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carolns
Participant

June 4, 2013 at 10:36 pm

Post count: 88

#8799 In reply to: please see my mri and explain it some to me….thank you |

I have severe pain under my right skull and pins and needle go to the top of my head. and also my left ear and jaw get pins and needles not as bad as my right side.I have had this for 14 mts. My pain comes and go. Driving my car makes it worse and so does sitting. My neck is very weak.
Had therapy,tens,hot,cold,accupture helped the most.Saw DR. in Halifax and he thinks I need a operation.
Going to have flexion/extension xrays in a few months to see if there is stability at c2 and c3 there. If my c2 and c3 is stable do you think surgery is necessary if I can live with the pain?
I am 72 so don’t do alot. Like to walk though.thank you so much
hope this is what you meant carol

Donald Corenman, MD, DC
Moderator

June 4, 2013 at 10:19 pm

Post count: 8660

#8798 In reply to: Scared about MRI results |

Wearing an Aspen collar for almost 10 weeks will guarantee a stiff neck that will need substantial therapy to regain range of motion. At 10 weeks after surgery, there should be little pain but with prolonged immobilization, this can stiffen up muscles, ligaments and tendons. These structures can be painful if contracted.

I agree with the PT that you need to move “to strain but not pain”. Slow progress should be expected at this point.

There is a technique called “active release” that can be helpful. Move your head to the maximum strain position (strain-not pain) in whatever direction you are focused on at the time. Remember that there are six directions your head can move (flexion, extension, right and left lateral bending, right and left rotation).

At this point, put your hand against your head in the opposite direction (if you are rotating to the right-keep your head in right rotation but put your hand on the left side of the head). Push your head against your hand (your head is still rotated right but you are contracting your muscles to rotate your head to the left to push against your hand). Neither your head nor your hand should move as this is an isometric contraction.

This will cause “stress relaxation” of the muscles by a reflex called reciprocal inhibition. Muscles oppose each other and the body has developed a reflex to prevent joint destruction by inhibiting the antagonist (opposite) muscle from contracting. This technique of active release uses this reflex to relax the contracted muscle.

You will find that after this forced contraction, the head will move further in the direction that you are focused on.

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.

Donald Corenman, MD, DC
Moderator

June 4, 2013 at 9:41 pm

Post count: 8660

#8795 In reply to: neck muscle spasms misdiagnosis? |

Muscle spasm is typically the result of a disorder and not the cause of the disorder. Your problem is not from “muscle spasm”.

Many times, degenerative facet disorders are missed by radiologists and this is what I assume that you have based upon your symptoms. There are a number of other possible origins of your pain but facets will be first on the list.

Yes, flexion/extension x-rays should be part of any work-up. Also, with disabling pain, an MRI should also be undertaken which it sounds like you have had.

C1-2 problems would be unlikely but possible. More likely, C2-3 or C3-4 problems in your case.

You need a consultation with a good spine surgeon.

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.

zookriz
Participant

June 4, 2013 at 8:38 pm

Post count: 19

#8794
Topic: neck muscle spasms misdiagnosis? in forum NECK PAIN |

Hello Dr. Corenman,
Thank you for your time. To start, in the spring of 2012 I started having neck pain on my right side under my skull. I assumed I slept funny and just had a stiff neck. It never went away. I went to see my P.C. in the spring of 2013 after trying lots of over the counter anti-inflammatories and heat. I’m a bit afraid of anti-inflammatories because my mother suffered a perforated ulcer from them. My doctor immediately diagnosed it as muscle spams, wrote me a prescription for muscle relaxers, an x-ray and a blood test because I had other joint pain. I did not receive any results from the x-ray but after getting a copy for myself, I found I have a slight reverse curve to my neck. My ANA was 1/80 (not a big deal), My P.C. said I might want to think about a rheumatologist.
My first question is can a loss of lordosis cause muscle spasms or do muscle spams cause a loss of lordosis?
The muscle relaxers did not help, so I tried to deal with it.
The discomfort is disabling. I broke down and went to see a chiropractor that my husband uses. After my adjustment, I got dizzy and my blood pressure went up. He told me he should not do any more adjustment because of the bad result. I took lots more anti-inflammatories and tried to deal with it. He prescribed stretches and natural anti-inflammatories.
I decided to see a rheumatologist and after more neck x-rays and blood work he found basically the same results. My ANA was 1/160 a loss of lordosis and said it was muscle spams. I’ve been on a short term of steroids, two different kinds of muscle relaxers, and prescription anti-inflammatories. He also prescribed something to help me sleep because my pain keeps me up all night.
Nothing is remotely helping.
My pain is mostly under the base of my skull on the right and less so under my skull on the left. I get a sharp pain at the base of my skull if I look right with my head slightly cocked. The pain will remain several minutes after that movement and almost makes me nauseated. I have almost a constant headache from the base of my skull and up to my temples. Sometimes my ears or my jaw hurts. The discomfort gets worse when I shake around from riding in a car or on a mower, it also gets worse if I have to hold my head in any one position for very long. Resting my head in my hands seems to help a bit. Sometimes I feel like I can’t hold my head up anymore.
I’ve had normal view x-rays, open mouth x-rays and some where I’m facing away at an angle with my head turned. I also had a previous cervical MRI because of arm and wrist pain. The MRI showed a little something at c5 c6 but nothing to concerning.
My neck question is should I request a x-ray in flexion and extension, I’ve never had one. Could I possibly have an instability at c1 c2 or am I just dealing with muscle spams? How long is this going to last? Can a muscle spasm last over 1 year constantly? Should I go get another opinion from a specialist?
I forgot to mention that I have had many falls off of horses, once with my head contacting a rail fence and once landing me in the hospital for a few days. I had a accident at the beach boogie boarding, did a face plant in the sand and the wave took my body over my at a 90 degree angle, I heard a terrible crunch/crack and blacked out for a few seconds, and suffered a terrible headache. My point is in my younger days I was very active quite possible damaged something.
Thank you for your help,
Kathy

lmy13
Member

June 4, 2013 at 7:13 pm

Post count: 4

#8790 In reply to: mri and my symptoms conflict dco says one thing/radiologist say anoth |

Hi dr I replyed to your question but im guessing you didnt get to it yet,,the is reference to cord signal in first question,and I responded with the same info i highlighted where it say hyperintensitie in cord signal..also just realised how to do the paragraphs..

smiley30
Member

June 4, 2013 at 4:34 pm

Post count: 3

#8788 In reply to: I've done L5 S1 Microdescectomy.. need help. |

Doctor,

First time using this site and asking questions. I have had back pain off and on past year. It hurts in my lower back. There is no kidney infections and i have also had a bladder sling (2 times,first didn’t take.

my back is hurting more,trouble sleeping and walking it pops alot. I still excercise alot.

my xray for lumbar spine 4 views and lateral feexion and extension views

radiologist reported as his inpression: possible muscle spasms,transitional vertebra at L5-S1 with partially lumbarized S1 segment.

straightening of lordotic curvature.

please in lamen terms explain what this is and if its important to follow up with doctor.. my back just hurts.. im 29 f almost 30..

thanks
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Viewing 6 results - 1,693 through 1,698 (of 2,199 total)

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Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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