Donald Corenman, MD, DC
Moderator
Post count: 8368

Pain radiation into the shoulder blades is a common pain referral location for nerves C3-T1. It is not uncommon for the C3-4 level to radiate into the scapula. I would make sure that the fusion at C4-7 is really solid. An MRI can reveal that but also can give misdirection. Flexion-extension X-rays would be a better tool for evidence of fusion.

If solid fusion is noted, and you have “moderate to severe right foraminal stenosis, and moderate left foraminal stenosis”, a selective nerve root block at C3-4 with good temporary relief would give evidence of the pain generating capacity of C3-4 where you could do something about this surgically (or the injection calms down the area and can be used for treatment).

See:
https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and
https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

Dr. Corenman

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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.