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chronic pain back , left arm , left leg, right leg, neck , left shoulder

hi, I'm 39 years old when i was 28 years old i had a car accident a car hit my car from the side and after a few day i started having pain to my neck and back and lost power in my left hand, i went to the doctor and he send me to do scans on my back, neck and send me to a neurosurgeon where i had nerve conduction test and been told i suffered a ulnar nerve compression in my left elbow, i have had steroid injection and I'm taking Oxycontin and panadeine forte and Valium for pain, i went to physiotherapy but it did not help on many occasions.

The CT scans showed the following;

Cervical spine: At C4-5 there is anterior protrusion of the disc with marginal osteophyte foreman, there is minimal broad-based bulging of the disc but no focal protrusion is seen

At C5-6 there is a definite narrowing of the disc with degenerative change involving the disc space and marginal osteophytes as well as at the posterior vertebral joints resulting in the narrowing of the left foreman, and small posterior osteophaytes also encroach slightly into the spinal canal.

apart from a slight bulge of the disc at C6-7. no abnormality is seen and the foreman is paient

left C8 brachalgia. with C6 and C7 weak

no abnormality is seen at C7-T1.

Lumbar spine : the alignment is normal, in the sagittal scans, the sagittal scans shows Schmorl's nodes facing the T12/L1  and the L2/3 discs.
the axial scans show normal disc contours between L1 and L3.

there is an annular bulge anteriorly at L3/4 with spurring, the posterior margin of the disc is normal.
At L4/5, there is posterior bulging of the annulus which is in contact with, and deforms, the anterior margin of the thecal sac, there is no forarminl stenosis at L4/5.
the lumbosacral disc has a normal contour and there is no foraminal lesion and shows no destructive lesions.

MRI scans shows:
The T12/L1, L1/L2 discs show Schmorl's nodes and the foraman are clear.
The L2/3, L3/4 discs show Schmorl's nodes with small posterior bulge. prominent anterior osteophytes are seen at the L3/4.
The L4/5 disc shows Schmorl's nodes with broad based prostrusion towards the left side displacing the L5 nerve root and indenting the sac.
There appears to be a small inferior fragment migrated from the protrusion. the foramina are clear.

at the L5/S1 level fairly lateral protrusion is seen with some displacement of the S1 nerve root. focal annular tear is also seen, mild reactive bone change is seen in the endplates.

can you please help an explain my pain, my neck and lower back, as the pain goes down to my left arm and hand and to my left leg and foot, and to my right thigh.

i really thank you a lot.
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3 Comments Post a Comment
Avatar m tn
You have a lot of degenerative age related changes in your C-spine, but keep in mind most of this doesn’t cause symptoms or pain. Minor disc bulges typically don’t cause problems.

In addition to the ulnar nerve compression, the left sided foraminal narrowing you have at C5-6 could be partially responsible for your arm and hand pain. You’ve developed arthritis around some of the joints and the edges of the vertebra in the spine which in turn can narrow the foramina. The foramina are the holes where the nerve roots come through from the spinal canal, in some cases the arthritis can narrow these holes and press on the nerve roots. The type of pain you’re having in your arm and hand is typical of nerve root compression, it’s fairly common. The neck pain you’re having is probably being cause by arthritis as well.

I don’t understand: left C8 brachalgia with C6 and C7 weak, is this the result of an EMG test? Anyway brachalgia just means neck and arm pain due to nerve root irritation or compression, which is pretty what I said up above.

Lumbar spine
Schmorl's nodes are protrusions of spinal disc tissue into the adjacent vertebra and don’t generally cause symptoms, they are a sign of wear and tear of the spine.At L4-5 you have a disc protrusion that’s displacing the L5 nerve root and you have a similar situation at L5-S1 with the S1 nerve root. L5 and SI nerve root compression both can cause the thigh, leg and foot pain you’re having.

