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Neurology (Expert Forum)
c spine injury
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
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c spine injury
by BHR2411, May 13, 2009 10:25AM
I had a car accident over a year ago now and sustained severe whiplash with rotation.
Still getting pain in my neck and more severe pain upon heavy activity or dancing. A recent MRI showed I have got bulging discs in my C Spine C3-4 C4-5 and although they are not actually compressing my spinal cord the space is very narrow in places. I have also been told that the the areas that would normally be whiter on the MRI in the discs appear to be showing as darker.
The question is if the discs are bulging will they stay where they are or will my C Spine become "normal" again or will I always have a weakness in this area? There have been some concerns raised by occupational health as to the risk of further injury to my neck whilst completing my usual activities at work. Also, I am now having my second lot of physio and some acupuncture for pain relief and to loosen off the movement in my neck.
Still getting pain in my neck and more severe pain upon heavy activity or dancing. A recent MRI showed I have got bulging discs in my C Spine C3-4 C4-5 and although they are not actually compressing my spinal cord the space is very narrow in places. I have also been told that the the areas that would normally be whiter on the MRI in the discs appear to be showing as darker.
The question is if the discs are bulging will they stay where they are or will my C Spine become "normal" again or will I always have a weakness in this area? There have been some concerns raised by occupational health as to the risk of further injury to my neck whilst completing my usual activities at work. Also, I am now having my second lot of physio and some acupuncture for pain relief and to loosen off the movement in my neck.
Doctor's Answer
by Lama Chahine, MD, May 13, 2009 08:02PM
, May 13, 2009 08:02PM
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 obtain a history from you and examine you, I can not comment on whether or not you need surgery for your disc. however, I will try to provide you with some information regarding this matter.
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 disc. The disc may push on surrounding structures, namely the spinal cord and/or the nerves exiting from the spinal cord. Most often, it is the nerves that are pressed on, and not the spinal cord itself.
In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people every require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. 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, and so on, these are best prescribed by an experienced physician, each has its own indications. It sounds like your pain persists; this may be related to persistent herniated disc or could also be related to paraspinal muscle spasm and what is termed myofascial pain. In some patients, after conservative non-surgical therapy is tried and the pain is still severe or if other symptoms/indications arise, surgery is the next step.
While some recovery is expected, it is prudent to avoid further trauma to the neck region. For example, in a car, make sure your head rests on the head rest during driving so that if impact occurs, your head does not pull back. Limitations of heavy lifting and other occupational activities may be necessary depending on what your occupation is, how severe your pain and herniated discs appear, and other factors. Follow-up with your physician, with referral to a spine medicine specialist as necessary, is recommended.
Physical therapy is one of the most useful treatment for chronic neck pain and is recommended if your doctor has cleared you for this.
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 obtain a history from you and examine you, I can not comment on whether or not you need surgery for your disc. however, I will try to provide you with some information regarding this matter.
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 disc. The disc may push on surrounding structures, namely the spinal cord and/or the nerves exiting from the spinal cord. Most often, it is the nerves that are pressed on, and not the spinal cord itself.
In most people, the pain of a herniated disk resolves over 4-6 weeks. The most severe pain actually eases up within 1-2 weeks. Only a minority of people every require surgery. With time, the amount of disk that has herniated shrinks and with time resolves completely in most people. Therefore, for the majority of people, non-surgical treatment is the first option. 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, and so on, these are best prescribed by an experienced physician, each has its own indications. It sounds like your pain persists; this may be related to persistent herniated disc or could also be related to paraspinal muscle spasm and what is termed myofascial pain. In some patients, after conservative non-surgical therapy is tried and the pain is still severe or if other symptoms/indications arise, surgery is the next step.
While some recovery is expected, it is prudent to avoid further trauma to the neck region. For example, in a car, make sure your head rests on the head rest during driving so that if impact occurs, your head does not pull back. Limitations of heavy lifting and other occupational activities may be necessary depending on what your occupation is, how severe your pain and herniated discs appear, and other factors. Follow-up with your physician, with referral to a spine medicine specialist as necessary, is recommended.
Physical therapy is one of the most useful treatment for chronic neck pain and is recommended if your doctor has cleared you for this.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
