18 month post op C-6/C-7

[QueenofSeams]

Had fusion in March of 2010 great results most of pain gone and function returned to hands.  I have had a couple of episodes where I coughed very hard and have passed out for a brief time. Now when I cough or reach with my right arm I have a crippling pain in the side of my neck and down over the top of my right bicep and shoulder area.  I have no health insurance now and went to the Dr last week.   I was prescribed a prednisone dose pack, Flexaril, Tramadol and Tylenol 3.  NO relief from any of those meds.  

[QueenofSeams]

Thank you for your answer!!  I am going to continue to follow up with my doctor and have come to the realization that it may very well be a chronic pain management issue to deal with.  In addition to the previous described I have had 3 episodes when I was coughing and lost consciousness (at least that I am aware of) for a brief time.   My concern is that is it possible for the plate and/or screws to loosen or move and cause the symptoms I have described here?  The pain in my neck, and right shoulder have finally been somewhat alleviated by lortabs.  Tramadol, Tyenol-3, Flexeril, Aleve, Motrin, and all the other over the counter pain relievers have had no impact what so ever.   I am a seamstress and had almost been totally disabled by this pain, till I started taking the lortabs.  Will continuing pain meds that allow me to work do any additional permanent damage to me physically?

Thank you,

[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.

If there is associated headache, a concerning cause of neck pain associated with headache is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma (such as with coughing), or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. A dissection is diagnosed with a specific type of MRI test (MRA with fat saturation) or an CT angiogram.

If the pain is localized in the shoulder, you may have a muscle strain, etc. It is difficult to provide much more information given the inability to examine you.

I suggest you follow up with your primary physician to discuss further. If there is worsening of the pain or new symptoms, you should be seen sooner than later.

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