Have you had any injections for your low back and leg pain, they might help. Also, have you considered surgery for the ulnar nerve entrapment; it’s a relatively simple procedure? It would be interesting to see how much arm and hand pain you had after you recovered, it might be minimal.

Take Care

MRI results for my neck
by dognameduke, 10 hours ago
1. there is mild reversal of the normal lordosis, centered at C3 to C6. centered at C4-C5.
2. at C3-C4 the is moderate to severe right foraminal narrowing due to a right paracentral disc osteophyte complex.
3. at C4-C5 there is also a posterior disc osteophyte complex, with moderate narrowing of the left neural foramina due to spurring and disc.
4. at C5-C6 there is also loss of disc height and a posterior disc osteophte complex, with mild bilateral foraminal narrowing. no spinal canal stenosis.
5. at C6-C7 there is also diffuse posterior disc osteophyte complex with mild to moderate bilateral forminal narrowing  

Avatar m tn
thank you very much for you reply,
i did have an injections , but it did not help at all.
and the C8 brachialgia with C6 , C7  weak  is a MRI scan result.
I tried PT 5 times without any help.
will my pain increase by time.
is there any solution or i have to live with pain.
is surgery a valid option.
i saw a neurosurgeon and he said i need an operation on my back.
if i did will that help me.
and you suggested an operation on for my nerve pain, what kind of operation and will that help as well.
and the pain in my back goes down to my hips is that part of my back problem, or they not connected.
you also mentioned that i have arthritis , how bad is that is there is a treatment.
and i keep losing power in my left hand and leg is that preventable , some days is bad and some days it's less.
i take Oxycontin and panadeine forte and Valium for the last 10 years , am i used to the medication that they do me nothing, will these medication cause me any other problems in my body, kidney, liver or heart, if i stop them will my pain increase. and will i cause more damage to my neck and back.
it seems you had problems with your back and neck, how did you go about it, did you have treatment, and did it work.
i thank you for your time Kalvin.
i am awaiting your reply
thank you and god bless you.
Avatar m tn
5 sessions of P.T isn’t really that much, when I was recovering from my back surgery I went P.T. 2-3 times a week for 4 months. You had injections for your back?

For your low back pain, yes surgery is a valid option. You need to meet the Surgeon and have him explain to you about how much of your pain he thinks the surgery will help. I’m sure it will help some, but it probably won’t take away all your pain. If possible try to see another surgeon as well, the more opinions the better. Yes the pain that goes down your hips, leg and foot are all a part of your back problem, the weakness in your leg is probably coming from this too.

The arthritis you have in neck is really not that bad for a person of your age.

For your ulnar nerve compression in your elbow, the operation is called an anterior sub muscular transposition of the ulnar nerve. They make an incision in your elbow and move the nerve so that it’s not compressed anymore. Your Doctor should be able to tell you if you are a good candidate for this procedure. This is probably causing some of your arm weakness too.

With Oxycontin and Valium, you probably have to take more and more because of tolerance. Panadeine Forte contains Paracetamol make sure you do not take more than 4000mg of Paracetamol a day that’s the maximum, if you could take half or none it would be better. Paracetamol can affect your liver. Can’t you get Codeine without Paracetamol? Do not stop these medications without speaking to your Doctor. You have been taking them so long that your body is used to them, if you want to stop taking them you need to slowly decrease the amount you’re taking over time. Your Doctor can help you with a taper plan or if not post here and I can put you in touch with some members on another forum that can help you. If you try to stop all the medications at once, it will make your pain worse, so don’t do it.

I had problems with both my back and neck, for both I had surgery. The back worked out good. The neck is still giving me problems; I need to another neck surgery. The next one might help, I don’t know. Sometimes these surgeries don’t help; and they can make you worse. You have to make the decision for yourself whether or not to have surgery. If your pain is unbearable and you’ve tried everything else, then maybe you should consider it. Talk to your Doctors and ask them if they think surgery will help you, and how much it will help you. And try to talk to as many Surgeons as possible.

Take Care

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