[Perry]

#6764

Good morning Dr. Corenman.Need some help.AT best of times I have numbness in right foot from knee down,numbness in right hand from elbow down.Foot feels completely asleep.Headache and pain in back of neck.Numbness in right thumb and pointing finger.All of this on a daily bases for the past 5 months. At the worst of times or every several days I have severe headaches,neck pain,metallic taste in mouth,feels like something is trying to drain out of my ears and nose.At night in bed I wake up with a build up of fluid drainage in the back of my throat.Pins and needles or numbness all over my body.Walk with my right foot plopping down and use a cane at the worst of times.Balance issues and tough holding on to things,tough simply trying to tie my shoes.Become weak kneed and weak handed.Do get some relief when sitting down and more so when laying down.Also after a drainage I usually have two good days,symptoms some what lessen.As soon as I get up in the morning and start the least bit of head movement the symptoms worsen. Great difficulty and hindered movement of neck..Walking and the slightest change in elevation causes more pain and discomfort in my neck and back of head.Misery! Had C-6 removed in 1990 because of injury.Now because of new injury I have all of this.Difficulty performing the simple daily routine pleasures of life.Sense 1990 Ongoing symptoms: drop things at times,difficulty eating certain things (choke easily on certain foods),drooling when leaning over doing anything and weakness on right side.Handled all of this fairly good.But it did put a damper for certain types of work and recreation. CT scan shows severe degeneration in cervical and lumbar regions.MRI shows damage to C-4,C-5 and C-7.Spinal Stenosis,spurring, extended bone growth and calcium build up in the area which is how I understood some of the info from my GP.It took my GP three months to declare my condition as urgent but this same GP found blood in my urine on three occasions in 2008 and refused my request for a prostate exam,refused me an ultra sound and a uralogist.So I have little faith in this gentleman. Very poor communication skills.Sense May 30th I have been waiting for a call from a neurosurgeon.My GP will not say if I am on a waiting list or what is the usual wait times ,no information at all. Could you please give me or try an attempt to give me some answers as to what is happening to me.Concerned up here in Eastern Canada.looking foreword to hearing from you Dr.Corenman.Thank you.

[Donald Corenman, MD, DC]

#6767

It is generally better to start your own thread than to put your unique situation onto another thread.

Your symptoms cover many different systems. “metallic taste in mouth,feels like something is trying to drain out of my ears and nose.At night in bed I wake up with a build up of fluid drainage in the back of my throat” will be from the sinuses or another ENT system and needs to be diagnosed by a primary doc or an ENT doctor.

“Balance issues and tough holding on to things,tough simply trying to tie my shoes.Become weak kneed and weak handed; Headache and pain in back of neck; Pins and needles or numbness all over my body.” symptoms could be from spinal cord compression and myelopathy although other systems can also cause these complaints.

“MRI shows damage to C-4,C-5 and C-7.Spinal Stenosis,spurring, extended bone growth” does tend to confirm spinal stenosis and myelopathy possibility but a formal radiological report would be most helpful. Your prior cervical surgery could also be a problem area.

“Foot feels completely asleep; Walk with my right foot plopping down and use a cane at the worst of times” could indicate foot drop from a lumbar spine problem.

You do need to have these addressed sooner than later. If you have a copy of the prior CT scan of your cervical spine, please put it on this forum.

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.

[Happyseniorchic]

#10708

I have read this Ladies entire complaints about her spinal issues. I believe from my lay position she needs a Board Certified Spine Surgeon or Orthopedic Spine surgeon to review her case. Her dizziness might be caused by the a neck impingement. After reading those facts that relate to the neck area, I have similar issues. However I have been diagnosed with Minneer’s disease . I take mecclazine and this does the trick and keeps the unsteadiness and dizzy spells to a min.
I have had two spinal surgeries. One at L-5-S, ruptured disc. Surgery was performed in 1977. No issues until 2001 when L-4 collapsed onto L-5-S1. Instead of having hardware put into the spine. I chose a cadaver bone match. A cage was made to support the spine. I too have hip pain which I live with but an occasional injection does the trick.
I too have osteoarthritis. Feet and hands are always giving me trouble. Very similar to the previous ladies post. I have just recently had a Thoracic MRI, C-3/4 there is marked hypertrophy of the left facet and left lateral disc osteophte complex producing severe left foraminal stenosis with displacement of the left C-4 verve root. I will meet with my pain management team and get the Dr’s opinion. I believe that I need an injection to cool off the nerve root at C-4..
When I am able to settle down the neck area we will work on the Lumbar area. Since being diagnosed with osteoarthritis the ability to walk normally has changed slightly. Pain in my feet also includes heel pain. The other night I was up all night because of pain in my legs and feet. Pain comes and goes. right now I take Vicodin with I-bo. I am dealing with these body changes and learning to manage my body as I enjoy the golden years. Attitude has a lot to do with your mental well being. I try not to worry or dwell on my issues. Just become informed and forge ahead.

