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Old 07-18-2009, 01:54 PM   #1
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Stabbing pain under right scapula neck injury

have neck injury and C4-5, C5-6 and C6-7. Remarkable for intevertebral disc space narrowing. Anterior marginal ostgeophytes. Mild disc dessication. Disc bulge indents secal sac and contact spinal cord at c4, c5-6 with spinal cord compression. foraminal narrowing. Mild central canal stenosis.

IMPRESSION:

Cervical spondylosis with central disc protrusions at C5-6 and C6-7 which compresses the spinal cord.

Small central disc bulges at C3-4 and C4-5 contact the spinal cord.

I have seen a neurologist who wants to do a myelogram, but I am scared because I have worked as a paralegal and hello... everything in your body is below your neck so it is risky procedure not to mention surgery. This is all from auto accidents which became a legal mashup and no decent lawyer to sort it all out. I am in constant pain in both my neck which radiates down my arms, but the insidious part of the whole mess is that the sharp stabbing most debilitating pain is under my right scapula. As soon as I start my day, if I lift a toothbrush, it is like a dagger right in the mid region of my back with the popping in and out which feels like someone pulled my right arm out of the socket. If I use my left hand and place it along my spine the clicking is at that location and the muscle spasms are agonizing. My doc told me I have the neck of a 90 year old woman. He said I could let anyone touch my neck. PT I tried but when they went to put my neck in tractionI asked them if they were trying to paralyze me??? My brother was a paraplegic so this is a very sensitive issue with me along with all the back surgery med recs I've read in my career that were not remedied by invasive surgery. What mystifies me is that all the pain is referring down to that part of my back. I have Darvocet which helps a little, but every day I sit on heating pad. The range of motion in my neck is limited of course, but stiffness more than pain. The horrible pain is further down my back where I believe I have another bulging disc and I am wondering if this is the culprit rather than my neck even though that is the tipping point of my injury. I'm confused and want to see ortho but have to go to hoops at medicaid, etc. I have filed for disability because now I am unable to drive, ride public transportation for fear of paralysis if the torqueing motion. I have also had injections in the middle of my back which again, stopped the pain for 6 mos. That is why I am confused. The next time, this pain management doc put the needle in my neck and it was a waste of money. I asked him why he didn't put it in the mid back area and he said there was a danger of collapsing a lung???? Sheesh.

My question is then can a chiro do anything without touching my neck, and/or what about acupuncture??? I just feel like the solution temporarily is to inject at the mid back region or isolate the nerve that is causing the muscle spasms. I am merely guessing. I'm in constant pain and it is major effort to get to any appointment and when nothing helps, I loose motivation to do anything but turn to meds. A glass of wine really helps, so that makes me think it is muscle related spasms?????

With all my experience doing med chronologies on back injuries I'd be better informed. This is a paradox and is ruining my life -- I'm 60 in November so I guess what's left of it. Another consideration because of convalescing after neck surgery I think would be prudent to wait until hopefully I get the disability. I can't work so this is driving me nuts psychologically - major depression because I am a "need achiever" and have always enjoyed my career. I just feel like I am going in circles. HELP!!!
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Old 07-19-2009, 07:22 AM   #2
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Re: Stabbing pain under right scapula neck injury

Hi there, I think you'll get more responses if you post on the spinal board, this board is primarly lumbar & down I believe. There's alot of people on the spinal board with problems in the same area as you, me included.

I can understand why your wanting to wait for any surgery but at the same time you have to consider the damage thats being done to the spinal cord.
I put my surgery off for a matter of weeks thinking it cant possably get any worse then it was at the time. Of course it did & I never knew pain like that existed.

Do you have any ideal at all if or when your disability will begin? I know it can be along wait.

I had the same thing your describing but with the left arm before my fusion. I used to say it felt like someone was twisting my arm behind my back to the point it was going as you described pop right out of the socket.

Although it was the cervical disks that were the problem that was not where the majority of my pain was. Those nerves from your C area travel through out areas of your body causing pain in other areas. Then there is what they call referred pain that can effect another area other then the injured area itself.
Your more then likely having muscle spasms galore in there & I'm wondering if you've tried a muscle relaxer? I had to try several before I found one that worked for me.
It was explained to me by my PT & an ER doctor that when the nerves are bothered it causes the muscles to spasm big time. Its like a domino effect.

Also you have to consider not every little thing show up on these tests. Many times surgeons find additional problems when surgery is done.
For example there was no explanation for some of my pain but when the surgeon was doing the surgery he found other discs involved that did not show on my MRI, my vertabrae was also gone at that point & what was still present had collapsed into the spinal cord. Another problem that did not show on the MRI.

I can see why your confused about the location of the injection that brought you relief. Do you recall what kind of injection it was, a nerve block perhaps?
Your PM should be able to explain why, or your surgeon as to why your had relief from that injection. I am thinking if it was a nerve block perhaps the doctor targeted & was successful at locating the nerve that was causing pain. Perhaps that nerve still orginated from the cervical though. I'm guessing of course.

