7 mths of neck pain-MRI results shows osterphtyes
 

First time poster here...... Here's a brief rundown of my story and I'm hoping another member with similar issues might be able to offer some insight And share their experience.

I started experiencing a deep ache in my left trapezius area about seven months ago which worsened usually at the end of a long shift (nurse). I figured it was a muscle strain; I don't have the best posture and my job is both pretty physically and emotionally draining so I'm familiar with neck strain. I decided to be pro active and get into PT for treatment. Unfortunately the stretches and strengthening exercises only seem to exacerbate my problem and I began having spasms. After three months of trying several different approaches, traction, ultrasound, joint mobilization, electro stimulus without improvement, I stopped PT.

I finally had an MRI which showed the following:

Reversal of cervical lordosis

C3-C4: Small left paracentral disc osteophyte complex with effacement of ventral CSF and no cord compression

C5-C6: Small to moderate right paracentral disc osteophyte complex with efface net of ventral CSF and bare contacting of the right side ventral margin of cord.

C6-C7: Minimal broad-based disc osteophyte complex


I just received these results so I haven't had a chance to discuss it in detail with a knowledgeable care provider. The PA who ordered the MRI just suggested I see a spinal surgeon. I'm certainly no expert but "bare contacting of my central margin cord" doesn't seem to warrant a surgical approach at this time. Yes, My neck feels stiff and achy all the time but I don't have any radicular symptoms.

The PA agreed to put in a referral for me to a local pain management specialist with a good reputation. I am hoping that some type of cortisone injection can ease the inflammation enough so I can do some neck strenghtening exercises

Does this sound like a reasonable plan? From the minimal research I've done so far it looks like surgery for osteophytes is a last resort.

Has anyone had cervical injections for a similar condition with good (fairly lasting) results?

Thanks for reading!

Hello pensive
 

Yes, I wouldn't do the surgery right now. However, I would look up this cortisone injection before you submit to it. I would seek a pain specialist and ask if there are other medications that can be used in place of cortisone. I am not a big fan of this injection. Asking won't hurt. There are mixed reviews from this particular medication. I am cautious by nature. After listening to multipal accounts, I would ask if this is all that can be done, or the only thing that can be done. I hope it works out for you. ginnie:hug:

I have similar
 

problems in my neck as you, very similar, and the exact same locations. I too have tried several bouts of PT and 9 months of chiropractic treatments, all with zero results. I think it actually made it worse :confused:. next week I will be giving acupuncture a try, fingers crossed, but that's my last shot aside from surgery I think. I have an apointment at the pain clinic in three weeks to see about injections, however I have heard of HORRIBLE side effects from steroid injections. So I will go to the apt and see what other options they might have.

Interesting that you have pain in your trap. I do as well, sometimes it gets so severe I can't even lift my left arm. Does your arm ever fall asleep? or get pins n' needles? I would love to hear more about your symptoms and also about what you are doing to cope with it all. Please share! :)

I wish you the best of luck and hope that you find some treatments that work for you. Cheers Cali :)

80% of the population by the age of 50 on imaging have degenerative changes (including osteophytes). That, in of itself, is not an indication for surgery.

Dubious is right. These are basically aging problems. :rolleyes: Steroids are crummy for the body, and are just a "bandaid" fix and lots of times just don't work. Doctors like to give a "series" of them, but if the first one doesn't work, the subsequent ones won't either. It's just that they get anywhere from $1,800 to $2,800 for EACH ONE.

Physical therapy usually gives better results than injections.

I wish you the very best! God bless & please take care. Hugs, Lee

Yeh Leesa
 

Glad you don't care much for the steroids either. I didn't do well gettin my first and only of that. I was not a happy camper. ginnie:hug:

Hi Cali,

Not that I'd wish this neck pain on anyone, but it is comforting to know someone else out there is experiencing the same symptoms. For those who state PT is "usually more effective" than steroids, as my original post said I gave PT several months and it only seemed to aggravate my condition. As far as steroid injections go, I'm not too familiar with them but have read "just one" did the trick....for some folks, including a nurse co worker of mine. We'll see as I have a pain management consult in less than 2 weeks. I'm an RN who works in a teaching hospital so when I return to work this Sat, I plan on asking our Orthpedic PAs their opinion/advice; They see these conditions all the time and are actually in the OR with the local neurosurgeons. I know they'll offer honest advice.

Cali, occasionally my left arm feels a bit heavy and aching but no numbness or tingly to speak of. What works best for me is NO stretching , strengthening or even isometric exercises of the neck..... The more Gently I treat it along with bio freeze, the better. This is why I didn't even consider seeing a chiroprator., I don't need my neck structures contorted any more than they are.

