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311310 tn?1214442997
I am under educated. Please educate me on this
I was in a car accident Dec 20 2008 and have had bad problems ever since.. The Mri Results I have of my cervial sprine are as follows:

History:  Neck Pain, Radiculopathy.
Findings:
MRI examination of the Cervical sprine demostrates reversal of the normal lordosis consistent with muscle spams, correlated with clinical findings.  There is no antero- or retrolisthesis, vertebral stature is maintained,  Imaged spinal cord apprears normal of normal signal intensity, Central canal is patent.

There is mild disc dehydtation at c2-c3 through c4-c5.  c3-c4 level demostrates right paramedian/neral foraminal disc bulging effecing the thecal sac.  There is annular bulging enffacing the thecal sac at c4-c5.  There is mild bulging of the annulus at c5-c6 and c6-c7.  Cervical disc heniation is not identified.

IMPRESSION:
1. Reversal of the normal lordosis consisten with muscle spasms, correlate with clinical findings.
2. Right paramedian/neural foraminal disc bulging at c3-c4. c4-c5 annular bulging effacing the thecal sac.  Mild bulging of the annulus at c5-c6 and c6-c7.  Please see above discussion.

Now I am in pain everyday.  They had me on Percoicet 10 but because I started taking it everyday changed id it to 1-2 lortabs (vicodin) 7.5/500 ever 4 to 6 hrs.  and I still have the pain all day.  I have to put it by my bedside to get out of bed each day.

I also have numbness and tingling in my right hand ( start out both 3-4 wks ago and now its only my right)  

I have hurt my shoulders too ( i tensed up in the accident) for that mri the impression is  1. mild supraspinatus tendinophy.  no eveidce of rotator cuff or burtitus
2. tear of the anterosuperior labrum ( both shoulders are like this)

I go to a chiro, which helps,  and i do massage therapy.  I did PT however it hurt too bad so I couldn't do it anymore...

My question is what are my options.. what do they normally do..

Oh and i did pain managment but he pushed me off on another dr for epidual injections (which im scared to do)
I take naproxien for the tingles...

any ideas?
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Avatar universal
Welcome to the Back and Neck Community. Members are  here to provide assistance and support to individuals experiencing symptoms related to possible abnormal conditions of the spine. Advice given is non-professional and is primarily based on personal experiences

I am sorry to hear of your continued health problems.  When pain becomes persistent and not relieved with conservative measures it can be very frustrating.
The results of your cervical spine MRI show a change in the normal curvature of the neck which is most likely due to muscle spasms.  There are areas that show some bulging of the intervertebral discs, but no disc herniations.  This means that the intervertebral disc material is pushing against the annulus (outer protective covering) but has not caused a tear or break in the annulus and the disc material is still contained within its capsular setting.
There is contact with the thecal sac  (outer covering of the spinal cord) at the C4-C5 level but no significant nerve or spinal cord compression is noted.
The fact that there are multiple levels involved as the result of your accident can be the reason your recovery is hindered.  The numbness and tingling in your hands is likely due to inflammation and irritation or a chemical like reaction to the nerve tissue, but no severe compromise of the nerves was identified on MRI.
The conservative treatment you have done has not provided significant relief and the referral for pain management was indicated.  Medications such as Percocet or Lortab help with decreasing the symptom of pain, but do not address the underlying cause of the pain.  An epidural injection would be beneficial for two reasons: it would provide a more long term pain relief if effective and it would be a valuable diagnostic tool to the doctor in confirming that the pain is definitely related to disc problems in the cervical spine.
As a long term osteoarthritis patient in numerous major joints of my body, I have dealt with pain and its effects on a daily basis.  Degenerative changes in my cervical spine including spinal stenosis and disc herniations necessitated surgery due to compression of nerve roots and spinal cord involvement.   This does not appear to be a significant factor in your presentation.
Pain is a very real and intense symptom and it can produce very real hurdles in our daily activities.  Beyond epidural injections, there may be other modalities that could be tried to alleviate your pain, but the pain management specialist would be best able to discuss them with you and their expected outcomes.
Alternative txmts such as biofeedback and other less utilized modalities have helped others in similar situations where the fear of needles is preventing more accepted methods of pain control.
You also have the option of obtaining a second opinion with another pain specialist to see if other options are

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indicated.  Only you can make the decision regarding what direction you wish to pursue.

Post again with an update and any additional questions/concerns you may have.
Best wishes ----
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311310 tn?1214442997
hey there.  Thank you for your help.  I really had no idea what that meant.  Do they normally get worse?  Someome told me that (not a dr) that  I will always have problems.

I think im gonna go for the Epidural.. My problem is.. I had a stroke before.. (at 13 yrs old.) At first I was paralyzed on my entire right side.,.. it lasted a few mo.. I had my son with an epiddural but that was an extreme situation.. where I thank go di ocouldn't feel it.. but what kind of feelisn do epidurals give.. and does it radiate?
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The type of epidural injection you would receive for your neck condition is a more localized delivery of anesthetic and pain medication to alleviate the symptoms you are experiencing.  It is done under fluoroscopy (x-ray) to be certain that the needle is in the epidual space.  There may be some numbness and weakness of the arm and hand after the procedure, but it is not unexpected and does not always occur.
I am amazed that you had a stroke at the age of 13!  What did they determine to be the cause of that incident?  
The epidural is anticipated to provide good pain relief for a longer period.  If necessary, they are given in a series of three approximately 2-3 wks apart to maintain pain control.
The full series is not always needed.  My Mom had a single epidural injection and has been pain free for over a year.  Hopefully, you will have similar results.
Keep us informed of your progress ----
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311310 tn?1214442997
Thank you for all your help back then. Unfortunately my issues have became significantly worse over time.  MRI a couple years after the last show Herniation and the numbness and tingling was radicalpathy and carpal tunnel in the wrists.  My low back has mulilevel budging and arthritis and issues with nerve pain into my butt, legs.  Need to get emg for Neuropathy .  Also saw a R hematologist that dx me with fibromyalgia and a low vit d Def.  

So at least I know what is going on and still am doing epidurals and pain management.  I got epidurals back in 2010-11 for the first time I believe.  They did give me relief. Started them again this year with no such luck.  

Hope everyone is doing well  
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