[Donald Corenman, MD, DC]

#10715

I agree with you. Some spinal pain is unavoidable and you have been tolerating this pain well. There are some patients who have pain that is not tolerable and even some patients who have “poor pain filters” between their body and their brain (the thalamus) and the same pathology in two different patients is perceived differently.

You do sound like you have a significant C4 root compression. The good news about this root is that it is not connected to any significant motor structures (except the diaphragm but this muscle has 5 more root to allow it to work well). Hopefully, a selective nerve root block will reduce the pain and allow this condition to be tolerable.

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.

[Malcolm]

#11143

Sorry for freplying here but I have been unable to open a new topic. I am 55 year old type 1 diabetic who has had severe pain in hands and lower arm for the last 3-4 years. Mild pain has been going on for a lot longer. Back muscles fform botton of spine to shoulders are also very tight and commopnly in spasm. I have had a facet joint injectionn at L5/S1 and T6/7 to releieve pain at thise points which was reletively successful. I do piilates for 2 hrs a week and have a sports massage fevery 3 weeks. Without these I think I would seize up.Pain in lower back was controlled by 50mg diclofenac and occasional pain killers.

I had an MRI done 2 years ago and one recently due to the arm pain which was occuring and the differences are quite marked. In the same time I have added chest soreness (mainly on left side in floating ribs) and it will occasionally spasm causing tightness for a couple of seconds which can make it hard to breathe.

Over the last 4 years I have had bith carpal tunnels releaseed which has removed some of the parathesia and numbness but not stopped the aching pain which is continuous. I have also seen a neurologist who could not find any neurologicl deficit but has treated it as if it was neuropathy with duloxetine ( I take 90mg a day). My Endrochronolgist says that this is not diabetic nneuropathy. In the last 3 years I have also had an attack of thyroditis with no apprent long term affect.

My MRI results are as follows:
Summary only:

19/6/2012

There are minor degenerative changes within the cervical discs. There are shallow broad based discal bars at C3-4, C5-6 and C6-7 levels. The canal dimensions at these and other levels are adequate throughout. Bilateral uncovertebral osteophytes are resulting in moderate constricction of the C7 neural foramina with potentia l for root impingement. Minor disc builges at T5-6 to T7-8 levels are noot resulting in neural impingement.

03/06/2014

At C3-4 a disc osteophyte bar causes marked bilateral foraminal C4 narrowing.
At C5-6 a broad based disc protrusion reaches the ventral aspact of the spinal cord (without causing cord compression)as well as causing moderate to marked degree of left C6 foraminal narrowing. This protusion has slightly increased in size since the previous study.

At C6-7 a broad based disc-osteophyte bar causes marked bilateral C7 foraminal narrowing.

Thoracic outlet and brachial plexus appear normal.

I have been referred to a spinal neurosurgeon and would like some help intepreting the above and the likelihood of surgery.

Regards Malcolm

[Donald Corenman, MD, DC]

#11146

You have to match the symptoms with the spinal pathology to make a differential diagnosis. This differential diagnosis means “there are suspected culprits in a line-up and you are trying to identify the one who perpetrated the crime”. In your case, the differential includes nerve compression in the neck (cervical radiculopathy-see website), peripheral neuropathy (see website) and some other form of metabolic pain syndrome (polymyalgia rheumatica or other disorder).

You have significant nerve compression of the C7 nerves bilaterally (“At C6-7 a broad based disc-osteophyte bar causes marked bilateral C7 foraminal narrowing”). You also have left C6 nerve compression (“moderate to marked degree of left C6 foraminal narrowing”). Are your symptoms similar to compression of these nerves (see “symptoms of cervical nerve injuries” to compare to these symptoms).

Also see the topic “peripheral neuropathy” to understand this disorder.

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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