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BACK TO SQUARE ONE...ACTUALLY WORSE...AFTER CERVICAL ACDF
A short history...I was discovered to have a degenerative disk condition in my entire spine about 15 years ago. From time to time, I have had to see a doctor for neck stiffness and pain and would usually feel better after about a week off work and medication.
Starting in October or November of 2006, I started having additional and more severe symptoms that included severe limitation in range of motion, extreme pain when attempting to move my neck. It was worse when attempting to touch ear to shoulder, where there is almost zero range. There was a bit more range when attempting the other neck movements, but not much more. There was also a cracking or crunching noise when I moved my neck the little that I could.
I also had pain and tingling in my neck shoulders, upper back and "traps", with the most severe pain on the right side. I also had painful cramps in my "traps" and fingers on my right hand. Ocassionally, I would have tingling on the right side of my face.
I ended up being treated with physical therapy with no relief and I also had several epidurals with no relief.
In the course of this time, I had x-rays done as well as an MRI. It was determined that I had very severely degenerated disks at C-5,6 and C-6,7.
After having a nerve block with no relief, I had a diskoscopy done but which came back inconclusive.
The surgeon indicated that although the test was inconclusive, the disks were more than likely the cause of my problem so after advice from him, I decided to have the ACDF With Instrumentation.
done.He did caution me that the results may stay the same, improve or get worse.
I had surgery on May 9th and wore a soft collar for 2 months. I had my second follow up on July 5th and at that time, I explained that I was still having the same symptoms as before surgery. The doctor seemed upset and stated that I should be ready to resume normal activities and return to work with restrictions.
I explained to him that I still could hardly move my neck and after having me attempt to move my neck and saw a lack of range, he stated that I should have more movement then what I had and prescribed a month of physical therapy.
I did the month of therapy with no relief other than regaining the small bit of motion that I had before surgery and which had been restricted by the surgery and collar. This was not much of a gain and was so stated in the therapist's final eval.
When I went to my latest follow up August 16th, I again explained that nothing had changed...that I had the exact same symptoms as prior to the surgery.
The doctor looked at the latest x-rays and said that everything is going fine but never addressed why I was having the same problem accept to say that it may take more time..
He told me that he was sending me back to work with limited lifting restrictions. I explained to him that was fine, but I was more concerned about the pain and lack of range in my neck because my job requires constant bending and twisting of my neck for 8 hours and that I could not do it, especially since that was the reason I sought medical care in the first place.
He basically ignored me and stated that he was just going to go with the limited lifting restrictions and said that I needed to get back to a normal routine.
He never examined my neck, back or shoulders to determine the amount of range, pain or anything else. He also ignored the findings of the therapist. The only thing that he did was give me that standard strength test.
I returned to work on August 27th and since then, my symptoms have gotten worse...due no doubt to the requirement of my job.
I have become very frustrated and untrusting of the doctor so I sought a second opinion. The second doctor looked at my medical records, did the same strength test and that was. He didn't actually check my neck either and made reference to the slight gain in range mentioned by the therapist...totally ignoring the fact that the slight gain was actually what I had gained after having the surgery and wearing the neck brace.
I kept asking him about the worsening of my symptoms and the only thing that he offered was the I had serious surgery and that I couldn't expect it to be better after only 3 months, that it could take up to a year. I asked him if that were the case, then when could I expect some improvement and he stated that I should see some improvement after 6 months and if I didn't, it probably wouldn't get any better.
He seemed very reluctant to offer any opinion contrary to my surgeons and I just felt that he was giving me the run around.
Either I am supposed to be better by now or I should not expect to see any improvement for some time, which is it? Those who I know who have had the same type of surgery talk about how much better they are after 3 months and hav lost almost no range...actually gained almost all of what they may have lost prior to the surgery.
I am very disappointed and frustrated at this point and have no intention of returning for my next follow up since it seems to be useless to do so.
Is there any suggestions on what I can do to get help from another doctor? Someone who is going to be more concerned and caring and who will listen to his patient and run more tests based on his patients complaints?
Starting in October or November of 2006, I started having additional and more severe symptoms that included severe limitation in range of motion, extreme pain when attempting to move my neck. It was worse when attempting to touch ear to shoulder, where there is almost zero range. There was a bit more range when attempting the other neck movements, but not much more. There was also a cracking or crunching noise when I moved my neck the little that I could.
I also had pain and tingling in my neck shoulders, upper back and "traps", with the most severe pain on the right side. I also had painful cramps in my "traps" and fingers on my right hand. Ocassionally, I would have tingling on the right side of my face.
