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Cervical Spine
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Cervical Spine

After yet another MRI, It shows herniation of C5-6 and C6-7 on the LEFT side as well as nerve impingement.  Spinal narrowing, bone spurs.  Some other things that I have no clue about.  The pain radiates to the right shoulder blade.  It wakes me up at night, burns, tingles, and wraps around my side into my right breast and also down the under side of my arm. This has pretty much stopped my otherwise active life. I know I'm taking too much Ibuprofen but it seems to be the only thing that works for a few hours. (I dislike pain meds so it's not an addiction thing.)    
The doctor is confused as well as the radiologist that made the report.  I'm not seeing a small town doctor, I'm in Houston at Texas Orthopedics.  They now want me to have a nerve study done.
My question, why is pain so severe on the right side if the nerve is pinched on the left?  

8 Comments Post a Comment
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10389859_tn?1409925468
Welcome to the forum.  Either someone made a mistake in documenting the side of your symptoms/pain, or they are looking at something else.  You mention that you have a herniated disk and nerve impingement with spinal narrowing and bone spurs all on the left side.

Are they doing the EMG/Nerve Conduction on the right side to see what is going on?  Have they done a Myelogram?

Are you seeing a Neurosurgeon, Neurologist, or Orthopedic MD?  Are you going to PT for pain control in the meantime?  I would suggest you do to at least try cervical traction and other modalities to help ease your pain.  

If the doctors are confused about the side of your pain, call them up (or send a fax) and correct them.  You should also be seeing a Neurosurgeon based on your symptoms.  Let us know how you do.
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They haven't done a Myelogram yet.  They have asked me to a EMG/NCV.  This doctor isn't a Neurologist, he's an Orthopedic.  I've been to PT without much pain relief.  Seems the exercises I was doing with PT was wrong and just aggravating the situation. The Houston PT has given me new exercises and it seems to be working, could the dose pack I'm taking also.  There was no mistake as to what my complaints were.  All notes were noted to include the injections I had in 2012.  I'm exhausted from no sleep, which is good for fighting pain and healing.  I really like the Ortho but I can tell it's time to see a Neurologist or a Neurosurgeon but which?  

The MRI reads as follows.
Plain films reveal mild disc space narrowing at C5-6. The cervical MRI scan reveals moderate subligamentous protrusions at C5-C6 and C6-C7. Cross sectional images reveal mild bilateral C3-4 foraminal stenosis. At C4-C5, there is broad posterior osteophytic formation and early uncinate hypertrophy with mild to moderate right foraminal stenosis.  At C5-C6, there is broad posterior osteophytic formation, there is a broad left foraminal zone prolapse causing severe left foraminal stenosis, there is moderate right foraminal stenosis.  At C6-C7, there is broad diffuse bulging, a focal central left paracentral disc protrusion not causing significant neural compromise, right sided foramen intact.  C7/T1 images unremarkable.  
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7721494_tn?1411517293
You also have right foraminal stenosis.

However, the picture is not the body -- people present with clear MRIs in terrible pain, while some with spine MRIs that look like a pile of stones make no complaints of pain.

In chronic pain, it is not unusual for signal leaving the DRG on one side of the dorsal horn to synapse through to the DRG on the other side, causing referred pain on the opposite side. I imaging this is what may be giving you trouble.

See a board certified interventional pain doc. Only they understand chronic pain.
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10389859_tn?1409925468
Given your MRI report and your symptoms, I suggest that you see a Neurosurgeon.  Have the EMG/NC, and get copies of all your diagnostic studies and records to give to the new doctor.  An interventional pain MD can only focus on relieving pain, whereas you most likely need surgery.  If you are taking a "dose pack," meaning steroid dose pack, this will help reduce inflammation, but not cure the problems.  You can either ask your Ortho. MD for the name of a good Neurosurgeon or "who would you see if up needed a neurosurgeon", and make an appt. since it often takes time to get one.


In the meantime, the Ortho MD should do something to keep you more comfortable.  Have they considered home cervical traction (NOT the kind that hangs over the door, but the kind made by Saunders with a pump that you lay on the floor and YOU can control the settings)?  Usually PT shows you how to use it, but it is often used with cases that ultimately need surgery.  Talk to your Ortho MD about this.
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I would definitely recommend getting a couple of referrals for a neurosurgeon.  It sounds like due to your chronic pain and even with pt and injections you are not improving.  Do not make the mistake like me and use an orthosurgeon for your back surgery if you end up needing one.  I am not 6 surgeries later and about to have 2 more unfortunately.  
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10389859_tn?1409925468
I agree with you.  That's why I suggested to the OP that she see a Neurosurgeon.  She doesn't need more problems.
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So, nerve and muscle study came back just fine.  I asked my ortho for a referral to a neuro and he told me they would look at my results and see no need to see me.  They now want to do a myelogram because he said that's basically the only thing left to do.  The last thing the man said after giving me the  radiologists appointment desk's phone number was "you could just live with it".  
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10389859_tn?1409925468
Just live with it?  Nice comment coming from an Ortho MD!  Good thing you are leaving him and going to see a Neurosurgeon.  Research the Neuosurgeon (make sure he/she is not the "cut-happy type) and is Board Certfied and had done research recently or teaches.  If you don't feel comfortable with him/her and have open communication, then go to someone else.  Ask others in the Waiting Room what their experience is with the MD.  But I do agree a Myelogram would be the next test unless the Neurosurgeon finds something different.  Keep us posted.
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