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    Old 04-08-2009, 10:47 AM   #1
    Power95
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    C5-6 Question

    I have already had a fusion at C6-7. Most recently I was in a MVA while working and had to have another MRI of my neck. It showed another herniation at C5-6. I have gone through about 4 weeks of PT with my family doctor. I am now seeing a neurosurgeon, who has ordered another 6 weeks of PT. I am getting a major tingling and burning through my left shoulder blade (Rhomboids - Major and Minor), radiating into my triceps and then down into my elbow. I also get nagging headaches that last days at a time. My neurosurgeon does not feel there is any nerve damage but something does not feel right especially when the pain and sensation hits unexpectedly. I don't want to misjudge anything and question my doctors but this is a workers' comp injury. I just hope I am not getting a run around. Please give me your thoughts on what I should do.

    Last edited by Power95; 04-08-2009 at 10:50 AM.

     
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    Old 04-08-2009, 01:18 PM   #2
    jennybyc
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    Re: C5-6 Question

    Most of the pain you feel seems to be associated with your muscles, not nerves. And muscles in spasm can cause that tingling and electric shock sensations. I know from my son being in a bad MVA at 18 that it took months for the muscles to heal. Doc told us that muscle fibers are one of the slowest to heal in the entire body as they are very long. He said to expect a full recovery to take 8 months and he was right on the money. He did about 10 weeks of PT and then did exercises at school(I hope he did)and was fine by the time he came home again.

    So give yourself some time. Signs of nerve damage would be of 2 types. Impingement(pinching) causes pain...lots of pain down a particular nerve pathway. look up a Dermatome Map that shows you where each nerve goes. the other sign of nerve damage is loss of function, numbness, tingling, and very little pain. A damaged nerve screams, a dying nerve is silent so make sure to report any numbness or not being able to use hand like you used to. If I recall, C5-6 affects the index and thumb(have to check my map). But the biggest thing to be aware of is spinal cord compression and I guess the neurosurgeon didn't see that. That is insidious paralysis and at C5-6 it would be your legs and well as your arms. Watch for difficulty walking and no pain. the spinal cord, like the brain, has no pain fibers so you don't feel the compression.

    Good luck and gentle hugs.............Jenny(fused from C3 to T1 due to cervical spondylosis with mylopathy and paralysis).

     
    Old 04-08-2009, 05:08 PM   #3
    Power95
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    Re: C5-6 Question

    Well I checked out the Dermatome Map and it seems to be showing the same pathway I spoke of earlier, especially C-6. Also, the MRI seems to show a significant herniation at C5-6. My accident was over six months ago and earlier symptoms did seem to be muscular but things have changed significantly over the past two months. In my opinion and sufferer of a previous cervical injury, which required a fusion, this does not feel muscular to me. There is no knotting or tightening. The sensation seems to be triggered and the quickness and sharpness is what I am concerned about most. Thanks for your insight.

    Last edited by Power95; 04-08-2009 at 05:12 PM.

     
    Old 04-08-2009, 07:55 PM   #4
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    Re: C5-6 Question

    Hi Power - it does sound to be nerve type response. One of my levels that was bad was C5-6 and you describe it exactly. I had nerve root compression at that level and I did have perm damage but the symptoms were the same. You do not have to have "nerve damage" to have the sensations you are having. The bulge can be irritating the nerve roots - or there even could be a minor tear or leak they cannot see, leaking disc material and causing inflammation. What you are describing is not muscular it is radiculopathy. If you check the dermatome map I bet you can directly map it to your arm. C5-6 is a very obvious route.

    Do you have the exact text from your MRI? I am thinking it says you have a bulge on the left and possibly in the nerual formin? Let me know what it says, can't tell how bad it is without that text!

    I had burning that started in the outside of the shoulder, down the outside edge of the arm through the deltoid and tricep, came around the backside of the elbow and came up around the top of the forearm. I used ice on that forearm constantly, it can get to burning pretty bad. If those sensations start moving into your wrist you probably don't want to do much by PT except heat/ice treatments, maybe ultrasound if it doesn't irritate you. PT that involves stretching can flare it up more when it is nerve roots. Stretching maybe avoided for a few weeks and see if it calms down. You know there is a medication that works good on those burning pains and that it called Neurontin. I would ask for Neurontin if this is pretty constant type pain. Otherwise how they are treating you is pretty standard from what I know about you now.

    I will check back for your MRI text.

    Last edited by PNo; 04-08-2009 at 07:59 PM.

     
    Old 04-08-2009, 08:12 PM   #5
    Power95
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    Re: C5-6 Question

    Here is my MRI text: Congenital narrowing of the spinal canal. There are posterior osteophyte disk complexes most prominent at C5-6 resulting in moderate-to-severe spinal stenosis. There is flattening of the anterior aspect of the spinal cord. The spinal cord signal is normal. Bilateral neural foraminal narrowing most significant on the left at C3-4 (mild-right/moderate left) and C4-5 (moderate-to-severe left/mild-to-moderate right) and on the right at C5-6 (mild left/moderate right) .

    Like I said in a previous post, my symptoms have seriously gone the other way the last two months. The MRI was done in November '08. I sure hope the PT has not made things worse. I greatly appreciate your help. It gives me a better understanding why I feel the way I feel and what might be the best treatment.