I ended up being treated with physical therapy with no relief and I also had several epidurals with no relief.
In the course of this time, I had x-rays done as well as an MRI. It was determined that I had very severely degenerated disks at C-5,6 and C-6,7.
After having a nerve block with no relief, I had a diskoscopy done but which came back inconclusive.
The surgeon indicated that although the test was inconclusive, the disks were more than likely the cause of my problem so after advice from him, I decided to have the ACDF With Instrumentation.
done.He did caution me that the results may stay the same, improve or get worse.
I had surgery on May 9th and wore a soft collar for 2 months. I had my second follow up on July 5th and at that time, I explained that I was still having the same symptoms as before surgery. The doctor seemed upset and stated that I should be ready to resume normal activities and return to work with restrictions.
I explained to him that I still could hardly move my neck and after having me attempt to move my neck and saw a lack of range, he stated that I should have more movement then what I had and prescribed a month of physical therapy.
I did the month of therapy with no relief other than regaining the small bit of motion that I had before surgery and which had been restricted by the surgery and collar. This was not much of a gain and was so stated in the therapist's final eval.
When I went to my latest follow up August 16th, I again explained that nothing had changed...that I had the exact same symptoms as prior to the surgery.
The doctor looked at the latest x-rays and said that everything is going fine but never addressed why I was having the same problem accept to say that it may take more time..
He told me that he was sending me back to work with limited lifting restrictions. I explained to him that was fine, but I was more concerned about the pain and lack of range in my neck because my job requires constant bending and twisting of my neck for 8 hours and that I could not do it, especially since that was the reason I sought medical care in the first place.
He basically ignored me and stated that he was just going to go with the limited lifting restrictions and said that I needed to get back to a normal routine.
He never examined my neck, back or shoulders to determine the amount of range, pain or anything else. He also ignored the findings of the therapist. The only thing that he did was give me that standard strength test.
I returned to work on August 27th and since then, my symptoms have gotten worse...due no doubt to the requirement of my job.
I have become very frustrated and untrusting of the doctor so I sought a second opinion. The second doctor looked at my medical records, did the same strength test and that was. He didn't actually check my neck either and made reference to the slight gain in range mentioned by the therapist...totally ignoring the fact that the slight gain was actually what I had gained after having the surgery and wearing the neck brace.
I kept asking him about the worsening of my symptoms and the only thing that he offered was the I had serious surgery and that I couldn't expect it to be better after only 3 months, that it could take up to a year. I asked him if that were the case, then when could I expect some improvement and he stated that I should see some improvement after 6 months and if I didn't, it probably wouldn't get any better.
He seemed very reluctant to offer any opinion contrary to my surgeons and I just felt that he was giving me the run around.
Either I am supposed to be better by now or I should not expect to see any improvement for some time, which is it? Those who I know who have had the same type of surgery talk about how much better they are after 3 months and hav lost almost no range...actually gained almost all of what they may have lost prior to the surgery.
I am very disappointed and frustrated at this point and have no intention of returning for my next follow up since it seems to be useless to do so.
Is there any suggestions on what I can do to get help from another doctor? Someone who is going to be more concerned and caring and who will listen to his patient and run more tests based on his patients complaints?
firstly, certain nerves from the brachial plexus run through and around the scalene muscles in the neck. these finger sized muscles take major punishment and go into spasm and get rock hard when there is chronic forward head posture as in computer users or people with desk jobs. these muscles can compress nerves. I only posted becaue you had the surgery and did not get better--- logic may tell you that the compression may be taking place outside the spine. tight neck musculature can easily cause the crackling sounds--- the muscles are so tight they pull the vertebrae together and cause them to rub on each other. My neck MRI reads horribly--herniations, stenosis, cord flattening etc etc. i had the crackling sounds all the time. After a few months of correcting my posture and working out the tightness in my scalenes, upper traps, SCMs , I can turn my head noiselessly like an owl. After a few hours on the computer-- i sound like rice krispies again and I have to go work on the muscles in my neck.
surgeons do surgery-- they are not really well read on things like crossed syndrome and muscle imbalance. Mention Upper Crossed syndrome to a surgeon and he will look at you crosseyed !!!!
Just food for thought for you, that's all. I agree your symptom are nerve related... the question is where is the compression??? the difficult part is that MRI findings do not always translate into the source of pain. Mot MRI finding are harmless and cause no symptoms, as bad a they may sound.
surgeons do surgery-- they are not really well read on things like crossed syndrome and muscle imbalance. Mention Upper Crossed syndrome to a surgeon and he will look at you crosseyed !!!!
