Post count: 34

Dr. Corenman:

I am pretty sure this is at C2-C3 (vs. C3-C4). I now have some pins and needles in the C2-C3 distribution after my PT sessions and at other times.

This problem started about 6 weeks ago. After about 2 weeks, I couldn’t turn my head enough to drive safely. After trying the other usual stuff, I had a few days of prednisone (from an emergency stash) — 20mg/day (BW~50kg). The result was marked — even after just a day. I continued 20mg for 5 days and then 10mg for another 5 days. After a couple days, my range of motion and my pain had dramatically improved. I completed this trial of steroids about 2.5 weeks ago.

This seems to be a bit of synovitis if you ask me. But no signs of inflammation on MRI — not even a little bit of edema? Is the C2-C3 facet joint adequately imaged in the typical C-spine MRI views? Would one expect MRI findings if there was synovitis of 6 week duration? (I do vaguely remember seeing a physio back in Australia maybe 5 years ago for an annoying problem — probably soreness/stiffness on rotation — which she told me was at C2-C3. I went to physio a couple times a week for a few weeks and it got better. I didn’t need any tablets for pain. This time around is a different story!)

While no one really LIKES to use prednisone (including the person taking it), what type of doses do you prescribe for these sorts of things? I read of high doses (60-80 mg) with taper being used. I get the feeling, the practice I have been going to passes out dose packs in the physiologic dose range. That is quite a variation in prescribing habits!

Do you have anything to say about injections for this problem? Risk vs. benefit.

BTW, I go to physio 4 times a week. I think the “manipulation” might be stirring things up a bit. I have been laying off that and doing pilates sessions with a different physio in the office instead this last week. My physio (the same guy who helped me with T spine for months) is brilliant but I just feel like the current treatments are fueling the inflammation.