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Old 03-25-2013, 07:12 PM   #1
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Cervical myelopathy?

Hi, new to this forum. Forgive me, I have a propensity for being longwinded:

Four weeks ago I attended a rock concert where I did a lot of "head banging." The next day I felt some moderate soreness and tenderness in my neck, which caused me to apply a heat pad - this seemed to resolve the pain by the next day or so. Approximately a week after the concert, I was involuntarily feeling the back of my neck while driving and felt something, possibly one of my cervical vertebrae, pop or move. Shortly afterward, while eating, I noticed my right hand felt clumsy, like it was having difficulty manipulating the food I was eating. I should note that I also have anxiety/panic disorder, which exacerbates my symptoms, and this caused me to have a panic attack. I got the panic under control and went to my GP two to three days later, who palpated my neck and had me do range of motion and concluded I was fine. My job involves me walking around a lot, however, and I noticed in the days following at work that not only did my right arm/hand still seem to be "clumsy" and have abnormal sensation, but my lower back would get very tight followed by both my legs feeling tingly or weak. I returned to my GP, who did a neurological exam on me, and could find nothing. He told me I most likely have whiplash from the concert, and it could take up to 6 weeks to resolve. He gave me neck strengthening exercises to do and sent me on my way. After this visit to my GP, my arm still felt (and feels) odd, like some of the muscles are having trouble ennervating, or that it is "heavy," but I am rarely clumsy. I can still write, type, and do most fine motor tasks. However, my right leg has continued to give me problems - at times I get a pinching, irritated sensation running down the back of my thigh to my calf accompanied by muscle twitches in my calf or quadricep, or it would feel like my foot was "heavy" and difficult to lift while walking. This has only occurred in one leg this time, not both legs as before. At times this still is accompanied by a feeling of lower back tension, at times not. I would not describe the sensation in my right leg as being "painful," however, simply very uncomfortable at times. I went back to my GP again to address my leg, who palpated my buttock and lower back region, found a point of tenderness in my right buttock, and concluded I have sciatica in my right leg. He prescribed Mobic (Meloxicam) once daily, gave me sciatica exercises to do at home, and sent me on my way. He believes that I may have irritated my Sciatic nerve from my daily bike commuting to work, where my bike seat dug into my buttock region. He said he does not believe, at this point, that my Sciatica is a result of any lower back/spine dysfunction.

Everything I have read screams that I may have some sort of cervical myelopathy going on, either from compression of the chord or some other cause. I am relatively young - almost 29 - but from my reading at other forums it seems like the perception that cervical myelopathy cannot happen to younger people is a bit overstated. Regardless, the symptoms of unilateral (one-sided - both of my right limbs) leg and arm weakness/altered sensation, the muscle twitches all over, the discomfort I have when walking, all seem to add up especially given that I started feeling this way after a neck injury ("whiplash" from the concert/feeling something pop in my neck.) In other words, I'm having a lot of trouble accepting my GP's diagnosis of Whiplash AND Sciatica at the same time, on the same side of my body. When I pressed him if the Sciatica could be related to the Whiplash, or if it could have anything to do with "Spinal Stenosis" he said no pretty emphatically. He has ordered no imaging studies so far to speak of - he did mention getting an MRI of my neck, but is convinced enough based on physical examination/neuro examination that my symptoms do not necessitate an MRI at this time. Perhaps he is right, given that it has only been a short amount of time. I am coming up on 5 weeks since the rock concert and 4 weeks since I have been symptomatic this upcoming Saturday - should I push my GP for an MRI, or does it seem reasonable that I may just still be experiencing Whiplash/Sciatica to anyone else? It does seem a bit odd that my symptoms have come on so quickly, I'm barely a month into them. My understanding is that other people with cervical myelopathy have had a longer course of disease and more severe symptoms. I have ZERO pain in any of my limbs or my neck at this point, just a lot of discomfort and neurological signs.

Thanks to anyone for the help.

 
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Old 03-26-2013, 05:35 PM   #2
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Re: Cervical myelopathy?

<< I'm having a lot of trouble accepting my GP's diagnosis of Whiplash AND Sciatica at the same time, on the same side of my body.>>

Me too...

<< When I pressed him if the Sciatica could be related to the Whiplash, or if it could have anything to do with "Spinal Stenosis" he said no pretty emphatically. >>

I suppose he's basing this on your age, and also the fact that the symptoms came on quickly, which might incline one to think that there's muscular trauma involved.

