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  • thepigcollector1
    Member
    Post count: 4

    First I’d like to thank you for putting your videos on youtube to explain the neck and MRI of the neck. After comparing my MRI to the healthy MRI that you showed; I was concerned there was more of a problem then the “specialist” said.

    I am a 47 yr. old female; and in pretty good health besides a slow thyroid problem that I have had for about 15 years. Blood work is good, etc.
    I have been having severe neck pain radiating into my shoulders for several months now. I went last month for the MRI of the whole spine but was more concerned with the pain in my neck.
    Here are the results of the MRI on the MR Cervical Spine W/O

    Reason: Severe lumbar cervical radiculopathy back pain scoliosis

    Clinical indication: Severe lumbar and cervical radiculopathy.
    Technique: Routine multiplanar, multisequence imaging was performed of the cervical spine without contrast.

    Findings: The cervical vertebral bodies maintain normal height and alignment and signal intensity without pathologic marrow infiltration. There is normal appearance of the craniovertebral junction and normal signal throughout the substance of the cervical spinal cord. Level by level findings are as follows.

    C2-C3: No significant disease.

    C3-C4: There is a mild left para-central disc osteophyte complex resulting in left greater than right-sided neural foraminal narrowing and cannot exclude nerve root impingement on the left. There is no central canal stenosis.

    C4-C5: There is moderate left-sided facet joint degenerative changes which narrows the left-sided neural foramen and cannot exclude nerve root impingement on the left. There is a mild disc osteophyte complex also present. There is no central canal stenosis.

    C5-C6: There is a small broad-based posterior disc osteophyte complex resulting in mild bilateral neural foraminal narrowing but no nerve root impingement. No central canal stenosis.

    C6-C7: There is a mild posterior disc osteophyte complex resulting in mild bilateral neural foraminal narrowing but there is no root impingement. No central canal stenosis.

    I have been to a chiropractor (before the MRI was done and after); he could not get my neck to manipulate except for one time and it felt like one bone on either side “popped”; after that he didn’t want to adjust me any longer because it caused more pain.

    I have been to my doctor who ordered the MRI and after he read the results I was sent to a Neurosurgeon. This particular doctor first ask me to move my head forward; then backward; and then side to side. I did the movement forward and backward, and told him I could not move side to side without pain. He then told me after looking at the MRI images and reading the results that he was a Surgeon and not a general practitioner; and that he only could help me if I needed surgery. He then ask me to walk across the room; and sit on the table where he checked my reflexes in my arms and knees. Not once did he touch my neck, and he also apparently didn’t read my paperwork because he had no idea that I was familiar with surgery. Not on my neck but just in general. While he was telling me he was a Surgeon that is when I told him I had several surgeries in the past (7 in all); that’s when he ask me “On what”? When I ask him about going back to work, he ask me what I did for a living. That was also in my paper work. (my line of work was cleaning residential homes and offices) He told me that it was arthritis and I needed pain management.
    I went to an acupuncturist, tried moist heat, ice packs, and even narcotics. It hurts 24-7 and this doctor made me feel as if I was crazy. The only thing that seems to help is if I take something that helps me sleep, then I can’t feel the pain. (which isn’t good)
    My doctor got the results back from the Neurosurgeon and his nurse told me on the phone that I could probably go back to work. I told her; how could I possibly go back to work when I was in so much pain? That is when she set up a follow up appointment. I have that appointment tomorrow; but I’m wondering if I should get an EMG test?

    Please help; I haven’t worked since the end of the year and it is effecting my mental health now. I still have a 15 year old daughter at home and I am a single mom. Thank you and God Bless!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Neck pain is typically caused by degenerative discs or degenerative facets. Shoulder pain can be caused by the same structures but also by nerve compression of the C4 or C5 nerves. You must indicate percentage of neck vs. shoulder pain. That is 80% neck and 20% shoulder, 70/30, 60/40 or ???? This makes a difference in the type of potential surgery and prognosis.

    The surgeon you saw was obviously incomplete if he did not know your surgical history or even your occupation prior to your meeting with him.

    Dr. Corenman

    thepigcollector1
    Member
    Post count: 4

    Thank you for getting back to me so quickly. I will be going to my appointment 3 hours from now.

    You ask how much pain in my neck vs. how much pain in my shoulders; The pain in my neck I would say probably 70%, and 30% in my shoulders. It just depends on which direction I move my neck and the pain will shoot into my shoulders. Sometimes on the right, sometimes on the left, and sometimes both. But the pain in my neck is constant, it’s there 100% of the time, sometimes it hurts so bad I just sit and cry.

    In your opinion; should I get an EMG test? Or are there other tests that could possibly give me a clue as to why I’m in so much pain?

    Thanks again.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Neck pain is typically generated from degenerated discs or facets similar to knee pain from an arthritic knee joint. In your case, it is unlikely that an EMG test will give any information as the nerve is most likely not the source of pain generation in the neck. EMGs are only useful if there is a significant pinched nerve and motor weakness. If there is motor weakness, the physical examination will reveal this so the EMG test is not a very useful test.

    IF you have no spinal cord compression, you might be a candidate for an epidural injection (see website for description). Ask your surgeon if he would consider ordering that injection.

    Dr. Corenman

    thepigcollector1
    Member
    Post count: 4

    Thank you, I now feel like I have some kind of direction as to what to ask my doctor about.

    I know about the epidural injection, I had it done on my lower back 5 years ago because of a degenerated disc. Luckily I was a great candidate for the procedure, it lasted a little over 3 years before the pain returned. And it didn’t return full blown as before I had the injection.

    Unfortunately; the doctor that did that injection doesn’t take my current insurance, but I will find one that does.

    Thank you again for actually “listening” to me.

    Patty

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Make sure you find a well skilled injectionist and he or she performs a thorough history and physical examination.

    Dr. Corenman

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