[Miss Foot]

#6659

Hello Dr,

In about March 2001, I was getting ready for work one morning when I sat on the bed and bent over to put on panty hose. I heard a cracking noise in my neck/traps area. Within 10 minutes, it was stiff and I couldnt turn my neck properly, and I couldnt sit up. I had to work lying down on a beach chair. Initially I had chiropractic care, which didnt help too much. A few months later, another chiropractor offered some relief. I had been crying myself to sleep because I couldnt find a comfortable position for my neck. At the time I weighed 242 lbs. I am female 5ft 8in.

In Oct 2001, I went away to school. The teachers used powerpoint for everything and the chairs were lower than the screen. Having to look up at the screen was uncomfortable so I asked them if I could sit higher up on the desk.

During my one year course, I went to the gym often (5 – 6 days per week most weeks). I lifted weights, but not what I would consider heavy. For eg if I were doing lat raises, I wouldnt use more than 10 lbs.

During my one year course, I had reason to go to the doctor because I was having constant pain my pec muscles deep in towards behind the breast tissue. I got some stretching and strenghtening exercises. Those pains continue today :( I have had an MRI in 2009 and the impression was “normal study”. The mammograms all point to fibrocystic disease, with no tumours present. (have had the imaging study as well). At the end of the year, I went down to 203 lbs which I have maintained.

Between 2004 – 2005, i did Pilates 4 – 5 days per week and yoga once per week. There were some exercises that I couldnt do, but I dont recall feeling horrible and I did enjoy the classes.

In 2006, I went to the doctor because i was feeling lots of discomfort and what I describe as a woozy feeling, a feeling of being unbalanced. He wanted to be sure so sent me for an MRI of the C-spine and brain. The clinical data on teh report said “paraesthesia in neck”. The c-spine report said in part

“the intervertebral discs appear within normal limits with no significant disc space narrowing identified. Axial images through (all the vertebrae) and C7/T1 demonstrate normal appearance of the thecal sac and exit neural foramina, no significant spinal canal or exit neural foraminal stenosis. no evidence of spinal cord or nerve root impingement or compression.”

I continued to exercise normally. A few years ago, i started noticing that whenever I did any prone exercises I would get dizzy (not the room spinning kind of dizzy). For example, If I lied on an exercise bench on my stomach with legs hanging off and lifted them straight up (like a Superman type pose for the butt and hamstrings) later in the day if I sat and then got up, I would feel like I was going to fall down and like my spine was gone out of alignment. This feeling would also occur if I did a stretch wherer I sat on teh floor, legs stretched out and bent and touched my toes with my back flat.

I just thought that was something which had to be managed so didnt mention it to my ortho doc until May this year. All the time I have been doing physio therapy which sometime included traction. I continued to have pain in my traps and base of neck on teh left side, and sometimes I have tingling down my left arm only, to my little finger. Occasionally, my thumb would get stiff.

When I told him, he immediately sent me for an MRI. That report said:

“Non contrast sagittal and axial study were performed. The field of view extends to the level of T4. The vertebral bodies are normal in height and demonstrate normal marros signal. There is no subluxation.

At C2-C3 there is a small central disc protrusion but there is no compromise of spinal canal.
At C3-C4 ditto.
At C4-C5 there is slight diffuse posterior disc bulge but there is no compromise of canal.

The entire cervical cord is normal in calibre an ddemonstrates normal signal. The craniovertebral junction is unremarkable.
IMPRESSION: Mild multilevel degernative disc disease but there is no compromise of spinal canal”

Another thing which has started happening is if I sit for long periods, my lower spine into the butt area gets numb. Also, sometimes from my lower spine through the back of my legs feel weak and I feel like how I would feel if I were nervous about something.

Also, what has been happening for a few years is when I sneeze, I get pain from my middle back radiating out to both arms to the fingers. Then it goes away after I sneeze.

I have started to sleep on a small flat cushion, as even though my pillow is soft and depresses when I lie on it, my neck was uncomfortable to the point of not allowing me to fall asleep.

My job involves sometimes sitting for 1 – 2 hours at a time. I have now started to get up ever so often. I have also changed the chair since the one I had was one of those where the back rocked back.

I get pain from the middle of my backk through the shoulder blade and under the arm only on the left side, and also my left traps, all the way along up to where it joins with the neck. i have reduced range of motion when i turn my head to teh right. I wear a soft cervical collar when I drive, and when I am going to be sitting for a long time.

I have added all of this history and details because in the past topics I noticed that you asked a lot of questions.

The only problem I had before the 2001 incident was digestive issues. From 2008 Dec to the time of the incident, i was working long hours with little sleep and my diet was poor.

My main question is if you think that exercises prescribed by the physiotherapist, if I do them dilligently, should give me some improvement. I have to confess that i dont always do them. (dont quarrel). The last time I went to the ortho doc in May, he said if there was no improvement, he would look at Thoracic Outlet Syndrome to see if that was the cause. Right now, it’s cervical nerve root irritation (I think that’s how it is termed).

[Donald Corenman, MD, DC]

#6661

We can look at your potential disorder two different ways. FIrst, what can cause your symptoms and the other, what can your MRI findings cause?

Symptoms include deep pectoralis bilateral pain, woozy, imbalance, dizziness feelings, left sided pain in the trapezius and base of neck, lower back and buttocks numbness and pain into arms and mid back with sneezing.

In general, dizziness and imbalance will not be caused by the neck unless there is insufficient blood flow from the vertebral arteries and that is exceedingly rare. Pectoral pain can be caused by the C4 nerve root but compression of that root causing that particular pain is also rare.

Base of neck and trapezius pain is very common and can be caused by degenerative disc and facet disease. Back and buttocks “numbness” can be caused by lower back disorders and is most likely not related to any neck disorder.

As far as the pathology found on your MRI, you have mild degenerative disc disease not compressing the cord or any nerve roots. This can cause your neck pain and trapezius pain but will not cause any of the other complaints you mention.

There is a possibility that some of your symptoms could be caused by fibromyalgia but patients with fibromyalgia typically complain of many more symptoms distributed over a larger area of the body.

I generally endorse exercises for many disorders. Cardiovascular exercise is effective for symptom reduction as it makes symptoms more tolerable. As long as the exercise does not aggravate symptoms, it is probably safe to continue.

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.

[Miss Foot]

#6692

Thanks for the response Dr Corenman. I do moderate exercise, which usually includes the elliptical machine, but not using the arms part because it aggravates the neck. If I going to be doing a long session, I wear the soft cervical collar as I find my neck feels better during the exercise once it is stabilized.

Will continue with the physiotherapy and also try and elimiate any conditions at work which may be contributing to the symptoms (eg chair, sitting for too long).

Thanks again for the time to review and respond.

[Author]

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