[lemmon714]

Hello,

This is my first time posting on this site, and hopefully I might find some help. About a year and a half ago, I had a ruptured disc remove from C5-C6, and had bone fusion. I have a plate and four screws in it now. For the first 3-4 months, I suffered with horrible neck and arm pain. I had an EMG, and was told I had significant right side nerve damage, but it would ease in time. It eventually did, but has returned over the last couple of months, and it's worse than ever. The back of my neck up into the base of my skull feel like they're going to blow out when I wake up in the morning. After Tramadol, Flexeril, Excedrin, and a bunch of Ibuprofen, I can function somewhat well. The pain goes into my right-side shoulder, and it feels like electricity running up and down my right arm. Sometimes my right arm goes "to sleep", and becomes cold. My left arm doesn't have this. It feels like there's an elastic cord from my tricep, down over my elbow, and under tension as if it were being stretched. This pain can become horrible, even doing something as simple as lifting a cup of coffee. Does anyone have these issues, or know where I can get some answers? I don't want "pain mgmnt" i.e. Vicodin, Percacette, etc. Thanx

[Dr. Smith]

Hi Lemmon, welcome.

Please be vigilant about the amounts of Excedrin and ibuprofin you're scarfing down; the acetaminophen in Excedrin can be hard on the liver, and too much ibuprofin (especially combined with aspirin from the Excedrin) can cause bleeding (voice of experience—I got IBS from taking too much ibuprofin, and now I can't take any of that or aspirin).

I think you may have a misunderstanding of what pain management is/entails. Some PM doctors/clinics won't even prescribe opioid medications, and use other modalities instead.

Another approach might be to see a physiatrist.

Has any subsequent imaging been done to see if everything is ok with the fusion/hardware? Bone fails to fuse in up to 40 percent of fusion surgeries. Failed Back Surgery Syndrome (FBBS) is quite common. A few things that can happen (not that they are happening): 1.) As bone fuses or grows over the hardware, it can cause pressure on nerves. 2.) A screw may have come loose or cracked a vertebra. 3.) The vertebrae above/below the fusion may be weakening; this is called Adjacent Segment Degeneration - ASD. 4.) In some cases, the hardware can begin to corode, causing inflammation and other problems.

The last two usually take longer, but can happen.

Doc

[Dubious]

Originally Posted by lemmon714

Hello,

This is my first time posting on this site, and hopefully I might find some help. About a year and a half ago, I had a ruptured disc remove from C5-C6, and had bone fusion. I have a plate and four screws in it now. For the first 3-4 months, I suffered with horrible neck and arm pain. I had an EMG, and was told I had significant right side nerve damage, but it would ease in time. It eventually did, but has returned over the last couple of months, and it's worse than ever. The back of my neck up into the base of my skull feel like they're going to blow out when I wake up in the morning. After Tramadol, Flexeril, Excedrin, and a bunch of Ibuprofen, I can function somewhat well. The pain goes into my right-side shoulder, and it feels like electricity running up and down my right arm. Sometimes my right arm goes "to sleep", and becomes cold. My left arm doesn't have this. It feels like there's an elastic cord from my tricep, down over my elbow, and under tension as if it were being stretched. This pain can become horrible, even doing something as simple as lifting a cup of coffee. Does anyone have these issues, or know where I can get some answers? I don't want "pain mgmnt" i.e. Vicodin, Percacette, etc. Thanx

I would think with reoccurrence of same or similar symptoms, a follow-up MRI with contrast would be in order as well as electrodiagnostic studies with a neurologist. It is doubtful that there would be a problem with the hardware although it does happen. More likely with tricep pain you are getting a C7 (from the C6-C7 motion unit) root irritation. There are other reasons though. All of this would follow a detailed interim history and clinical exam...