[conniejjn]

#9742

for about a month and a half now what started as a stiff neck has radiated to severe sharp, stabbing yet numbness and weakness down my left arm. Pain in my shoulder blade and sometimes muscles spasams in neck and shoulder that feel like a Charlie horse. I am unable to lift arm above 1/4 way and the pain leaves me unable to sleep. I do have terrible lumber pain as well but at present am searching desperately for some advice and relief on neck and arm . My primary wants to only prescribe pain meds and then sent me for mri- I followed up with surgeon who told me to do Pt which only made it worse. Perhaps in my young old age I have just become a baby with pain but I am going mad with pain- here are the MRi results==please help!

c6-c7 there is a shallow broad based disc bulge causing mass effect on the thecal sac with no signs of spinal stenosis
c5-c6 fusion hardware is visualized and shows no evidence of fracture or loosening
c4-c5 there is a broad based left paracentral disc protusion which effaces the thecal sac and abuts the ventral aspect of the cord and narrows the left neural foramen
all other cervical levels appear within normal limits

[Donald Corenman, MD, DC]

#9759

You have a disc herniation at C4-5 above the old fusion level at C5-6. I assume that you have pain that radiates into the left shoulder and part way down the arm but not past the elbow. The lower arm is still strong but you cannot lift you left shoulder up.

If this is true, you have a C5 radiculopathy (see website). With pain and weakness lasting 6 weeks, your options are more limited. The two treatments generally recommended are an injection (SNRB-see website) or a surgery. This could be an ACDF like you had before or an ADR (artificial disc replacement) if you are a candidate.

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.

[conniejjn]

#9771

My previous lumbar pain has also returned and I have already had three epidural steroid injections. Could you give me thoughts on MRI and tell me if any other rx options are available.

There is straightening of the normal lumbar lordosis. No focal, worrisome marrow signal abnormality is seen. Incidental note is made of end ate degeneration anteriorly along the superior of l4 and t 12 hemangioma

Disc desiccation seen at l4-l5 and l-5- s1. There is no intervertebral disc height loss

The distal cord is of normal signal and morphology. The conus medulla rid terminates at l1-l2
T12 and l1-l2 within normal limits without spinal canal or neural foraminal stenosis

L2-l3and l3-l4 mild spinal canal narrowing from facet arthropathy, ligament in flavum hyper trophy and spur disc complexes. No significant neural stenosis

L4-l5. Facet hypertrophy, ligament in flavum hypertrophy and tiny central protrusion (2mm) effacing the thecal sac, all contribute to mild central stenosis without significant neuroforminal narrowing

L5-S1. Mild diffuse disc bulge and tiny central annual fissure with no significant neural formaminal or spinal canal stenosis

How is it possible that at only 47 I am having such pain at both ends and no one seems to want to address them other than with Motrin

Thanks in advance for helping me understand in English!

[Donald Corenman, MD, DC]

#9774

You have CBS in your lumbar spine (crappy back syndrome). In reality, you have degenerative changes that occur in some individuals. Interestingly, there are some individuals who display these changes and have only mild symptoms. You have an educated spine and great nerve pathways that connect with your thalamus. Unfortunately, this means that pain information is well processed in your brain.

The beginning of treatment is a good core strengthening program. Find a therapist who really knows spine rehabilitation. There are many therapists who claim to know the spine but few who are really talented. It takes some due dilligence to find a good therapist.

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.

[conniejjn]

#9776

Can an srnb be used for lumbar pain

[Donald Corenman, MD, DC]

#9777

An SNRB (selective nerve root block) is typically used to identify and treat a specific nerve root that is suspected of causing leg pain (which includes buttocks or sacroiliac joint pain). An epidural (ESI or a TFESI-transforaminal epidural steroid injection which is an SNRB with more volume)can treat back pain as long as the pain generator is from posterior annular tears (tears in the back wall of the disc).

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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