jellyfishMemberDecember 13, 2011 at 7:12 amPost count: 2
Hi, I had a C5/6 fusion 8 years ago after 12 years of severe pain which gave a huge improvement for 7 years. A year ago the pain in my neck started getting bad and I have now got to the point where I cannot look down (either sitting or standing up) for more than a few seconds without causing a painful flare-up which lasts for about a week. Sitting on most chairs also causes severe pain at the back of my neck. I had a recent MRI which didn’t show anything. My doctor has suggested neck strengthening. I have been doing isometric exercises for a month. My neck feels a bit stronger but no less painful and I am still unable to sit and do things at a desk, or sit in seats such as on planes or most cars. Which muscles are the main problem? Should I be doing particular exercises targeting the back of the neck? How much improvement can I expect from strengthening? Might there be permanent damage, e.g. scar tissue, to the muscles which will limit my ability to get them functioning normally again? Thanks.Donald Corenman, MD, DCModeratorDecember 13, 2011 at 2:32 pmPost count: 8468
Severe pain in the neck that increases with flexion and can last for more than one week after onset could be from disc origin. An MRI that “didn’t show anything” could have demonstrated degenerative disc disease and not have been recognized. Facet disease and inflammation will typically not show up on MRI but facet pain typically occurs from bending the head backwards (extension)- not your complaint.
The previous fusion could also have failed and taken this long to declare but that is unlikely. You need to have your films reviewed by a spine surgeon and get an opinion from him or her.
Dr. CorenmanjellyfishMemberDecember 13, 2011 at 3:05 pmPost count: 2
Hi Dr Corenman. Thanks for your reply. The doctor I saw was my spinal surgeon who is very well regarded. He said he couldn’t see any reason on the MRI why I was having so much pain and so he did tests which ruled out MS. He came up with the weak muscle diagnosis saying that was the only explanation left. He acknowledged there seemed to be a lot of swelling around the neck and I have had some facet joint cortisone injections which helped for a few weeks. However I don’t understand why the pain got worse a year ago, and why I am having such a severe reaction to sitting and looking down. Could it be weak muscles that are causing me so much pain when looking down?Donald Corenman, MD, DCModeratorDecember 13, 2011 at 9:27 pmPost count: 8468
You reply that you had good but temporary relief from your facet blocks. I pay great attention to the diagnostic portion of the block- that is the first three hours when the numbing agent is active. If your pain was substantially relieved by the block for this period, you may have facet inflammation. Ask your surgeon if you might be a candidate for a rhizotomy (see website) a procedure that can disconnect the nerves that travel to the facets.
Neck pain so severe that you are incapacitated for a week just by bending your head forward is unlikely to be caused by weak muscles.
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