Sharp pain in shoulderblade and arm

[tjohnson08]

Hi. I have been diagnosed with buldging discs at C5-C6 and C6-C7. I went to see a surgeon who wants to perform a fusion with plating. The thing I can not understand is I have little to no pain in my neck. I do however have tremendous pain in my right shoulder blade and down my right arm into my hand. This has been going on for about 3 months and when I cough I have sharp pain in my shouder blade.  Is this a normal sensation for a compressed nerve?

Thanks

[Abhijeet Deshmukh, MD]

Hello.

It is more likely to be in the neck. You should also check any blood circulation problem when you bend the neck to the right. This is just to rule out any locked artery when you bend the neck.

The MRI was taken when the neck was straight. When you bend it, the bulging might be more prominent.

Regards

[tjohnson08]

Thanks, One more question though. I have little actual neck pain, but have pain in my shoulder blade (about the middle and I can pinpoint the exact spot), arm pain in the top of my forearm and the inner part of my uper arm and pain in my middle and ring fingers. The pain throbs and becomes excrucuatiing when I move to much. I can make the pain worse when I bend my neck to the right while looking forward and if I hold the position can make my fingers throb in pain and start to tingle. In your opinion, does this sound like my nerve is pinched in my neck or can the nerve be pinched in my shoulder? If I cough, my shoulder blade hurts and I am awakened about 3 times during the night with severe pain in my shoulder blade, arm, and finders that only subsides with ice applied to my shoulder blade.

Thank you very much!

[Abhijeet Deshmukh, MD]

Hello.

A normal EMG does not rule out nerve root compression.

Also, a study in 2001 by Karppinen et al has found out that "...neither the degree of a patient's disc displacement (herniation), nor the degree of nerve root compression correlated with the magnitude of the patients subjective pain or level of functional disability. Or in plain English, 'bigger and more compressive disc herniations don't create any stronger pain and disability than a small non-compressive disc bulge may...."

Regards

[tjohnson08]

OK - I am a little confused. I have major pain in my arm and shoulder and I can not bend my neck to the right much at all. The MRI shows buldging discs at C5-C6 and C6-C7, but my EMG results were normal. The surgeon thinks i should have the surgery and if I do not I could risk my arm paralysing. I do not understand how he can be sure of  surgery when the EMG is normal.

[Abhijeet Deshmukh, MD]

Hello.

You can start taking physical therapy. Use mild traction if felt necessary. The physical therapist will teach you some useful exercises for neck muscles. The neck muscles have to be strong to ward off any jerks or movements which put more pressure on the bulging discs.

As long as the discs are not compressing the nerve roots, you can benefit from the non-surgical methods of treatment.

Regards

[tjohnson08]

Thanks for the re-assurance. My MRI did show a moderate to severe buldge at C6-C7 and a moderate at C5-C6. I just want to make sure I am not getting a surgery if I do not need one.

Again, thanks for the explanation.

[Abhijeet Deshmukh, MD]

Hello.

The neck may not have pain when you have bulging discs which compress the nerve roots. The reason you should go for the surgery is the effects the bulging discs have on the nerve roots and the distal areas.

Coughing or sneezing does bring on the pain and is a sign of disc bulging.

Regards