in my limbs, however the Dr I am seeing noticed a decrease in strength of my left big toe about a month ago which he said has now resolved. I do frequently get numbness/tingling down both legs when sitting with feet touching the floor. This happens within 5-10 minutes of sitting in that position and is resolved by walking.
Other symptoms:
Vision blurry and double vision with night time driving
Left side of mouth slightly droopy after accident until about 10 days post accident
Extensive deep bruising on almost every part of body post accidentPrevious Tx:
Physical therapy for 4 wks one month post injury-would feel slight improvement in some areas for a few hours after visit. Went 3x week
Chiropractor 2 visits greatly increased pain
Physical therapy again for the last month 2x week- usually makes things worse the night of and day after
Ultrasound to neck and low back at PT
E Stim to neck, shoulder and low back at PT
At home stretches and exercises which also increase pain in low back and neck after doing them
Heat and Ice do relieve flare ups occasionally but only for a short period of time and more for muscle pain not radiation down arms or legs.
Physiatrist doing manual treatments on neck and back with so far have made my pain extremely unbearable following the treatment.
I have tried a slew of medications for headaches, muscle pain, nerve pain, inflammation, etc. None have helped much. They make me sleepy but don’t do much to relieve pain.
Physical medicine and rehab Dr who is treating and managing my care lists the following Dx on my recent clinical summaries:
Neck pain
Cervical spine stenosis
Myofascial pain syndrome
Herniated lumbar disc
Lumbar disc degeneration
Hypermobility syndrome
Concussion grade 3/post concussion syndrome
Cervical spine pain
Parascapular pain
Cervicalgia
Nonallopathic lesions
Lumbago
Migraine headaches
Visual disturbancesMedications I am taking or have tried recently:
Nortriptyline HCI 25mg 1qd at bedtime
Aspirin 81 mg (I have factor v leiden)
Calcium
Nabumetone 500mg 2 tabs 2x daily as needed for pain
Vit D3
Disipramine HCI 10mg 3 tabs daily at bedtime (DC’d)
Meloxicam 7.5mg 2 tabs daily (DC’d)
Gabapentin 100mg 3 tabs daily at bedtime (DC’d)
Vicodin (DC’d)
Flexiril (DC’d)I had several x-rays taken after injury of neck and all were negative.
MRI done of cevical spine and lumbar spine on 11/29/13
Both were non contrast closed MRI
Final Results:
CERVICAL:
Craniocervical junction is unremarkable. No cerebellar tonsillar ectopia is seen. No abnormal cord signal is identified. There is congenital narrowing of the osseous central canal from C3-C7 level. Osseous central canal measures 9 mm in AP dimension.
C2-C3
C3-C4
C4-C5
level shows no significant osseous central canal or foraminal stenosisC5-C6 level shows a posterior disc osteophyte complex which impresses on the anterior thecal sac and mildly deforms the cord. There is moderate narrowing of the bilateral intervertebral foramina.
C6-C7 level shows no significant osseous central canal or foraminal stenosis. Mild posterior disc is identified.
C7-T1 level is unremarkable
Impression:
Moderate posterior disc at C5-C6 produces moderate narrowing of the osseous central canal. There is moderate narrowung of bilateral intervertebral foramina at this level. Patient has background congenital narrowing of the osseous central canal from C3-C6.
Lumbar Spine:
There is straightening of the normal lordotic curvature. Conus terminates at the T12-L1 level. No abnormal signal is identified within the conus. Sagittal evaluation of the T11-T12 and T12-L1 discs show no significant disc pathology. Osseous central canal and bilateral intervertebral foramina are patent.
L1-L2
L2-L3
L3-L4
Level shows appropriate disc signal. Osseous central canal and bilateral intervertebral foramina are patent. Nerve roots are evenly distributed throughout the thecal sac.L5-S1 shows a posterior disc protrusion. No significant osseous central canal or intervertebral foraminal stenosis is identified. The traversing S1 nerve roots are interposed between disc material and ligamentum flavum without evidence of impingement. Sagittal sequence shows a posterior annular tear. No marrow edema is identified within the vertebral bodies or the pedicles.
Impression:
Posterior disc at L5-S1 with a posterior annular tear. No evidence of nerve root impingement is seen.
Again, I appologize for the extremely long post. I just figured if I give you all the information I can think of now maybe you would have all you need to help if you can.
Oh yeah, almost forgot…work comp sent me to a neurosurgeon and he said he can’t help me that he believes I do have significant pain but that it is muscular and not something he can fix. He also said that he doesn’t see any cord compression or that anything is even touching my soinal cord and that my MRI results are comparable to any person over 12 yrs old in America if you were to take a random screening of MRI’s.
He said I need pain management and made a referral for me to see them. The work comp nurse is supposed to be getting them to see me but it is going to be a month before they can get me in.I truly appreciated any help you can offer!!!
Can’t answer if I don’t know the question!
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.So sorry. Accidently posted. Working on full information for you. Sorry…slip of the fingers
No problem.
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.Im sorry but the post with all of my info ended up at the beginning. I think because it took me so long to write it and I started it right after I accidently posted just the subject. Just wanted to make you aware so you could review it.
Thank you again!!Here is the thread that I posted my original post on that was missed. Again, thank you!!!
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