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Neurology (Expert Forum)
broad based disc bulge c5/6 c6/7 ??
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
broad based disc bulge c5/6 c6/7 ??
by matilda1, Aug 09, 2009 09:41AM
a car accident 2 years ago, I am 47, i was sent for physio, after months i progressed abit then had to go every day for heat treatment to settle it down, my specialist said i couldnt have an MRI as it was for people that needed surgery. his report basically washed his hands with me and because i had mentioned that if i get cold or anxious or tense up the pain is worse, he says it is all in my mind. and that i should have psychological referral.
i was sent for an MRI and the results were sent to him.
he is now saying that i have broad based disc bulge at C 5-6 and C 6-7 without nerve root compromise,
and dehydration of all the cervical spin discs these are degenerative changes but are minor and there are some additional features, not of clinical significance.nothing else no explanation, of what this meens or what will happen to me or if i can have anything done, but says that pain management would be appropriate and that they will give me a psychological test...
I am on tablets of tremedol and diclofenic for the last 2 years and i am limited to what i can do.
I am wandering if i now believe the results that the specialist said as i think my solicitor may have upset him by sending me for the MRI he said i couldnt have and that he washed his hands of me and totally contradicted what he had said on the previous 2 consultations.and he was told to look at the doctors notes, to look at all my physio notes and his past notes before he made his report, do you think that this may have upset him...i do.
as i feel the strain right up into the base of my skull, i am wandering if there is any more i should be worried about,or does this come from C5-6 an C6-7 being damaged??
was this brought on by the car accident?? i had deep muscle and tissue damage in the same area and i have been like this now for 2 years, please can you tell me if pain management will help,? or what will help me,? please.
i was sent for an MRI and the results were sent to him.
he is now saying that i have broad based disc bulge at C 5-6 and C 6-7 without nerve root compromise,
and dehydration of all the cervical spin discs these are degenerative changes but are minor and there are some additional features, not of clinical significance.nothing else no explanation, of what this meens or what will happen to me or if i can have anything done, but says that pain management would be appropriate and that they will give me a psychological test...
I am on tablets of tremedol and diclofenic for the last 2 years and i am limited to what i can do.
I am wandering if i now believe the results that the specialist said as i think my solicitor may have upset him by sending me for the MRI he said i couldnt have and that he washed his hands of me and totally contradicted what he had said on the previous 2 consultations.and he was told to look at the doctors notes, to look at all my physio notes and his past notes before he made his report, do you think that this may have upset him...i do.
as i feel the strain right up into the base of my skull, i am wandering if there is any more i should be worried about,or does this come from C5-6 an C6-7 being damaged??
was this brought on by the car accident?? i had deep muscle and tissue damage in the same area and i have been like this now for 2 years, please can you tell me if pain management will help,? or what will help me,? please.
Doctor's Answer
by Lama Chahine, MD, Aug 12, 2009 10:04AM
, Aug 12, 2009 10:04AM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history and review your imaging, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
The cervical region is the upper part of the spine (neck area). C5-C6 and C6-C7 are the areas between these respective bones in the spine. It sounds like there is a bulging disc there that is not pressing on the spinal cord or nerves as they exit the spine. There is a material that cushions the space occurring between the vertebra (bones of the spine). This material may sort of be squished out from in between the two bones; this is called a herniated or bulging disc. It sounds like you also have arthritis of the spine (which is what the degenerative changes), which is very common in older adults but also younger adults who participate in certain athletics or occupations. It is not possible to know if the disc occurred due to the car accident; discs are very common. The arthritis is a slower process likely unrelated directly to the accident.
What to do depends on your symptoms and the exact imaging findings.
In some people, a herniated disc does not cause symptoms at all. For most people, if there is pain, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. More chronic pain, such as in yourself, lasting years, may be related in part to the disc, but also to the arthritis, and myofascial pain: related to strain of the muscles.
For the vast majority of people, non-surgical treatment is the first option. Arthritis of the spine is also usually not treated surgically except if significant narrowing of the spine or pressure on nerves is occurring. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants, referral to a pain management specialist, and if stress or anxiety are contributing to the muscle strain, psychological counseling can help. Physical therapy for neck pain can be very helpful but this is best prescribed by an experienced physician; each of these therapies has its own indications.
In a minority of patients, surgery needs to be done. This often is the case when the herniated disc is pressing on the spinal cord itself, or on nerves, which it does not sound like is the case in you. Symptoms suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation.
In some patients, after conservative non-surgical therapy is tried and the pain is still severe or if other symptoms/indications arise, surgery is sometimes done again if there is pressure on the spine or nerves or other specific indications.
It would be best for you to discuss the therapy options with your physicians.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history and review your imaging, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
The cervical region is the upper part of the spine (neck area). C5-C6 and C6-C7 are the areas between these respective bones in the spine. It sounds like there is a bulging disc there that is not pressing on the spinal cord or nerves as they exit the spine. There is a material that cushions the space occurring between the vertebra (bones of the spine). This material may sort of be squished out from in between the two bones; this is called a herniated or bulging disc. It sounds like you also have arthritis of the spine (which is what the degenerative changes), which is very common in older adults but also younger adults who participate in certain athletics or occupations. It is not possible to know if the disc occurred due to the car accident; discs are very common. The arthritis is a slower process likely unrelated directly to the accident.
What to do depends on your symptoms and the exact imaging findings.
In some people, a herniated disc does not cause symptoms at all. For most people, if there is pain, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. More chronic pain, such as in yourself, lasting years, may be related in part to the disc, but also to the arthritis, and myofascial pain: related to strain of the muscles.
For the vast majority of people, non-surgical treatment is the first option. Arthritis of the spine is also usually not treated surgically except if significant narrowing of the spine or pressure on nerves is occurring. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants, referral to a pain management specialist, and if stress or anxiety are contributing to the muscle strain, psychological counseling can help. Physical therapy for neck pain can be very helpful but this is best prescribed by an experienced physician; each of these therapies has its own indications.
In a minority of patients, surgery needs to be done. This often is the case when the herniated disc is pressing on the spinal cord itself, or on nerves, which it does not sound like is the case in you. Symptoms suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation.
In some patients, after conservative non-surgical therapy is tried and the pain is still severe or if other symptoms/indications arise, surgery is sometimes done again if there is pressure on the spine or nerves or other specific indications.
It would be best for you to discuss the therapy options with your physicians.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