I hope you can get into a ortho for another opinion. I had an Ortho for my surgery. After I had asked others for their opinions on Orthos vs. Nueros for spinal surgerys. The response was Nueros due to specializing in nerve involvement. I wish I would have went for a second opinion but was to desperate to bother. Of course it all comes down to the surgeon & how much faith you have in that person who will be doing your surgery. I will go with a Nuero for any future surgerys as I dont feel my Ortho addressed my problems with nerve involvment. He was great in other areas & very careful but when it came down to why I was still having problems he never bothered to answer my questions or go out of his way to investigate further. He focused only on the fact the fusion looked good. Everyone is different as is every surgeon but I want a surgeon who knows as much as possable when the nerves are involved. With spinal cord involvement there is always the possability of nerve issues.
Not sure if this helped you any, but I do wish you the best of luck & try the spinal board. There are alot of knowledgable people there when it comes to cervical problems. If I can offer some advice be careful, no lifting & such with that cord involvement. I hate to see anyone go through what I went through before my surgery. god bless, Sammy

 
Old 07-22-2009, 07:34 AM   #3
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Re: Stabbing pain under right scapula neck injury

thank god you declined traction with actual cord compression going on at even more than one level from the way i took that report? it could have been a very dire situation considering what you have going on right now in there. i see you saw only an actual neurologist for the eval? you seriously need the expertise and experience of a good neurosurgeon in order to really get the real skinny here on just what leaving this for too long can cause and also what damage may already be done in there 'just' from that cpmpression alone too.

despite other findings in that report the very most critical and crucial for you right now is those areas of actual contact and compression going on. also what you are more than likely feeling under that blade right now is more than likely stemming from the level of c 7-8 nerve roots/cord compression(while you do not actually have a c 8 vertebrae, you DO have that c 8 nerve(ulnar). i had this very same hidious pain and two particularrly bad trigger points under there from my cord involvement.

the only way i could even begin to get any real relief is if i actually ground that blade into a nice solid wall and held it there. unfortunetly as soon as my compression stopped and i moved away from that wall, bam, it all started up again just as bad as it had been before i did this. it was making me absolutley crazy 24/7. if that blade crap is actually a more constant type of issue like mine was, your compression at that lower end of the c spine and what could also include nerve fibers of that t 1 too since there is just alot of crossover when you get down to the c 7 8 and t 1 areas is the most likely culprit.

just what are your very exacting symptoms right now? anything to also do with the arms,hands/fingers and even the lower torso can all be stemming from cord compression, it all comes down to where the hardest compression actually is upon/within that actual cord itself.

the one thing i do not quite understand in that report is the 'SMALL" bulges up in the high end of your column that actually are causing compression?? usually it is more moderate to severe and not "small' bulges that can actually do this. but as with anything that any radiologist reads, whatever terms they use to actually describe any real finding are pretty much up to them? but it still just does not sound 'right' or possible to me, ya know? what would be considered to be "small' bulges by most standards would nnot even BEGIN to actually even enter that spinal canal where that cord resides, thats what does not make sense to me there. like i mentioned already, more like moderate to severe would do it. it kind o contradicts itself there a bit in the words simply used to describe it.

but getting to a good knowledgeable experienced NS who can actually even work within that canal would be the best place to start for the best possible eval for yourt level of spinal issues(trust me, not all NSs or even other surgeons are always created equal). if you did not have that compression on your cord, seeing an ortho would not be a too bad idea, at least for second opinion. but you unfortunetly DO have very real compression and that really takes that neurosurgeon level of expertise to give you the best possible chance at relieving it without damaging things even further.

on the good side of things, the one thing that could have been found along with cord compression was not listed as a finding. it is called myelomalacia? this is an actual 'process' that simply kicks in to remove deadened tissue from our spinal cords. if that is ever going on on any new MRIs that could be done before your surgery to relieve this, it would mean that the blood supply was so low or non existant from compression that it actually killed of at least some of that actual cord tissue. so not actually seeing that show yet is a really good thing for you and your cord.

but i would definitely see about getting referred to a neurosurgeon asap just to get that eval of your films and your symptoms too. when it comes to really assessing any patient with any level of spinal involvement of any kind, its kind of the MRI ALONG with any patients symptoms that really tells the bigger story. as sammy told you above, not all MRIs will always pick up everything in any given scan since it IS only a scan of an area and not a kodak moment, ya know what i mean? but just seek out that NS and once you get an idea of what it is you are really dealing with here, maybe seeking out just one more opinion from another NS may also help? i actually got three seperate opinions before i finally found the one NS who just really knew the most and had the most experience with what was going on inside my spinal cord. and thats the real key here, finding that surgeon who simply has the most experience with what YOUR particular spinal issues are. like i said above,not all surgeons just are created equal.

but DO stay away from any chiros at least til you have gotten that full eval from an actual NS who gives their permission. its just really iffy getting any chiro adjustments in the first place since they really cannot see the area they are adjusting at all. but when you add actual cord involvement to that mix, well it can get kind of ugly if that chiro simply moves anything the wrong way and can place more compression on that cord than you started with. or even dissect that vertebral artery. scarey stuff that has kept my c spine from being touched.

i do wish you luck with this debi. please keep us posted. and do stop down to that spinal borad. there are some really knowledgable people down there who can provide info too. Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
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