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Neurology (Expert Forum)
Pain, aching and burning on right side of neck, shoulder, and forearm
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Pain, aching and burning on right side of neck, shoulder, and forearm
by mdwillms, Dec 18, 2005 12:00AM
Yet another question referenceing pain and aching in the neck shoulder, and arm. I am 42 years old and have been having these symtems for about 4 years. I saw an MD 3 years ago and he ordered an MRI. The finding were: C3-4, minimal annular bulge mildly flattening the thecal sac and minimal unconvertebral osteophyte. No significant central canal or foraminal narrowing. C4-5, minimal annular bulge at this level. Unconvertabral osteophyte, more prominent on the left, only mildly narrowing the left c4-5 neural foramen. No significant central canal or foraminal narrowing. He referred me to PT and they gave me documents for correct posture and a band to use for strengthing the shoulder. No change in condition until about a year ago when things started getting worse. I went to a neurosurgeon in August and again an MRI was ordered along with an ENG to test for Carpal Tunnel. All I have been told of this MRI is things are still the same only with more wear and tear identified. They did however identify that I had carpal tunnel and since have done surgery. Hand feels better but still experiening the same symtems. I was informed the other day by the neurosurgeon that I am borderline surgery for my neck. They have put me on a neuropathy medication for 4 weeks and say if this doesn't work I will require steroid shots and then surgery. My concern is, if the medication or shots work, what is the possibility after all this that the disc won't bulge again. It would seem that after 4 years something has weakened. I wear a 4-pound helmet at work and who's to say that things won't re-occur
Doctor's Answer
by CCF-Neuro-M.D.-PW, Dec 21, 2005 12:00AM
Its probable that over time, wear and tear on the cervical spine will get worse, maybe somewhat faster if you are wearing a heavy helmet a lot
The disc is probably still bulging, and was probably not a direct cause of your symptoms. A disc bulge that is prominent or serious would cause either nerve root (pain lancing down the arm, or regional weakness and muscle wasting) or spinal cord (lower limb weakness or spasticity and loss of bladder control) symptoms, in these cases where there is neurological compromise is surgery most beneficial at preventing further neurological damage.
Surgery for pain only without neurological symptoms is less likely to benefit and conservative treatment is preferred - if the disc is not the cuase and you operate on the disc, then it wont help, surgery has the potential to destabilise the spine furhter above and below the site of surgery
Good luck
The disc is probably still bulging, and was probably not a direct cause of your symptoms. A disc bulge that is prominent or serious would cause either nerve root (pain lancing down the arm, or regional weakness and muscle wasting) or spinal cord (lower limb weakness or spasticity and loss of bladder control) symptoms, in these cases where there is neurological compromise is surgery most beneficial at preventing further neurological damage.
Surgery for pain only without neurological symptoms is less likely to benefit and conservative treatment is preferred - if the disc is not the cuase and you operate on the disc, then it wont help, surgery has the potential to destabilise the spine furhter above and below the site of surgery
Good luck
anyway, the amount of hands on therapy you get with conventional PT is way too little to have any kind of lasting effect on fascial tissues. Here I am being treated hands on 4-5 HOURS PER DAY.. I noticed a difference after 2 days. Do some research. Surgeons operate-- that's what they do. the see something on a film and attempt to fix it. Be careful. Read up on the indications for surgery in the neck.
operating on pain is a tricky thing--- be cautious and good luck. having been through what you've been through it seems to me your issues are myofascial. they may need intense, repeated attention that you can't do alone. that's my opinion.