    Last edited by Power95; 04-08-2009 at 08:26 PM.

     
    Old 04-09-2009, 02:44 PM   #6
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    Re: C5-6 Question

    Thanks for posting the additional information. Now that I have seen it I have some ideas for you and also a question or two. There is no mention of herniation here in this text you posted, can you add in that text?

    Just curious, are you having any noticeable breathing changes. Even like you feel like you can't get a good breath? Or are you having any type of chest pain/aches? It doesn't say where the anterior cord flatening is but based on how the rest reads I am guessing it is in the area of C5,ish. The reason I ask is on the anterior side the nerves come out that supply the phrenic nerve, diapgragm, and also the intercostal nerves. If you are not having any noticeable changes I am thinking the flatening is on the mild side and although needs to be watched. (a question I would ask on next visit is what is causing the flatening, exactly what level is it at, is it from disc bulge or is it from osteophytes?) If caused by herniation/bulge then there is a possibility the bulge will continue to shrink and take pressure off that area. If from osteophytes (bone ridging) then it will need to decided if any future treatment is required. If there are no neurological symptoms, pain, or other changes - the neurosurgeon might want to watch this for a while.

    Your headaches are most likely from the C3-4. How do you sleep (on your back, R/L side, stomach?) I also have problem at that level that has not been fixed and I get headaches if I make any attempt to sleep on my back and from bad head positions (like on computer!) I hope you aren't a stomach sleeper, if you are stop!!!! When the headaches come on- try icing the back of your neck up high on the occipital bones (where the skull starts the curve to your neck).

    I definifetly suggest you ask them to get on neurontin based on what you are experiencing and looking at your MRI. Neurontin helps radiculopathy pain/burning quite a bit for many people, some none, but it is worth a try.

    There are osteophyte complexes (bone spurring/ridging), those might have been there for years, maybe influenced by your prior fusion, and not just from a recent accident. Of course you are having pain and problems now since a work injury so they will treat you for all of it most likely. Conservative treatment is best that means rest, PT, ice/heat, medications, maybe a try at very gentle traction. You might really benefit from transforaminal epidural injection (also caled nerve root block. My physical therapist and I made a deal that we would try anything 3 times, and if I continued to get worse each time we would eliminate that treatment. What treatments are you doing in physical therapy?

    I will watch for any posts from you. Bye. NP

    Last edited by PNo; 04-09-2009 at 02:44 PM.

     
    Old 04-10-2009, 06:52 AM   #7
    Power95
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    Re: C5-6 Question

    It is strange that you say that about my breathing because I never thought that my neck injury would affect it. I have had some shortness of breath and discomfort, minor twinges of pain, in my chest. I haven't even mentioned this to my doctor. I also am a side sleeper. I use a heating pad on the same part of my neck as you spoke of. I do this much of the day. This has helped tremendously for my headaches.

    As far as the herniation/bulge, I am not sure why the neurosurgeon did not see it or report it, but it is very noticeable, much like what I see on example scans found on the Internet. http://www.spineinstruments.com/Cervical%20Disc%20Bulge.htm It is definitely pushing on the nerve root.

    Last edited by Power95; 04-10-2009 at 06:55 AM.

     
    Old 04-10-2009, 07:30 AM   #8
    sammyo1
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    Re: C5-6 Question

    My problem orginally at C5-6. I have the chest & breathing issues. In fact that was the first symptom I had before any pain, tingling & so on.... Not one doctor mentioned it could be spinal & I have seen others post with the exact same symptoms. As it progressed I had some major problems with inhalation. Had me pretty shook up. The chest pain could be sharp or could be a dull ache. The first PT I went to was stunned at how tight the chest wall was & said it was in constant spasm. Of course I had to go through tests to rule out cardiac. Which were ok other then slight tachy cardia. As things progressed it went into the shoulder/arm hand & so on...This took a couple yrs to figure out, now I more then likely will have some perm. damage.
    When I did find out about the cervical problems I asked but still could not get a direct answer. I had headaches, still do but so far not as bad. I have some problems with C4 & 7 also.
    I am fused now at 5-6 & still have the inhalation problem but not to that degree & pray it does not start up again. I have a feeling alot of people do not connect the breathing or chest to cervical problems. Its good to post about it so others know.
    Good luck, Sammy

     
    Old 04-10-2009, 11:09 AM   #9
    Power95
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    Re: C5-6 Question

    Thanks Sammy! I will definitely mention my breathing troubles at my next appt. What was wrong at C5-6 and how did your symptoms progress? I guess I can look for other signs for the future. I wish I could just get this fixed rather than going through the lengthy process of PT and medication. I don’t want to feel like crap for years before they decide I need surgery. The pain and feelings with this injury are quite similar to my last neck injury, which did result in very successful surgery. I am sure I am not alone on this one!

    Last edited by Power95; 04-10-2009 at 11:10 AM.

     
    Old 05-19-2009, 05:38 AM   #10
    MikeTh
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    Re: C5-6 Question

    Power95,

    Sorry to hear about the injury. I am a workers' compensation attorney. The workers' compensation system is fairly complex and there are pro-active steps that need to be taken to ensure that you receive the benefits that you are legally entitled to under the law. Without knowing what state your injury occurred in, it is hard to offer any advice, as all state have different workers' comp. laws. What state did the injury happen in? Thanks.

     
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