Looking for a diagnosis

I was injured five years ago by a violent student.  I was the only one trained to restrain the young man, who was 19 and had autism.  His favorite place to aim his hits were to the head.  One week I was hit every day and needed to restrain him daily. When I  went home that Friday I was  in a lot of pain.  The next day I was driving in my car, and my left hand and arm curled into my body (my left hand curled tight into a ball.) My body curled over and I was in horrible pain.  I tried to relieve the pain by going to bed (I thought I had muscle spasms,) but couldn't move.  The  next morning my husband took me into the dr..  Eventually, I had an MRI of the spine, which showed that I needed surgery on C5-6 and C-7.  I was told after  the lamenectomy that my arm and hand would be fine.  They weren't.  The dr. I saw didn't xray or MRi my shoulder or hand....I was given a little OT/PT.  The OT said that I had hypertonicity in my hand, and I saw some improvement with  therapy.  The case was quickly closed by workman's comp. They told me my arm and hand would be okay in two years.  They weren't.  A year ago I again went to a neurologist, a shoulder dr., and a hand surgeon.  I have had nerve testing which showed an old injury to the C-7 nerve.  It also showed that all nerves were normal at rest, but when I  tried to move them they were all abnormal except for the brachia and deltoid muscles.  There were also abnormal motor patterns in all muscles except the brachia and deltoid.  The hand surgeon said that there is a break in every motor system in my hand.  The xray of the shoulder showed that the ball of the shoulder had rotated up with the muscles in the front and back of the shoulder very small.  He wanted the PT  to strengthen these muscles, but she said that my shoulder was like that because of hypertonicity.  She said that to strengthen the muscles would only increase the tone.  The OT and PT say I have hypertonicity and continue to ask if I had a stroke. The MRI of my brain, however did come back normal. My hand has limited use as I cannot straighten my fingers and my hand is hypertonic. They have referred me back to the  neurologist who said that they didn't see tone.  The neurologist said I had a frozen shoulder, but the OT, PT and shoulder surgeon said that that this is an incorrect diagnosis.  All the drs. say that this cannot be a result of the pinched c-7 nerve, but have no diagnosis. The lower paraspinal muscles on the left were also found to be weakened. Can anyone help with ideas?

[Abhijeet Deshmukh, MD]

Hello.

I can hardly imagine the distress caused to you over these years.

It will be unwise to say that any one of your doctors is wrong. In your case, a concerted effort is needed. The doctors from various disciplines (Neurology, orthopedics, physiotherapy) must discuss this with each other. Is it possible ?

The muscles that have atrophied (reduced in size and strength), are supplied by the C5,6,7 nerves !!! And a muscle atrophies when the nerve supply is cut!

I hope you succeed in your way to recovery. Try to get a common concensus from your treating doctors!

All the best.

[betth]

Thank you for writing.  I am confused as how the nerves are normal at rest but not when I try to move.  I would think that this would mean that the nerve itself isn't damaged but the message the nerve is receiving is broken.  How does this occur?  Is radiculopathy synonymous with root avulsion?

Thank you
betth