Hi everyone, my partner suffers from chronic neck pain. A few years ago he had a mri which showed degenerative disc disease at the C5 and C6. (MRI results: mild degenerative C5/6 disc disease and small right paracentral T1/2 disc protrusion which is non compressive in nature.)
What options are there to treat this?
We are thinking of visiting Dr Matthew Scott Young...would love to hear from anyone suffering from similar cervical degeneration. Thankyou.
If that's all the MRI report said, then it is really quite benign. DDD - to one extent or another - is pretty much universal after a certain age. A "small" disk protrusion, that is "non-compressive" seems harmless, as well.
I suppose that options would include physical therapy, exercises, and maybe traction. Trouble is, the MRI does not explain the pain at all, which may be entirely muscular in nature. Muscular pain can be very stubborn, and difficult to treat, but I guess a start would be physical therapy.
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Firstly I am from England, so maybe things will be different, treatment wise for your partner in Australia.
I wanted to reply to your post though, as a lot of people have been supportive of me, on here, and I like to give back when I can.
I have Degenerative Disc Disease throughout my cervical spine, and bulging discs, with some narrowing and some contact on the spinal chord etc. And please pass on my sympathy with your partners pain, unfortunately, as I have found to my cost, Neuro surgeons, don't have much time for pain, and aren't really interested if you are not at the stage of needing surgery (ie, with nerve compression or severe nerve damage etc).
I have had to fight to get any real treatment for my pain, for just over 5 years, and have this morning had my first physio appointment, where I feel a lot more positive. I take Tramadol for my neck pain, and it doesn't really help me much, but takes the edge off, I can't manage at all without it, and have had problems trying to cut down in order to maybe try out different meds, I am hoping physio may help me, to cut down on the Tramadol, I am not sure if I will ever be able to be meds free though.
Anyway, from the appointment I had this morning, with physio, I realise it is best to be realistic and accept I may never be totally pain free, but there does seem to be various options open with the physio, to help at least give some relief. Its very early days, so I wouldn't be able to say at this stage, it definately works (I am keeping optimistic though). But from a lot of people now I have spoken to, it seems physio and the use of painkillers, seems to be the main options for this kind of thing.
I wish your partner well.
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That MRI report is actually reasonably good. But it is old and he might need a new one, MRIs can also miss things.
Based on it, Your Dr. will probably assume just soft tissue strain and weakness in the neck. I'd expect several weeks of Physical Therapy to be suggested to learn at home targeted exercises and various good posture habits for sitting and sleeping. Ice, heat and maybe a muscle relaxant and anti-inflammatories. Then re-evaluate in three months.
If no improvement, epidural steroid injections might be considered
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Unfortunately back then when he had the mri it did not explain much. We saw a pain specialist and a neurologist who could not tell us anything. He had the pain then as he does now, although the pain has changed in nature. The mri was done approximately 5 years ago so some time ago.
He suffers from chronic pain, some days he feels well and some days the pain is worse. From my research it seems someone's "mild" degeneration could cause pain whereas someone else's "severe" degeneration may not?
We have tried almost every route possible: acupuncture, physio, exercises/stretches, vitamins/supplements, radiofrequency neurotomy x 3 (which is for the facet joints?), every pain relief possible such as anti inflammatories, aspirin, codeine, nurofen and even opoiod patches.
It really does affect his quality of life and we may need to re-think our life/family/priorities and make some major changes to allow the management of his pain to take priority.
Matthew Scott Young is an orthoepaedic surgeon who specialises in disc replacement amongst other things. I was hoping he would be an appropriate specialist for my partner to consult with? What do you think?
Also the T1/2 would that sit just below the base of the neck? We have noticed in the last year or so that it is developing a bulge/hunch at this spot.
Just wanted to add that we visited with a functional neurologist that diagnosed with cortical hemispericity from a qeg test. Basically they explained it as the brain was not functioning properly - the left side was not "firing" adequately as it should and in line with the right side of the brain. This they believed was a result of a concussion or trauma to the head...my partner was a competition water skiier and had many falls on face/head etc. Would have also probably suffered from repetitive whiplash.
Sorry to have left that info out. The bulge has steadily increased in size and looks somewhat swollen to me. What could this be?
Our GP and Physio shrugged it off and said they couldn't see anything!
We live in a rural area so I would love to know whether I should push to visit the orth that I mentioned and also what tests can my partner have beforehand, mri, catscan, xray? I am unfamiliar with the test you mentioned earlier also.
With the other spine issues, the bulge should not be just shrugged off.
Basically, a myelogram is the doc injecting dye into the spinal canal. Then examining the spine under a fluoroscope (live x-ray), then doing a Cat Scan with the dye still there. Much more detailed than MRI for spine examination.
<< Matthew Scott Young is an orthoepaedic surgeon who specialises in disc replacement amongst other things. I was hoping he would be an appropriate specialist for my partner to consult with? What do you think? >>
I think that you should be careful of docs who specialize in any one surgical procedure until you are sure that procedure is the one needed. As for the possibility of brain damage, I can't say, but the multiple-whiplash thing is certainly a red flag, and may well mean that MRI's will not help much.
The vast majority of the pain from spine problems comes from the musculature supporting the spine. In order for the spine to remain flexible, the muscles must remain strong and when pain starts to interfere, many do the wrong thing...they stop exercising. The muscles then weaken, forcing the bones of the spine to take on more stress, causing DDD(spinal arthritis) to get worse, faster.
The muscles then react to the weakness with spasms and BINGO, you have pain...lots of it. That in turn causes the tendons that connect muscles to the bones to swell and give you more pain. This is most likely what you are feeling and seeing on his back....a swollen inflamed tendon. Treat with heat.
The neck pain is most likely myofascial pain syndrome...pain from chronic muscle spasms. PT will work best for that. They can massage the knots out of the muscles. A good deep tissue myofascial massage hurts but gives incredible relief.
DDD at any one level of the spine is insignificant....just means you have some arthritis of aging showing up and everyone gets it with age. The disk bulge at T1-2 is only a problem IF the disk is bulging backwards toward the cord or to the back/sides towards the nerves. It is doing neither. Nor can it be felt or seen as the disk is about 3" inside the body on the front side of the spine.
If you want to do anything, get a new MRI and see if anything has progressed. But here is the truth from someone looking at a 4th spine surgery this spring.....no spine surgeon operates to fix pain. They operate to save nerves from dying and causing paralysis. And surgery may not relieve any pain and may actually cause more that will never leave.
Nerves that are producing pain are alive and kicking nerves...they can't produce pain signals otherwise. But if the real source is the muscles and tendons as most back/neck pain is, then that can be successfully treated with physical therapy.
Sorry, but if you are looking for a silver bullet cure for the pain in some kind of spine surgery, you are badly misinformed. Most spine surgery produces more pain than it resolves. Find a good physical therapist and make them a life long friend and he will do much better.