[Himanshu]

#8232

Dear Dr. Corenman,

I would like to introduce first. I am a phD student working on antimicrobial peptide based antibiotics in premier institute in India. I know bit of the biology and physiology of humans but obviously I don’t have the core knowledge. Now I will come to the point. My mother who is of 50 year old facing this severe neck and back pain for last one month continously. She also does not able to stretch her hand beyonds a height. She is having sometime sensational loss in her hand and severe pain in her shoulder. Now when the MRI scan was done the radiologist reported that degenerative changes noted multilevel disc bulges and described and likelihood of neural compression at c6/7 level due to paracentral disc extrusion. Now my question is that in this condition what could be the treatment. And will the treatment would be surgery based or without surgery also it can be treated. I hope doctor, I didnt bother you much so if you get some time and you can suggest me something that will be a great favour.

Thanks alot
Himanshu Sharma

[Donald Corenman, MD, DC]

#8233

Pain in the shoulder and arm with sensory loss points to a nerve root compression but thoracic outlet syndrome is possible. If the pain in the arm increases with overhead activity, thoracic outlet syndrome is more likely. If the pain decreases with overhead activity, radiculopathy is more likely.

Please see the section on this website “When to have neck surgery” to understand surgical indications more thoroughly. By the interpretation of the MRI findings, root compression of the C7 nerve (C6-7 level) is most likely the cause. If so, and no significant weakness is present, she can try epidural steroid injections and physical therapy. With severe pain and weakness, surgery (an ACDF-see website) might be indicated.

Dr. Corenman

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