Trigger point pain, cervical disc referral pain, lower back pain

[SilverLining00]

12 years ago, I had fusion of C5-6-7.  C4 was bulging back then, but wasn't too bad.  For the past 10 years, I've been having right arm pain off and on.  I was told is was trigger point pain from a point between my shoulder blade and my armpit.  Occasionally, now, for the past few months, I get similar pain in my left arm.  I've had lower back pain for the past year and a half or so.  I've had an MRI of my lumbar region, and there is some bulging and a small tear in the disk.  I've tried PT, hasn't helped, only aggravated it and my arm.  I've been trying the DRX decompression machine.  I'm not sure if it's helping my lower back or not, but it aggravated my right arm pain enough to bring me to tears.  Friday, they tried a wedge under my shoulders, neck and head, to minimize the pull on my neck.  It did seem to help relieve the pain of the session, but today, I was walking through a store and was in a lot of pain within an hour.  My lower back was really aching.  I don't know what I should do next, or if I should even continue with this DRX stuff.  I have two areas of pain.  What is going on here and how can I alleviate the pain in one or both of these areas?  Any recommendations would be greatly appreciated.  Thanks.

[Abhijeet Deshmukh, MD]

Hello.

You may be having a degenerative disease of the intervertebral discs. The intervertebral discs are not usually weak. The tear in the disc could be due to an injury or the degenerative disease. Did you have any injury to the lower back?

The inner part of the disc will come out if the tear is not fixed surgically. Conservative management does not help much in this condition, as you have experienced.

Please discuss the option of a surgical repair.

Regards

[SilverLining00]

Thank you for replying.  I haven't had any injury that I'm aware of.  I've just been a rather active and, at times, klutzy person.   Although, I've had right arm pain off and on for many years, the current treatment modality is aggravating it and I don't know why.  I feel as if I'm falling apart.  The following is a list of the findings from my lumbar MRI.  Nothing major (I've been told), just resulting in chronic pain in my lower back on the left side.  Pain radiates into my hip, but not down into my leg.  Discomfort when I sit at a desk or walk a bit.

L2-3 - minimal asymmetric left sided bulging of the disc without evidence of focal herniation or nerve root impingement.  There is assymmetric left sided facet hypertrophy as well.

L3-4 there is a minimal asymmetric left sided bulging of the disc without evidence of focal herniation or nerve root impingement.  There is mild facet hypertrophy.

L4-5 there is a minimal disc bulge and small right sided annular tear.  There is no evidence of nerve root impingement.

At L5-S1 there is no evidence of focal herniation or foraminal compromise.

I suppose I do need another opinion on the best course of action, for my lower back pain and my arm pain.  (10 years ago, MRI results indicated focal extradural defect indenting the thecal sac at C4-5, appears to represent an osteophyte in continuation with vertebral body, midline and to the right.  Other levels were fine.)  Do you recommend consult with an othopedist, neurologist or neurosurgeon?  Do you think the DRX could make any of this worse?  Do I have any other options?  Again, thank you for your time and help.

[SilverLining00]

Sorry, I typed the L3-4 part wrong.  

AT L3-4 there is a diffuse disc bulge with a more focal left proximal foraminal component.  Correlation for left L3 symptomotology is suggested.  There is mild facet hypertrophy.

Can the DRX treatment make this worse?  And can it aggravate my neck problems and cause the pain going down my arms?  I don't want to consider surgery again, if it can be avoided.  Can strengthening the back/neck muscles "cure" these symptoms.  They just seem to be getting worse with lack of use.  Would chiropractic help?

[timelesstouch]

has regular medical massage therapy been tried? Too often this least invasive and under utilized solution doesn't surface till late in the process. But even now, maybe it's worth a try. Your local massage school may have some names of experienced graduates or instructors for you.