Hi I was hoping someone could help me with understanding the following two MRI's. First, a little about me. I am a 43 year old male and have been working as a shipper/receiver for the last 25 years prior to going on disability in Feb 2012.

I first started to get neck and left arm and hand pain in 2009. My Doctor sent me to a pain management clinic for trigger point injections in the forearms and shoulder and trap area. This helped for about a month or so and the pain and spasm returned. During this time I was taking advil and T3's for the pain but did not really do much. In September of 2011 I started to experience numbness and tingles in the fingers of my left hand as well as thumb pain that was very sharp radiating between my wrist and elbow.

This went on until February 2012 when I woke up with severe pain in my neck and numbness while on vacation. I made a doctors appointment when I got home and xrays where performed and some bulging and spurs where found. Because of the nerve pain I was experienceing my Doctor sent me for some nerve tests and a MRI. Both of which would be repeated in early 2013. The first MRI was performed in May 2012. It reads as follows:

Findings: There are mild disc degenerative changes extending from the C3 through C7 levels inclusive. The is no evidence of abnormal spinal cord signal intensity.

At the C5-6 level, there is some posterior endplate degenerative spurring and there is a small right parcentral disc protrusion. This is some thickening of the ligamentum flavum bilaterally. The combined effect is mild-to-moderate central spinal stenosis. There is flattening and mild compression of the cervical spinal cord. There is some compression of the right lateral aspect of the thecal sac and I cannot exclude some compression or irratation of the right C6 nerve root by the disc material. Clinical correlation is recommended. Degenerative spurring in the Luschka joint on the right resulting in minimal right-sided foraminal stenosis.

At the C-7 level, there is posterior disc bulging and posterior endplate degenerative spurring and thickening of the ligamentum flavum bilaterally resulting in very mild central spinal stenosis no focal disc herniation or focal nerve root compression.

At the C7-T1 level, there are small Tarlov cysts involving the C8 nerve root sleeves bilaterally. No other significant cervical spinal abnormality is identified.

In July 2012 I received a cortizone injection which took some of the inflammation out of my neck, but did nothing for my arm pain which was getting worse to the point of not being able to use my hand with out pain and numbness. In December of 2012 I was prescribed oxycodone for pain relief.
In March of 2013 the second MRI was performed the findings were as follows:

Comparison is made to the previous MRI study of the cervical spine performed on May 04/12. There is normal alignment of the cervical spine. No marrow signal abnormality is seen. There is no evidence of a fracture or dislocation.
No signal abnormality is identified in the cervical and upper thoracic spinal cord. There is no Chiari malformation.

There are mild degenerative changes in the lower cervical spine. At the C4-5 level, there is a mild posterior disc-osteophyte along with mild facet joint OA and ligamentum flavum hypertrophy without significant central canal or foraminal narrowing.
At the C5-6 level, there is a broad-based right paracentral and foraminal disc-osteophyte which contacts and mildly effaces the right anterior aspect of the thecal sac and spinal cord. There is facet joint OA and ligamentum flavum hypertrophy. There is mild to moderate central canal narrowing and mild to moderate right sided foraminal narrowing at this level. There is a mild posterior disc-osteophyte at the C6-7 level along with mild facet joint OA and ligamentum flavum hypertrophy. There is mild bilateral foraminal narrowing without significant central canal narrowing. These degenerative changes appear stable compared to the previous MRI study from May 2012. As noted on the previous study, there are Tarlov cysts bilaterally in C7-T1 neural foramina, larger on the left side. These also appear stable compared to the previous study.
Impression:
Mild degenerative changes most prominent at the C5-6 level as described. Overall, there has been no significant change compared to the previous MRI study.

I am now waiting on an appointment with an orthopedic surgeon and would like some information if at all possible on what all this means. The pain in my arm and hand is like being on fire and everytime the pins and needles happen my neck goes into spasm, my index finger swells, and the pressure in my forearm feels like it is going to burst. Any commets would be greatly appreciated. Thank you and all the best!

Okay, I'll bite! If I am reading your post correctly, you have left sided symptoms and right sided imaging findings, particularly at C5-6. It is rare but possible that the two are related (contralateral imaging findings compared to symptoms). Possible other helpful thoughts might include selective nerve root block at your symptomatic level and side, interlaminar ESI therapeutically and/or diagnostically get hooked up with your friendly neurologist for EMG/NCV maybe even SEP if it looks like you need to go there (plexus origin) to help discover where all of this is coming from. You really need to sit down with your doc to discuss!

Hi Dubious,
Thank you for taking the time to reply. I will discussing all of this with the Neurologist during my next appointment. Take care and all the best!

[shipper/receiver for the last 25 years ]

Lots of lifting/reaching? overhead & heavy also?
Might even be repetitive related , combined with your c spine issues.
Any prior whiplash type injuries?

Can you hold your arms up in a firm "stick em up" position and open close hands for 3 minutes or so?
What happens? any pain or heaviness increase? hand turn white when up in air?

Have you had any expert PT or assessments by PT, or DC?
If some of the sx are soft tissue based, sometimes these will be helpful more than MDs mainly looking at a surgical, injections, or Rx fix.