Hello All,

I was in a car acident last year, August 2012. Had some bad sof tissue, Muscle spasm issues for months. I had very conservative treatment for several months; some Chiropractic work, Osteopathic Manipulative Therapy, stretching.
Finally pushed for an MRI since there was little relief. After receive the MRI and then getting a second opinion on my treatment I began PT for 4 months. then received an Epidural injection which had some relief but I was still having major issue with Muscle spams so the relief didn't last long.
My new PCP referred me to a great Chiro who started me on an intense Chiro (3X a week) and Massage Therapy (1X a week) treatment.
I have been seeing the chiro and Massage therapist since April and have now toned back to Chiro once every 2 weeks and Massage therapy once every month. I have come a long way but continue to have minor muscle spasms that lock for hours or an entire day. Nothing that is debilitating just a constant discomfort. Range of motion has come back almost 100%. Cervical pain still exist but again is not Debilitating just a constant discomfort.
Every morning I wake up with mild muscle tightness which loosens up with some stretching. In the morning, I have to "crack" my neck by stretching it side to side (not forcing it, just letting it fall to each side). This usually cracks 4-6 times each side. I have noticed a slight increase in headaches. Nothing major but I used to hardly ever get headaches but now I get them once a week on average and they can be borderline migraines.

I feel like I have come a long way from limited range of motion, constant severe muscle spams and extreme cervical pain, however I am concerned that this is the best it will get. I am only 28 years old and have no previous history of neck or back injury / pain. I do not want surgery at my age but I also don't want to think this is "as good as it will get" if it could be better.

I have not spoken to a Neurologist about my MRI nor have I discussed the possible future issues I could have with this condition. I know there are Disc Herniations but I don't really understand how bad they are except that there isn't any nerve infringment.

My Chiro said this might be as good as it gets for now and over the next five years I will see some more improvement with continued "lifestyle treatment" Monthly massage therapy and chiro visit. Along with continued Core Strengthening. Since this was an auto accident, I do have a lawyer. I am being told that since my treatment is coming to an end (as long as I don't have any setbacks) my lawyer will be looking to settle my case. I am worried that I have missed something and that there will be severe issues down the road.

Can someone please help? Are my current symptoms as good as it will get? I shouldn't have surgery at my age right? Should I be aware of surgery down the road? Should I speak with a Neurologist and discuss the possibility of issues as I get older? Is it bad enough to warrant that?

Can someone explain my MRI to me?

FINDINGS: There is mild cervical kyphosis is centered at C5. No focal worrisome marrow signal abnormalities are present. The craniocervical junction is unremarkable. The visualized cord demonstrates normal signal and caliber throughout.

CT/C3, C3/C4 and C4/C5: Unremarkable.

C5/C6: There is a small central disc protrusion with associated radial annular tear without significant spinal canal compromise or cord compression.

C6/C7: Tiny left lateral disc protrusion is suspected superimposed on a mild
diffuse disc bulge without significant spinal canal or neuroforaminal compromise. No nerve root compression is demonstrated.

C7/T1: There is a tiny right paracentral disc protrusion superimposed on a mild
diffuse disc bulge again without significant spinal canal/neuroforaminal compromise or nerve root compression.

IMPRESSION:

1. Central C5/C6 disc herniation without significant spinal canal compromise or
cord compression.

2. Tiny left lateral C6/C7 and right paracentral C7/T1 disc herniations as
discussed.


Thank you very much for you help!

Hi jmangini19, welcome.

Surgery should be considered only after all other modalities have been tried & failed, when there is instability, danger of permanent paralysis/nerve damage, etc. Since you've been getting better over the past year, it doesn't sound like surgery is warranted in your case, and that's good.

I'd hate for someone to tell you that you could get better, then settle your case based on that assumption only to find out afterward that you cannot get any better, if you catch my drift. No-one can predict the future, but considering the results you've been getting, I don't see any reason to give up or stop trying. Have you tried any other conservative therapies, e.g. acupuncture, myofascial trigger point therapy, TENS, etc.? Have you been to a physiatrist?

You can certainly speak with a neurologist if you want to, but they can't predict the future either. I wouldn't worry about surgery down the road unless/until something happens (gets much worse) down the road, then deal with it if it's the only solution.

Has your doctor not gone over & explained your MRI? S/he should have, and I would request an appointment to do so. I don't see anything alarming about it, but some other folks here are better at explaining MRIs than I; it would take me as much time & effort as it would you, but to get the fullest understanding (nothing misinterpreted or left out) I would take the time to do it for myself.

Best wishes,

Doc

Do you have any arm pain or hand symptoms?
Was it a whiplash type injury?

Does the chiro do any upper cervical adjusting (c1 c2) ( special training for that)?
Might be something to look into.. www.upcspine.com

MRI words of tiny, mild & small make me think soft tissue is the main reason for your pain.

Some times seeking out or adding a new DC or PT with more techniques /modalities can be beneficial. A new set of eyes so to speak...


Does DC use a variety of therapies? Like ultrasound, IF stim, low level laser, trigger point work, and posture work?
possibly the top rib can become raised and sort of stuck and need to be dropped down, called rib mobilization.