Just food for thought for you, that's all. I agree your symptom are nerve related... the question is where is the compression??? the difficult part is that MRI findings do not always translate into the source of pain. Mot MRI finding are harmless and cause no symptoms, as bad a they may sound.
From the sound of it, you would think that it is a Workers Comp doctor but it isn't.
They have been quite unfriendly since my 2nd follow up visit when I mentioned that my symptoms had not changed at all.
As I have said, he has never examined my neck to see what might be going on. All he does is look at the x-rays and say that everything is looking good. He doesn't even respond to my complaints about my symptoms.
He just acts as if I never said anything.
Just last week, I asked his secretary if I could get a letter to send to VA so that I could show that I had surgery for a condition that I had while in the military and the dates that I was off recuperating and she basically said that the doctor will not do it.
The bottom line is that there is absolutely no interaction between the doctor and myself. It is as if he is trying to hide something.
He is not telling me why I don't feel any relief or anything and as I mentioned to the other poster, if it were something other than spine related, I am sure that he would say so just to get it off the issue of the surgery.
Also, before I had surgery I asked him if there could be other causes for my problem and he insisted that it was spine related.
I would hate to have to deal with a Worker Comp doctor is he is any worse than my own doctor.
They have been quite unfriendly since my 2nd follow up visit when I mentioned that my symptoms had not changed at all.
As I have said, he has never examined my neck to see what might be going on. All he does is look at the x-rays and say that everything is looking good. He doesn't even respond to my complaints about my symptoms.
He just acts as if I never said anything.
Just last week, I asked his secretary if I could get a letter to send to VA so that I could show that I had surgery for a condition that I had while in the military and the dates that I was off recuperating and she basically said that the doctor will not do it.
The bottom line is that there is absolutely no interaction between the doctor and myself. It is as if he is trying to hide something.
He is not telling me why I don't feel any relief or anything and as I mentioned to the other poster, if it were something other than spine related, I am sure that he would say so just to get it off the issue of the surgery.
Also, before I had surgery I asked him if there could be other causes for my problem and he insisted that it was spine related.
I would hate to have to deal with a Worker Comp doctor is he is any worse than my own doctor.
I appreciate what you are saying but the fact is, I do know that what you say is not related to the spine in fact is. I have done enough research to know that my symptoms are symptoms of a spinal condition.
Maybe you missed the part where I stated that I am having tingling in my neck, upper back and right hand as well, which is nerve related. Also the pain in my neck definitely is spinal related, with crunching and cracking and increased tingling on movement of my neck. Yes, there is some muscle issues involved, which would usually be the case.
I would also think that if it were something other than spinal related, the surgeon would indicate as much. He isn't telling me anything, especially whether or not he feels that it is unrelated to the spine.
Also, the physical therapist indicated that the only thing that would cause such tingling is a nerve related problem.
As for the muscles, that very well may be, but aren't the neck and shoulder muscles controlled by the nerves from the cervical spine?
Maybe you missed the part where I stated that I am having tingling in my neck, upper back and right hand as well, which is nerve related. Also the pain in my neck definitely is spinal related, with crunching and cracking and increased tingling on movement of my neck. Yes, there is some muscle issues involved, which would usually be the case.
I would also think that if it were something other than spinal related, the surgeon would indicate as much. He isn't telling me anything, especially whether or not he feels that it is unrelated to the spine.
Also, the physical therapist indicated that the only thing that would cause such tingling is a nerve related problem.
As for the muscles, that very well may be, but aren't the neck and shoulder muscles controlled by the nerves from the cervical spine?
im sure i sound like a broken record to many readers, but your problem may have nothing to do with your spine at all--especially since you had decompression and you are unchanged. Going to PT and DOING PT are totally different. there are postural exercises and stretches for your problem (tight traps and shoulder pain) that patients need to do many times DAILY for months before their efficacy can be judged. Going to PT for an hour even 2 or 3 times a week for a month just does not cut it most of the time. If the problem is postural or related to muscle spasm and tightness-- well, muscles are a lot more stubborn thna that-- muscle memory is a huge component. IF this interests you at all then let me know and I will try to direct you more. I've been where you arw and I am pain free now--fixed it myself.
if your initial symptoms were stiffness and pain in the neck------that is muscular usually. nerve impingements usually cause numbness, weakness, symptoms into the hand and/or arm.
if your initial symptoms were stiffness and pain in the neck------that is muscular usually. nerve impingements usually cause numbness, weakness, symptoms into the hand and/or arm.
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