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  • Jaccy
    Member
    Post count: 2

    Hello doctor, I was diagnosed at the emergency department in June this year with disc prolapse at C3/C4 and C4/C5 (MRI and CT scans). It is now mid-August.

    Since, I’ve visited emergency department doctors twice, and orthopedics clinic once and didn’t receive any useful advises other than to try not to take a fall or impact. From researching in my own time, it appears this type of injury needs to be managed and not left alone. I’m hoping you can give me some advices.

    To give you a quick background information.

    CAUSE: Injury during impact sport (impact to the back)
    DATE OF INJURY: June, 2011
    MRI scan: C3/C4 and C4/C5 disc prolapse. No follow up MRI since.
    CT scan: No fracture on C-spine or dislocation
    NECK: Gap for spinal cord at C3/4/5 is also narrow by structure

    DISCHARGE SUMMARY: Whiplash injury, neck pain, bilateral hand(s) numbness and paresthesia. Weakness in arms and hands.

    I was told to re-visit a doctor or emergency unit at a hospital if any negative changes occur. Also that it was okay to do light exercises to keep my back strong (though C3/4/5 are in the neck?). The paresthesia in my hands was completely gone after 2 weeks. Less than a week later after I did a back exercise (dumbbell fly – 5kg – bent knees and whole back tilt forward) I returned home to find myself with paresthesia again!

    PARESTHESIA: At about a scale of about 5 and alternating.
    AREAS: Parts of hands, arms, fingers, feet, arms, thighs.
    OTHER: Triceps muscle spasm, predominantly on left triceps.

    I visited emergency unit and the doctor tested my hands and legs coordination, balance, scratch / pricking test with a stick and blunt needle, reflex tests. Then sent me home saying the same thing, not to take on impact sports again. But like last time, no advises to for proactive treatment, physiotherapy, or any treatment advises at all!

    About a week ago, while laying in bed I experienced very intense pins and needles (and weakness in limbs) to the point of it being painful without touching. On all my four limbs and found it difficult to ignore and go to sleep. Tilting my neck too much to the left will also send a fairly strong deep muscle pain down from neck to mid fore arm on my right hand (my doctor dismissed it as muscle and not nerve related and ignored this..).

    Please help! It seems all the doctors here are telling me is to go home and don’t move much for the rest of my life!

    I’m now only doing sets of short and slow pushups and walking to keep my body in healthy state. The pins and needles now come and go, but I don’t know if that’s because I’m not really doing anything physical or because it is healing. My grip strength is good when testings happen but when I get pins and needles outside, my hands are weak again. My family wants me to catch a flight to see them, is this dangerous?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    There are many different diagnoses that could cause your symptoms. Visits to an emergency department are not typically helpful for accurate spinal diagnosis. The emergency room physician has to cope with so many potential fatal diagnoses that an accurate spine diagnosis is not expected.

    The MRI reading of “C3/C4 and C4/C5 disc prolapse” also does not describe what your condition is from. Are these herniations that compress the spinal cord? Do these hernations compress one nerve root or more? Are they disc tears/bulges that don’t efface any neurological structure? Are these segments in kyphosis (a reversal of the normal cervical lordotic curve)?. Do the flexion/extension x-rays note instability? As you can see, the MRI report is incomplete.

    Whenever I see the diagnosis of “whiplash injury”, it tells me that the diagnosis is incomplete. Whiplash is a generic term for a flexion/extension injury to the neck but does not delineate what structures were damaged. What did the whiplash do? Did this force tear a capsule of the facet, tear a disc, cause a herniation, tear a supraspinous ligament or an insertion of a muscle.

    Your symptoms could be from spinal cord involvement. You need to evaluated by a spine expert. A full history, examination and review of all studies needs to be performed.

    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.
    Jaccy
    Member
    Post count: 2

    Hi Dr. Corenman, I’ve just received another paper from the hospital. It is said on there that there’s spinal cord compression by the two discs. I can see them actually making 2 curves on the spinal cord on the MRI.

    My symptoms went away for a day where I felt completely normal, it returned yesterday but very lightly. I was at a physio today and we discussed traction. However, the physiotherapist did one on me without giving me any warning when I was laying down on my back with my head on the pillow. After the appointment it felt okay, but now that I’m at home, and if I am not imagining things.. I think it caused more harm than good as there’s now more tinglings on my arms than this morning and neck is feeling stiffer.

    I have the MRI scan from June if you would like to have a look at some pictures.

    Much appreciated.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Based upon your discussion of the presence of spinal cord compression, you need to get a consult from a spine surgeon. Make sure your physical therapist understands the ramifications of spinal cord compression so he or she does not perform any extension therapy to your neck.

    I would be happy to review your films. You can send them on a DVD/CD to my office. Please call (970) 476-1100 and ask for one of my nurses, Diana or Sarah.

    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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