AC joint separation w/cervical strain

In January I fell backwards off of a stool landing on I guess my right shoulder.   The MRI and x-ray showed an "AC joint separation with impingement and tendonopathy of the rotor cuff" this was done on 02/03/05 2 weeks after fall.  An x-ray showed cerivcal strain in neck/and the AC joint separation still on 3/24/05.  Pain/continuing (sometimes duller) at times is still present at top of shoulder with neck pain both on the right side. Sometimes I am dizzy and just do not feel right. Sometimes I have tinging and numbness in arm/hands. Went to physical therapy for 2 weeks. What do you suggest?

[Kevin Pho, MD]

I would consider further evaluation at this time.  A referral to an orthopedic surgeon as well as having him/her examine the MRI would determine if surgical therapy would have any benefit.  

Considering there is tingling and numbness present, there is a possibility of nerve compression.  A referral to a neurologist for nerve conduction studies can also be considered if the orthopedic referral is non-revealing.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[mecimoore]

Background info............
mecimoore
03/24/2005
. In January I fell backwards off of a stool landing on I guess my right shoulder. The MRI and x-ray showed an "AC joint separation with impingement and tendonopathy of the rotor cuff" this was done on 02/03/05 2 weeks after fall. An x-ray showed cerivcal strain in neck/and the AC joint separation still on 3/24/05. Pain/continuing (sometimes duller) at times is still present at top of shoulder with neck pain both on the right side. Sometimes I am dizzy and just do not feel right. Sometimes I have tinging and numbness in arm/hands. Went to physical therapy for 2 weeks. What do you suggest?
Forum-M.D.-KP
03/27/2005
mecimoore I would consider further evaluation at this time. A referral to an orthopedic surgeon as well as having him/her examine the MRI would determine if surgical therapy would have any benefit.

Considering there is tingling and numbness present, there is a possibility of nerve compression. A referral to a neurologist for nerve conduction studies can also be considered if the orthopedic referral is non-revealing.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

4/17/05
Thank you for your info...will be having an MRI (c-spine) later this week.  Woke up this morning with the same neck pain since January along with strange feeling like something crawling/buzzing going on in my head/face on the right side of face.  This is a dull/continuous strange feeling. Still am dizzy at times and the symptoms in above note increase especially with quick movement and increased activity. How can something so simple as a little fall give one so many symptoms?
This form is so wonderful and gives one a peace of mind that everything will be ok. It just takes time. Thank You!

[mecimoore]

Is this anything to be concerned about? This is the results of the MRI I had done.

MRI of the cervical spine:
Sagittal images show moderately severe reversal of cervical curvature.  The vertebrae are normal in alignment and height. There is a combination of annular disc bulge and a focal broad based lateral protrusion of the c5 disc on the right side.  There is moderately severe right neroforaminal stenosis.  Very mild annular bulge of the c6 discis present and the c7 sic is normal. The c3 and c4 discs have normal contours.

Conclusion:  There is a generalized bulge of the c5 disc with a protrusion in the region of the right neuroforamen causing moderately serve stenosis.  There is reversal of cervical curvature.  A mild annular bulge of the c6 disc is also present.

Do you have any suggestions?  What kind of doctor would I need to see?  The AC joint according to the xray is still separated also which was done a couple of weeks ago.

Thank you very much!!!!

[sweden]

Sounds like the problem I am having but mine is the result of a car accident. I have a bulging disk at C5-C6 and an ulna nerve impingement. I saw a neurologist who set me up for an MRI and an EMG. It was discovered that I also have degenerative disc disease and a nerve impingement at C5-C6. The doc said it is not yet serious enough for surgery, I think he is being to conservative, and would like to wait a few years. After trying different pain meds, I finally tried the duragesic patch and it works great. Now, to answer your question. You need to see a neurologist for this type of problem. I say that due to the fact that is the road I took. Hope everything works out for you.

Ken

[moose5053]

A related discussion, bulge vertbrae c5c6 disk chronic pain was started.