ventral csf soace effacement and foraminal stenosis

[Kimmyh619]

I have been diagnosed through MRI with facet joint arthropathy, spinal canal stenosis and complete effacement of the ventral CSF space with mild prepservation of the dorsal csf space at level C5-6 circumferential disc osteophyte complex with bilateral foraminal stensosi at C6-7 and mild flattening of the shape of the cord at this level.  I am in contstant pain.  My arms are completely numb every morning and most recently I have muscle spasms in my back causing extreme pain and immobility.  I had cervical epidurals to no relief and they want to do a nerve block (*mypain management team)  I have researched these blocks and concensus is they are painful,a diagnostic tool and not able to provide long term relief.  I have been an adminsitrative assistant/for 25+ years.  I am 51,  5"5' and 117 pounds, healthy diet. 1983 I was hit in the head with a hockey puck at MSGarden in NYC, frontal lobe just above my hairline - dead center of my forehead.  The whiplash of this impact caused the degerneration of my neck. Repetitive motions- has exacerbated the conditions.   Total numbness of my arms, spasms of my neck, arms, elbow  I am at the point of no return with the pain.  I take Cymbalta 60mg daily initially for fibromyalgia symptoms and herniated discs at S-1,2,and 3 in my lower back beginning 5 years ago.  I take no other medications.  I am allergic to aspirin, NSAIDS, I only take the Vicodin prescribed @ .5 m350mg tylenol to sleep.They make me feel dull and I cannot take them when I work as my performance must always be "on point."  I am definitely a "Type A" personality.  This inability to function is really getting me down and the pain, which I have "tolerated" for the longest time to keep a roof over my kid's heads - is really getting out of control and I am at the end of my tolerance line.  What should I do next?  Thank you for your assistance.  

[Neuro Forum]

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 examine you and obtain a history, I can not tell you what the exact cause of your symptoms is, nor can I provide you with specific treatment recommendations. However I will try to provide you with some useful information.

Unfortunately, in some cases, spine arthritis and spinal stenosis can not be corrected surgically. Evaluation by a spine surgeon, to investigate whether or not there are any surgical options for you may be of benefit, though again often in cases such as yours, in which the pain is further compounded by fibromyalgia, nonsurgical interventions are more likely to be successful.

One approach that may benefit you is enrollment in a chronic pain program which attempts to use a variety of medications and non-pharmacologic measurse (temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants) to control your pain and at least make it bearable to help you function. Other medications that can be used for neuropathic pain (pain coming from nerves, which may partially be caused by the arthritis and other spine problems) combined with fibromyalgia pain, can be treated wtih such medications as neurontin and lyrica, and medications such as elavil (which is an antidepressant but has actually been found to be helpful with neuropathic pain as well).

Evaluation by a pain specialist, with possibly a chronic pain program that offers multidisciplinary treatment of pain, is recommended.

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

[Kimmyh619]

Thank you for the response.  I have recently changed pain management teams and have found a wonderful practitioner who hase begun acupuncture treatments.  I experienced at least 50% relief after the first treatment!  Four days later, I am back to where I started, but will return this Friday for another treatment.  I am allergic to aspirin and NSAIDS which makes the pain and inflamation problem difficult to manage.  I have begun Skelactin which helps, and have been on Cymbalta 60mg 1xday for four years now.  I am told this cannot be combined with Lyrica, so although I have a prescription for it, I am afraid to combine them.  I will ask about this on  my next visit.  Thank you for your advice.  I did not think surgery would help as much as I would want it to.  I am also petrified of having LESS mobility after a surgery so delicate.  I will inquire about chronic pain programs with this new physician.  Thank you again for your kind response.