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Neurology (Expert Forum)
Burning/Aching in Shoulders
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Burning/Aching in Shoulders
by Roadking, Apr 21, 2005 12:00AM
For the last 8-Weeks I have had burning and aching across my uppper back and shoulders, it has been more on the left side at times. I have also had numbness around my lips and chin for over 4wks. Have taken steroid packs 2 X's, and have cervical MRI, EMG/NCS. Will not see doctor again until 5/5. Here are the results as I know know, any feedback will be appriciated.
MRI-Normal alignment of the cervical spine is demonstrated without evidence of subluxation. Mild disc desiccation is noted at C2/3 and C3/4. No lateralizing disc abnormality is seen. The central canal and neural foramina are patent; however, there is a small central focal disc protrusion at C4/5 (Image 31 of Series 4 and Image 17 of Series 5) that mildly indents the thecal sac touching the anterior margin of the spinal cord without deforming the contour of the spinal cord. This disc protrusion measures up to 5 mm in transverse dimension and AP dimension. IMPRESSION:SMALL FOCAL CENTRAL DISC PROTRUSION AT C4/5 MEASURING UP TO 5 MM IN GREATEST DIMENSION TOUCHING THE ANTERIOR MARGIN OF THE SPINAL CORD BUT NOT DEFORMING THE
ANTERIOR CONTOUR.
EMG/NCS- Myofascial pain syndrome, and a pinched nerve in the neck, not sure which one. The doctor doing this test said it could all be related to the pinched nerve.
What do you think? I had not been getting better.
MRI-Normal alignment of the cervical spine is demonstrated without evidence of subluxation. Mild disc desiccation is noted at C2/3 and C3/4. No lateralizing disc abnormality is seen. The central canal and neural foramina are patent; however, there is a small central focal disc protrusion at C4/5 (Image 31 of Series 4 and Image 17 of Series 5) that mildly indents the thecal sac touching the anterior margin of the spinal cord without deforming the contour of the spinal cord. This disc protrusion measures up to 5 mm in transverse dimension and AP dimension. IMPRESSION:SMALL FOCAL CENTRAL DISC PROTRUSION AT C4/5 MEASURING UP TO 5 MM IN GREATEST DIMENSION TOUCHING THE ANTERIOR MARGIN OF THE SPINAL CORD BUT NOT DEFORMING THE
ANTERIOR CONTOUR.
EMG/NCS- Myofascial pain syndrome, and a pinched nerve in the neck, not sure which one. The doctor doing this test said it could all be related to the pinched nerve.
What do you think? I had not been getting better.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 24, 2005 12:00AM
I cannot give you a diagnosis over the internet, and am limited in advice as I have not seen the results of the testing
A pinched nerve inthe neck could indeed cause your symptoms, particularly at the C4/5 level, - the nerve at this level supplies the skin sensation over the shoulder and lower neck area. The EMG has more difficulty picking up exactly which nerve is pinched higher up in teh neck, and this may be why they cannot pinpoint it exactly to the C4/5 level. They do seem to have identified changes in the EMG associated with a pinched nerve.
Youe doctors need to decide with you which would be the best treatment option - medication and physical therapy, surgery or a less invasive option than surgery such as keyhole surgery or thermoablation of the disc. Keyhole surgery or other less invasive methods to remove this part of the disc may be an option as the disc protrusion seems to be very focal (or limited to one small area). With conservative medical therapy the problem may still get better over time
A pinched nerve inthe neck could indeed cause your symptoms, particularly at the C4/5 level, - the nerve at this level supplies the skin sensation over the shoulder and lower neck area. The EMG has more difficulty picking up exactly which nerve is pinched higher up in teh neck, and this may be why they cannot pinpoint it exactly to the C4/5 level. They do seem to have identified changes in the EMG associated with a pinched nerve.
Youe doctors need to decide with you which would be the best treatment option - medication and physical therapy, surgery or a less invasive option than surgery such as keyhole surgery or thermoablation of the disc. Keyhole surgery or other less invasive methods to remove this part of the disc may be an option as the disc protrusion seems to be very focal (or limited to one small area). With conservative medical therapy the problem may still get better over time
