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Newbie needing help with MRI findings, C4-5, C5-6

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Old 02-06-2019, 12:00 PM   #1
Drunner
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Join Date: Feb 2019
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Default Newbie needing help with MRI findings, C4-5, C5-6

Hi all,

Looking for some help regarding MRI findings.

My background is 49 yo female, desk jobs for most of my life (although no longer working), used to be a long distance runner (30-106 mile races). I have no recollection of any injury to my neck so Im assuming my issues are through age & wear & tear.

About 3 years ago I started having left shoulder pain, pretty severe. So much so it was agony to lie on that side in bed at night and had very limited range of motion. Acupuncture helped that immensely, so much so the shoulder pain eased after months of acupuncture However, about 6 months or so after the shoulder pain disappeared, I started having pain in my left thumb/palm, its like electric currents/shooting pain/burning sensation/pins and needles and can change between any of these feelings. Nothing eases it, I've tried painkillers, massage, acupuncture, cupping, you name it I've tried it. There is weakness there, i struggle to do planks/push ups/opening jars & bottles.

Finally went to the doctor and have since been for an X-ray and MRI.

MRI results are in and Im trying to make sense of it. From what I can tell, its not too severe but my concern is that it will get worse over time.

Can anyone help me make sense of this please?

Impression
Multilevel degenerative change greatest at C5/C6 with
mild left paracentral and foraminal disc osteophyte complex and
associated uncovertebral degenerative change. This results in
mild central canal stenosis and left neural foraminal stenosis
with contact of exiting left nerve rootlet. At C4/C5 there is
mild right uncovertebral degenerative osteophyte with moderate
right neural foraminal narrowing.

C4-5: Mild right uncovertebral degenerative osteophytes. No
central canal stenosis. Moderate right neural foraminal
narrowing.

C5-6: Bilateral uncovertebral degenerative osteophytes, left
greater than right. Associated mild left foraminal and left
paracentral disc osteophyte complex. Mild central canal stenosis
with slight effacement of the anterior thecal space along the
left paramedian and foraminal region. This likely results in mild
contact of anterior division of exiting nerve rootlet along the
anterolateral aspect of the central canal. Cord signal and
contour is maintained. Left neural foraminal stenosis with
contact of exiting left nerve rootlet.



I understand that theres bony spurs there which in turn are affecting the nerve pathways. Will this get worse over time & whats the best way to manage it? And if everything is "mild and moderate" why is the pain so bad at times?

Many thanks!
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Old 02-07-2019, 07:35 AM   #2
glenntaj
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Join Date: Aug 2006
Location: Queens, NY
Posts: 2,761
Default The terminology--

--just refers to the degree of space compromise that they've found; a foramina is the space through which nerve roots pass on their ways in and out of the spinal cord, and you've definitely got some compromise at a number of levels, mostly left.

The degree of space compromise is not always associated with severity of symptoms--I've seen people with mild compromise with severe symptoms, and people with severe compromise who aren't very symptomatic at all. A lot seems to depend on heredity, exactly where nerves are being impinged, and confounding factors (diabetics, for example, who already have nerve problems tend to get more severe spinal symptoms--the so called "double crush phenomenon").

Still, you've got clinical correlation of your symptoms--and shoulder symptoms are common, along with those in the arm and hand. And depending on how severe they are, docs might recommend physical therapy, medications to reduce pain, or, if things get really bad, surgery to open up the spaces. Opinion on the latter are quite varied--some surgeons won't do surgery unless there is motor weakness, which generally means deeper nerve compression than sensory symptoms indicate, but some will operate for pain.

By the way, not surprising this is there if you have an ultramarathon history--I too was a runner, and serious basketball player and referee, and my MRI looks worse than yours (I have symptoms on both sides). So far, though, I've kept myself out of the operating suite with a lot of intensive physical therapy and exercise.

One other thing--you may want an MRI of your lumbar and sacral spine, which also tend to deteriorate over time with that type of athletic endeavor.
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