Megan,

I have had two cervical fusions and also have bilateral foraminal stenosis at various levels; no impingement...yet contact. I will say before my fusion of the C3/C4 the pain did NOT refer downwards...it went up the back of my head. The higher levels refer pain, tingling, etc. upwards. My C2/C3 has arthritic facets and I can feel tingling along my jawline at times. Or, if I aggravate it, I will have pain at the base of my skull. The C5/C6, prior to that fusion, referred pain right down into the base of my thumbs and the spinal cord was compressed. I should add that I had burning or PN type of symptoms in my hands PRIOR to the second fusion but after both surgeries...it is gone. I also have stenosis in the lumbar and of course it refers pain and burning downwards...and into my feet. I have buzzing in my left leg and wouldn't you know it...the lumbar/sacral issues are worse on the left. So, all in all, this is more radiculopathy causing PN like symptoms. I will also add that my Neurologist and spinal PM have both said many times...ANYTHING going on in the cervical spine can refer pain or altered sensations anywhere in the body and can travel up and down.

You can check out the dermatome charts to see where specific nerves travel. But keep in mind too dermatomes can overlap. I had one NS INSIST that the pain from the C3/C4 would travel downward...as in neurological deficits. But it didn't...it went straight to the back of my head causing horrible cervicogenic headaches. I just thank goodness I found the Spine Group I did after 3 years of heck. They found the culprit right away. And I should also add that when I get injections; different types in the lumbar, the burning in my feet goes away. Yet my lumbar isn't bad enough yet to warrant any surgery. So, this is why in my case, I know it is more stenosis causing the majority of these sensations. I even had a podiatrist once, without knowing my history at all, ask me if I had a pinched nerve in my lumbar/sacral area. He did NOT think it was PN at all!

Anyway, yes, an MRI or CT scan would reflect the stenosis. I just had a CT scan done for my cervical spine because of the "artificats" in other words, fusions. And my spinal PM went through each and every pic pointing out where the stenosis is. Also, I have had normal EMG's...every time! But remember EMG's are subjective and are just considered a tool in figuring things out....small piece of the puzzle is what I am trying to say. What really determined my pain generators besides having MRI's or CT scans, were injections. I am just about ready to have a Selective Nerve Root injection for the C6/C7 since it is taking on the load of the fusion above it. Again, no impingement...but I have aggravated the nerve root(s). And what are my symptoms? My index fingers are stiff, wrist flexors are stiff and there is slight burning in my hand, shoulder and forearm. So, you see...a person might THINK it is true PN when in reality it is all coming from the spine.

And don't get me wrong. I know PN is real and can be measured. And there are many causes for it. All I am saying is that if you have stenosis, it can and does cause various sensations.