Need advice ASAP (Neck herniation,down back and left arm)

[spankyandrex]

Well, here again, I woke up this AM with my neck in severe pain. My back of neck is swollen a bit (again) and my left upper back and arm hurts all the way down to my fingers (back side of arm) and I should not be driving although I had to drive to work cause my ROM is horrible. Last time this happaned in march. I could not get out of bed without help from my husband and I cried I wasi n so much pain there and at chrio's office.  I went to my chiro and after about 3-4 weeks he fixed me up but never ordered an MRI to see what had happened. NOW, it's not an amergency, so I don't feel like I should go to ER - should i go to my family physician or go to urgent care? Or should I do nothing? If you look at my past posts, youc an see my history - SIGNIFICANT for neck problems - herniations/bulges throughout C3-C6. Last MRI was in October of I think 2007. What should I do? It hurts to sit here at mydesk.

Ugggh, I don't even know what I did. I'm 38 years old. THanks.

Here's my MRI from 10/07.

Here's October 2007 MRI: - MRI Cervical Spine without Contrast.
The vertebrae are normally aligned. Stature of the vertebral bodies is maintained. Spinal cord is of normal morphology with exception of ventral impression on the cord in the left paramedian location at C6-7 secondary to moderate protrusion of the nucleus pulposus.

There is mild/moderate broad-based bulging in the disk/endplate complex at C5-6, but this finding does not cause impression on the spinal cord, there is no spinal or foraminal stenosis at this level.

Impression: Significant protrusion of the nucleus pulposus at C6-7, finding is positioned in the left paramedian location and causes mild ventral impression on the spinal cord. It is also possible that this finding may impinge the traversing left C8 root. Otherwise unremarkable MRI of the cervical spine.
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[spankyandrex]

Saw my orthopedic surgeon yesterday.  He does not have a fellowship in cervical spine (or something like that) so he would not do my surgery anyway.  He would refer me to a neurosurgeon or another orthosurgeon who does have a fellowship to a clinic about one hour away from where I live.

He reviewed my MRI from 10/07 and said yes, I have a significant protrusion that says right in the report is impinging on my left C8 nerve root and that I would probably require surgery, plus bony spurs!  However, before he can refer me, he must send me through a servies of cervical epidural injections.   So, the pain mgmt /anesthesiologist had a cancellation for today at 2:15, so I will have my first one today.  I'm nervous....I've never had one in the neck where the spinal cord runs through. He will be doing it under flouroscopy (xray) so that settles me a bit.  I've had 7 in my lumbar and SI joint regions in the past so I kind of have an idea of how they work.  But the neck one makes me cringe.  I've heard horror stories, you know?  He did a complete exam and she he put his hand on my head, turned it and pressed down it sent tingling down my left arm into my pinky.  When he was touching my hands to check for sensation, his touch was lighter on my left side on hand.  Said I was "hyporeflexic" on bith right and left arms - no reflexes?  What could that mean - nerve damage already.  In March when I had the last incident (couldn't get out of bed w/out help from DH) it was my Right side of neck. This time, it was my left.  Also said he felt weakness on my left arm and hand.  

I'm really hoping these work - but I honestly don't think they will considering everything I've already been through for therapy on my neck.  Seems like once the acute phase is over (these last 3 times) it gets a little better and it's something I can almost live with, then another incident and I'm back at square one.  I never do anything to cause these either - it just happens - I wake up with it. I sleep on a cervical pillow, have for years.  It's just I think everything in there is so weak damaged and then throw in the reversal of my curve and it's way more prone to damage.

Thanks for listening ;)

[spankyandrex]

PS - I did go to urgent care last week Wed.  They gave me a shot of Tramadol then gave me scripts for Tramadol and SOMA and said I had cervical radiculapathy.  

[spankyandrex]

THANK YOU so much!  I have  Dr. appt. with a local Ortho surgeon (he does not do cervical surgery) but he can/hopefully WILL refer me to a neurosurgeon to a hospital one hour away.  It is one week tomorrow and I still have pain down my neck into shoulder and left arm and fingers.  He will review my MRI from 10/07 and send me for another one.  Thanks again for your insight, I do appreicate your time on these boards VERY MUCH!  Have a wonderful day Dr.!

[Prem Pillay, MD]

You need help from a neurosurgeon. Please find one nearby and seek his advice.
There is a possibility ,depending on the outcome of you neuro examination and a new MRI, that you may need surgery : eg microdisectomy and disc replacement; to relieve pressure on your nerves/spinal cord. I would not delay this. There are those like you who have become worse (motor weakness and paralysis) while worrying about what to do.

Dr Prem Pillay FACS
Consultant Neurosurgeon
Director of Spine and Neuro Services
Neuro Spine and Pain Center Singapore