pain

I had a MRI and this is what it said."C6/C7 level demonstrates a moderate sized left posterolateral disc protrusion contributing to left preforaminal stenosis. Correlate for left C7 or C8 radiculopathy." Whats this mean, because my pain is none stop. I looked up all what they mean but i need it on my level (0)

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I wish I had more information about your pain location in your question to adequately answer the question. However, with the information you do provide, pain that occurs from radiculopathy (i.e., pain from compression of a nerve root as they leave the spinal cord) usually travels in specific locations in the body. These are called dermatomes. For example, if you have a left C7 radiculopathy, you would have pain in the distribution that extends in the middle fingers on the left down the back of your arm. You may also have weakness of extending your wrist. If the C8 nerve root is compressed by the stenosis (or narrowing), you would have sensory changes on the inner aspect of your arm and forearm. You may also have weakness with moving your thumb.

With time, the amount of disk that has herniated (i.e., the posterolateral disc protrusion) 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. Other options for the neuropathic pain include neurontin and lyrica, and medications such as elavil but a careful cardiac workup needs to be performed prior to starting this medication. Other options include physical therapy.

It should be mentioned that there are some people that will require surgery for the posterolateral protrusions. Symptoms (in general from herniated discs in the cervical region and lumbar region) suggesting the need for urgent surgery includes muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain. This will need to be decided upon by your PCP and/or neurologist.

You should follow up with your PCP who may then refer you to a neurologist. You may need an EMG/NCS to evaluate the extent of damage to the nerves from the herniated disc and whether the herniated disc is contributing to your pain.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.