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  • Want to understand and what are options that are best.

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    Old 04-11-2016, 07:01 PM   #1
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    Want to understand and what are options that are best.

    I have major pain in my neck, shoulder, shoulder blade and goes throughout my right arm. I have numbness and loss of strength in my daily use of my right arm and hand. (just lifting a coffee mug)
    I was first told that i had muscle spasms and was given muscle relaxers and inflammation meds, the pain was so bad i would be in tears, only thing that helps just a bit was putting my arm up. I have been taken off work for how many pain meds I take to control the pain to a level I can bare.

    Finally after having gone to chiropractor, acupuncture, pain meds a doctor had a mri completed.

    this is the results:

    Mild straightening of the normal lordosis. Marked levoscoliosis with tilt of the head to the right. Normal cord signal. Normal cervical medullary junction and c1-c2. 2centimeter cyst or polyp at the floor of the left maxillary antrum. Complex 3 cm cephalacaudad by 1.5 cm AP dimension mass in the anterior left neck, probably at the lower pole of the left lobe of thyroid. there may be a smaller 5x7 mm mass or lymph node posteriorly.
    C2-C3: Normal
    C3-C4: Normal
    C4-C5: Mild focal central endplate complex without latrerlization. Normal canal and foramen otherwise.
    C5-C6: Moderate soft disc herniation into the right nerve root entry zone and right foramen causing moderately severe stenosis at those sites. No cord contract. Normal left foramen and entry zone.
    C6-C7: Moderate right lateral disc endplate complex which does extend into the right nerve root entry zone and right foramen causing moderate entry zone and moderately severe right foraminal stenosis. Normal left foramen. No cord contract or flattening.
    C7-T1 Normal
    Additional findings: Normal facet joints. No central canal stenosis. No myelopathic cord signal.

    1. Severe levo scoliosis and tilt of head to the right.
    2. No myelopathic cord signal or significant central stenosis.
    3. There is moderately large right lateral soft disc herniation into the right lateral canal and fight foramen at C5-C6.
    4. At C6-C7 there is a moderate right lateral disc endplate complex into the right foramen and right entry zone.
    5. Complex mass left lobe of thyroid, not adequately seen or evaluated on this MRI.

    The pain and numbness is always there even with the pain meds, it just makes it bearable and me sleepy. Im 42, I just work up one morning, 5 weeks ago and felt stiff and just kept getting worse. Was buried alive at the age of 10, had a few car accidents with one being in the last 2 years.

    I just wonder how therapy helps when I have something pressing on my nerve and with surgery they cut it away. I dont want to mask the pain as its been tried doing for this long. I see a specialist in a week. My regular doctor stated that the c5-c6 is a herniated disc and that c6-c7 is bad. But i want to have a better understanding of what this MRI had stated so I can have a better knowledge to make the best decision on treatment and recovery. Im a single mom of 5 kids, ages range from 17 to 3. Im just very concerned.

    I had thyroid surgery 17 years ago and had most removed, whats left has pulled me through this far and not have to take meds. I knew of a "new" growth 5 years ago and they stated they didnt think it was cancer but to keep watching it. so had an ultrasound and waiting on the results on that and blood work.

    Thank you for any feed back.

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    Old 04-12-2016, 05:37 PM   #2
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    Re: Want to understand and what are options that are best.

    Welcome to the board. You have quite a bit of spinal nerve compression in the lower cervical vertebrae, which makes sense given your symptoms on the right side. If you enjoy doing a little research, take a look at a "dermatome map" found online. It will show you which spinal nerve root innervates which area of the body. When you tell a doctor your big toe is numb, he will know to begin looking at problems located at the level of the L4 spinal nerve, around the L4-5 level.

    You will note that the report indicates that the nerve roots at C5-C7 are being impacted by degenerative changes in the disc area. The cause at each level is slightly different, herniated disc at C 5-6 and disc osteophyte complex at C6-7 but the result is the same. There is stenosis in the foramen.

    Stenosis just means narrowing. It mainly occurs in two areas of the the central canal and in the neuroforamen. These are openings through which spinal nerves exit the spine to go out to the part of the body that particular nerve innervates...(look on dermatome map to see which areas of the arms and hands are innervated by C5, C6 and C7.)

    When some extra tissue or bone that isn't there normally forms (like with a herniated disc or bone spurs) it can push out of the disc space into the opening, thereby blocking it or taking up space that is needed for the nerve to function properly. This results in the nerve becoming irritated or compressed (pinched). If there is a big bone spur or good sized bulging/herniated disc, it can compress the nerve to the point of the person feeling tingling, numbness or severe pain.

    You will note the amount of stenosis you have is judged to be moderate...this is based on the following scale: minimal, mild, moderate and severe, and affects the right foramen, but not the left.

    It is these two levels that are causing the arm pain and weakness.

    In addition, there is a slight loss of the nature curve of the cervical spine (lordosis) but there is severe scoliosis curving off to the right side.

    The mass in the neck that is referred to I assume relates to the thyroid issue and needs to be further investigated, as it is not clear from this imaging.

    The good news is that you do not have myelomalacia and the degenerative issues you do have do not impact the spinal cord.

    General comments: pain meds do not work too well, if at all, on "nerve" pain...they just make you care a little less. People take drugs like gabapentin/neurontin and Lyrica, sometimes cymbalta for nerve pain.

    Surgery is considered as a last resort after conservative measures are tried and fail. Sometimes with a herniated disc steroid injections and physical therapy help the disc to heal, the tissue to be reabsorbed and this allows it to move off the nerve, alleviating your symptoms. I would not recommend chiropractic, as it won't help with stenosis and could cause nerve damage.

    Let us know what the spine surgeon recommends. I hope you get some relief soon and hope the older kids can help you take care of the little one.

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    back pain, c5-c6 herniated disc, mri, scoliosis

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