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Having upper neck and shoulder pain. MRI scan of cervical spine shows diffuse degenerative changes. Suggestions?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
Practicing since : 1994
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Hi dr XXXXXXX Sanap, radiolologist. My mri-of servical spine
Histort:48 year old female,upper neck and shoulder pain for 6 months,radiation down arms,radiculophaty.
A non-contrast mri scan of cervical spine shows diffuse degenerative changes.
C4-C5 shows left central dysvopphyte with minimal cord impigment with aut myelomalcia.
The C5-C6 shows moderateright centraldyscophyte causing moderate cord impigment with aut myelomacia.There is moderate to severe bileteral forminal narrowing impigning both exiting C6 nerve roots.
TheC6-C7 shows dyscophate formation causing mild to moderete cord impingment.There is severe left forminal narrowing impiging the exitind left C7 nerve root.There is moderete right forminal narrowing.
Impression:
Diffuse degerativne changes.The canges are moderate to severe at the C5-C6 andC6-C7 level causing cord impigment with aut mylomalcia as describe.In addition,there is marked forminal narrowing atC5-C6 levels bileteraly and left C6-C7 level impinging the exiting nerve root.
Mri thorasic spine:
A non- contrast mri of thoracic spine shows diffuse mild to moderate degenerative changes more pronaunced in lowervthoracic spine including disc space narrowing, disc degeneration,osteophyte formation and facetchypertrophy.
The T7-T8 shows tiny right central disc herniation with aut cord or nerve root impigment.No other significent abnormality.
I did contact you back in march if you remember with shoulder mri and problems.
Mybproblems are from beagining my both arms more right and neck problems including lower backband upper pain .this is happening from last summer i lockt my shoulder doing somthing then year beafore ibfelt and injured right hand and back.
All time from last year i have pain in wrist elbow,fingers shoulder tingling tru arm pins and needles more right side and....my righ fist i cant close anymore and weenes i went to neurologist in march for testing nervs kcm-mashine testing he said my nervs are fine .After mri of spine they said it did not do from shoulder means shoulder did not do this to my neck then my question "what causes to i have this with spine "when this happen if you can pausle all of this .Thank you your's E.I.
Posted Sat, 20 Jul 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Hi,

Thank you for posting your query.

I have gone through your problems, and detailed MRI report.

Your problems are due to cervical spine (neck region). In that area, at least two nerves have got compressed due to slipped disc. As a result, there is pain in arm and hands, and weakness. The nerves from the neck travel to the hands.

Initial treatment would consist of nerve pain medications such as pregabalin or gabapentin, physical therapy and use of neck collar.
In some cases, epidural injections may also be required to relieve the pain.

If the symptoms do not improve despite above, surgery may be required in about 10% people.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Having upper neck and shoulder pain. MRI scan of cervical spine shows diffuse degenerative changes. Suggestions? 2 hours later
Thak you do you think regarding my spine test i shoul have one neurologist or neuro surgen in further treatment regarding same or not.
I'm prity shoure i had bronchial plexus on very beagining bat my gp dinaed that she said you had neurologist and he test you on kcm-masine and told you dont have b.p. and also he. Said my nerves are all ok bat after him i did mri- scan of cervical spine it shows diferent i sent him back my mri hoping he will call me he still did not answer after weeak past.My original problem 1year ago was injury of shoulder left my hand olmost paralised wos like pice of metal no muvments wrist elbow terebole pain weeknes raunded shoulder sleeping problems....pins and nables tru last two fingers swolen hand i had blow in my shoulder with sombady original injury.Had at same time swolen neck to i ask her back in decembar to do mri of spine not jast shoulder she did not at the time in novembar she did X-ray of left hand and nack it shows degerative changes on neck bat no nerve problems and ca calcific deposits in left shoulder beacose i used that hand to help right wich was wery weeak and locked eventuly i get so sick with left i had so mach pain in fingers wrist and elbow with pince and namboling i end up not able to use any of them. Even naw i writing to you my last 2 fingers including middle iare so namb with pins going tru.
I wonder 2 years ago i felt injured my right elbow (not broke)very bad and back beafore that i wos complitly healthy never problem of any kind naw is oll diferent including lover back pain constantly problem with uper spine she slinching XXXXXXX giving me pain all over back.My eye specialist told me few weeks ago i have posible horner syndrom she said mast be from my shoulder sent me back to same neurologist bat he dont respond my gp said it is not bronchial plexus he check you olredy up i told her he said my nervs are fine bat after they are not i told her meby mashine test feild can happen right?? That is my story i'm going to se one reumatologist i will tell him all like to you maby he will sent me at some neurologist or neurosurgen.What you think i shoul do it is very hard latly to faund tru cause of my problems.
Can you please tell me after all i wrote you haw i get problem of my neck(spine)haw it is posible they giving me diagnoses like for shoulder tendinatis and...bat todey they saing nothing to do with neck then where i puting neck in all of thi haw posble i get problem wit it?
Thank you your's truly E.I.
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Hi,
Thank you for getting back with more details.

I think you should consult another neurologist, for more detailed evaluation of the neck and upper limb nerves, including brachial plexus. A detailed nerve conduction studies would help in diagnosing any injury to brachial plexus.
Most patients improve with medications. As I mentioned, only 10% require surgery. In that case, the neurologist would refer you to a neurosurgeon.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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