<< He has ordered no imaging studies so far to speak of - he did mention getting an MRI of my neck, but is convinced enough based on physical examination/neuro examination that my symptoms do not necessitate an MRI at this time. Perhaps he is right, given that it has only been a short amount of time. >>

Perhaps he is right. Why don't you ask him how long (after the concert) he would like to wait before ordering a cervical MRI? That way, you pin him down...

<< My understanding is that other people with cervical myelopathy have had a longer course of disease and more severe symptoms. I have ZERO pain in any of my limbs or my neck at this point, just a lot of discomfort and neurological signs. >>

Longer course, perhaps, but not necessarily more severe symptoms. Yours sound like the symptoms I had before I found out I needed a near-emergency ACDF, and they're actually MORE severe than before I got an MRI that my doc called "a mess", and ended up with a three-level laminoplasty. Pain, by the way, is not necessarily a symptom. To me, clumsiness is more worrisome. How about weakness in various arm muscles?

 
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Old 03-26-2013, 07:06 PM   #3
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Re: Cervical myelopathy?

Thank you for your reply. I suppose I should qualify "clumsiness" - I usually just feel as if I am going to drop something, or have to concentrate harder on a given task. No, I also don't have any actual muscle weakness in my arms or elsewhere, which is demonstrated by the fact that I can still run, bicycle, lift weights, and do pretty much any activity I was able to prior to the onset of my symptoms.

Yes, your advice that I might want to ask my GP for a timetable of sorts for an MRI sounds reasonable. My current plan is to get through this work week, see how my symptoms go, and if I'm still suffering go back to him on Monday. That would mean 4 weeks since I was symptomatic and 5 weeks since the concert/injury, and given that Whiplash has an average course of 6 weeks according to the GP, 5 weeks seems reasonable enough time to talk to him about how I don't see much improvement overall and would like more investigation. Given that my GP is also the one who manages my anxiety medication, as well, I'm fairly positive he's approaching the whole thing from the angle that I'm young, there's nothing wrong with me, and that my anxiety is manifesting most of my symptoms, not any actual disease process. Let's hope that if I go back to him for the fourth time in the course of one month he'll finally stand up and listen! Ha.

 
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Old 03-26-2013, 07:09 PM   #4
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Re: Cervical myelopathy?

Thank you for your reply. I suppose I should qualify "clumsiness" - I usually just feel like I have to concentrate harder, but all my fine motor tasks (handwriting, buttoning shirts, etc.) seem to be intact so far. No, I also don't have any actual muscle weakness in my arms or elsewhere, which is demonstrated by the fact that I can still run, bicycle, lift weights, and do pretty much any activity I was able to prior to the onset of my symptoms. Really, my arm bothers me far less than the symptoms in my leg, which really frighten me. My leg, and even sometimes both my legs if I've been walking all day, can really truly feel tired/weak.

Yes, your advice that I might want to ask my GP for a timetable of sorts for an MRI sounds reasonable. My current plan is to get through this work week, see how my symptoms go, and if I'm still suffering go back to him on Monday. That would mean 4 weeks since I was symptomatic and 5 weeks since the concert/injury, and given that Whiplash has an average course of 6 weeks according to the GP, 5 weeks seems reasonable enough time to talk to him about how I don't see much improvement overall and would like more investigation. Given that my GP is also the one who manages my anxiety medication, as well, I'm fairly positive he's approaching the whole thing from the angle that I'm young, there's nothing wrong with me, and that my anxiety is manifesting most of my symptoms, not any actual disease process. Let's hope that if I go back to him for the fourth time in the course of one month he'll finally stand up and listen! Ha.

Last edited by ihandle; 03-26-2013 at 07:14 PM.

 
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Old 03-29-2013, 08:27 AM   #5
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Re: Cervical myelopathy?

Just to straight forward your GP might think your anxiety level is really being over exasperated with the neurological symptoms you are feeling. If you truly feel that something just isn't right I would just ask him to write orders for a MRI, CT or at the very least a set of x-rays.... Then go from there. If something even half way comes up then he can send you to a specialist for further exam & work up.
The reason I am saying this is because I know how you feel to a point. I had been hurting for sometime with a lot of the same symptoms you are describing. Also don't try to diagnose yourself from reading on the web. There are so many thing that can mimic something else. But it does help to read up on things. So it really is a two sided sword.
So just to let you know that this is not going to be an over night process for you. But I would start taking a journal(I actually did it via an email draft), about how you are feeling, your pain level on a larger range(1-50) than what most doctors ask a scale on 1-10. It will help you try & pin point to how severe the pain, clumsiness/weak feeling & other things you are having. Believe me it does work.
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