We'll see what happens, I'll keep you updated!

Hi, I hope you were one of those compassionate RN's that didnt think everyone with spinal issues is a drug seeker! the condition with your arm aching and feeling heavy is a symptom of nueralgia (sp). i have the same issue and i believe it is caused by the c-3/c-4 as it is a symptom of herniation at that level. Surgery has a 1 in 3 chance of helping but is by no means a cure and should be avoided unless there is an impending serious issue. IF you can gut out the pain it does get better and the pain seems to lessen. at least for me. You should prepare yoursel;f to be treated like an addict, however, regardless of your background. you can also expect to be undermedicated due to the war on drugs and the effect its had on physicians. If you can, I would have my PCP prescribe all of your meds. good luck! I certainly can empathize with you and your pain
FRED

Fred, an astute and experienced RN (I've been a nurse for 30 yrs) can usually tell the difference between the "drug seeking" patients versus one truly in pain versus someone who is opioid tolerant (and in pain), not necessarily by their own doing but as a result of years of over medication by their prescribing MD. Whatever the case I like to think of myself as an empathetic nurse who doesn't let subjective judgements, co worker chatter or assumptions affect the way I care for the patient....... With dignity and respect (which believe me in SOME cases is a challenge.

Anyway, I don't expect to be treated as "Drug seeking" since I will make it clear I'm not interested in any narcotic analgesics. I'm fortunate that my pain isn't that severe, more of a gnawing ache that's livable just really annoying and I'm hopeful there lies a treatment for this nerve irritation/inflation which doesn't involve daily systemic oral medications.

Heavy achy arms, upper back/neck pain, some ulnar/hand sx - another possibility could be Thoracic outlet syndrome (TOS) depending on your MRI/xrays & symptoms.
C spine pain/issues/causes/ would need to be ruled in or out before the possibility of TOS is looked at by drs. TOS is not well known or not well known to many drs, TOS rarely "shows" on any imaging and no real test to prove it.

In the past we have had quite a few nurses with TOS due to stretch injuries from lifting/moving/catching patients.

We do have a TOS forum if you'd like to read about it more.
http://neurotalk.psychcentral.com/forum24.html

HI Pensive one;

I have not done them I had acdf in 2010 -no regrets.

As far as the ESI(epidural steroid injections) yes I have seen many family members and friends have much success. In fact right after my surgery I took one of my friends to my surgeon he had 2 very large herinations at c-5-6 --but he was not spinal cord compressed --my surgeon referred to have ESI done-- one shot worked its been way over 2years no pain!! But --it took 3days after the shot before he felt the relief. Now another family member had to do all three before it worked. IMHO --its worth it--it a quick procedure feels like bee sting its x-ray guided. It really might help reduce the inflamation causing the pain and allows the disc to heal. Wish you all the best!!

Thanks mg, that's encouraging to hear!

All of this is too progressive and jumped the shark....I'm out of here...

Just saw a pain management doc who said my MRI "looks great" and thinks trigger point injections might due to the trick to break up the spasms and give the area time to heal, if that doesn't work he'd consider Botox to loosen the very tight muscles......says there are lots of options but its definitely not a surgical case, which I knew but was nice to hear straight from an MDs mouth. Looking forward to my injections next week- steroids won't be used.

Is there going to be any PT along with the Injections?
I would ask about that and ask specifically for a highly skilled PT.

Triggerpoint (manual & injections) are often used to tx TOS and TOS like injuries, botox also.
Also in conjunction with PT to address/resolve the full cause of the pain.
Did the MD mention the possible cause of those spasms/tight muscles?

The informational sheet I was given on the injections mentioned that stretching and strengthening was an integral part of the therapy ; however 3 mths of unsuccessful PT led me to a pain management doc in the first place. The purpose of this is to decrease the inflammation in the area and give it a chance to recoup. Hopefully the PT exercises I will probably resume wont cause more aggravation to the area but this time help.

The cause was most likely cumulative stress and bad posture which resulted in the flare which became worse as I said with PT. Beware of reading books or your i phone while half slumped in bed. I'mpretty sure hours of this bad habit led to neck strain. I've always had huge knots in my shoulders or as long as I can remember too..... A result of a stressful job (nurse) and holding my stress up in my shoulders. He said given my my "young" age 52, good health and being slim and fit should all make this issue fairly easily resolvable.



QUOTE=Jo*mar;981482]Is there going to be any PT along with the Injections?
I would ask about that and ask specifically for a highly skilled PT.

Triggerpoint (manual & injections) are often used to tx TOS and TOS like injuries, botox also.
Also in conjunction with PT to address/resolve the full cause of the pain.
Did the MD mention the possible cause of those spasms/tight muscles?[/QUOTE]