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How is neck stiffness and soreness treated ?

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Internal Medicine Specialist
Practicing since : 2007
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I am a 52 year old female, 5’3”, 120 lbs. with neck stiffness and soreness, all the time. It has been getting worse over the past month.
MRI report: There is some straightening of the spine, and mild fatty endplate changed at C7/T1.
C5/6: : Moderately advanced loss of disk signal, moderate loss of disk height with 2mm disk bulge, mild ligamentous thickening. The anterior CSF space is partially effaced. The spinal canal remains slightly in excess of a centimeter. There is moderate unconvertabral joint spurring, mild unconvertabral joint spurring, and mild to moderate facet hypertrophic changes, left greater than right, and moderate facet hypertrophic changes, bilaterally.
There is moderately sever compromise of the left neural foramen and moderate compromise of the left neural foramen.
C4/5 is almost identical with “mild” instead of moderate.
What does all this mean and what kind of treatment options should I consider?
Posted Mon, 30 Apr 2012 in TMJ
 
 
Answered by Dr. Kiran Kumar 11 minutes later
Hi,

Thanks for your query.

The description you have given above goes with Cervical Spondylosis.
You have features of Disc Prolapse at C5-C6 levels with moderately severe compromise of neural foramen. There is also facet joint hypertrophy.

Usually, the spinal cord and nerve roots are protected within the spinal canal. The spinal canal is guarded by the vertebrae which separated from one another by a cushion like intervertebral discs. With age, degenerative changes occur which leads to disc prolapse and spinal cord/symptoms of neck stiffness and soreness is related to the disc and spondylotic changes at C5-C6 level.

Initial Treatment options include Pain Killers and Physiotherapy.

If this is not successful, then, surgical decompression of the disc will be required.

You must consult your physician/neurosurgeon and get yourself evaluated.

Hope this answers your query.
Please get back if you need any further information

Thanks and Regards

Dr Kiran
Above answer was peer-reviewed by
 
Follow-up: How is neck stiffness and soreness treated ? 15 hours later
FOLLOW UP QUESTION:
Please explain, in lay-men’s terms, exactly what each component of my MRI is saying and on a relative scale of 1-10, how bad each problem is.
a.     There is some straightening of the spine.
b.      Mild fatty endplate changed at C7/T1.
C5/6:
1.      Moderately advanced loss of disk signal
2.     moderate loss of disk height with 2mm disk bulge
3.     mild ligamentous thickening
4.     posterior bony ridging
5.     The anterior CSF space is partially effaced
6.     The spinal canal remains slightly in excess of a centimeter
7.     There is moderately advanced uncovertabral joint spurring, left greater than right
8.     Moderate facet hypertrophic changes bilaterally.
9.     There is moderately severe compromise of the left neural foramen
THANK YOU FOR YOUR HELP
 
 
Answered by Dr. Kiran Kumar 15 hours later
Hi,

Thanks for writing back again.

I totally understand your concern. I will try to make it simple for you.

a. There is some straightening of the spine. This a common finding in cervical spondylosis. Due to the disc disease, the neck muscles contract and straightens the spine. We treat the primary cause, i.e disc disease. Dont worry about the straightening, Score 1 on 10.

b. Mild fatty endplate changed at C7/T1. Its a finding which can be found even in normal people and does not need any intervention. Score 1 on 10. Same in case of C5/6.

1, 2, 3,4, 5) Loss of disc signal means, the water content of disc has reduced. This leads to drying and dessication and later prolapse of the disc.

This again leads to loss of disc height and compression occurs.

As a response, there is thickening of the ligaments which are closely attached to the discs and the vertebral bodies (Back Bones) develop ridges and projections.

The prolapsed disc, thickened ligaments and bony ridge can compress on the spinal canal and compress the CSF space anteriorly.

These suggests a potential for disc prolapse and compression of the spinal cord.
Score 6 /10.

6. Spinal canal diameter is more than one cm. This is normal 1/10.

7. Unconvertebral Joints are between the vertebral bodies.

They can some times form bony outgrowths called spurs. These are bony projections which form in response to wear and tear. Such bony spurs can cause compression of the nerve and nerve roots.

Score 7/10 - Needs treatment. Surgery is required as there is significant nerve compression.

8. Facet Hypertrophy is again a response to wear and tear. The facet joins connect adjacent vertebrae and can get hypertrophied. No active treatment needed.
Score - 1/10.

9. This is the most important and serious component of your report.

There is severe compromise of the left neural foramen. This means, there is severe narrowing of the canal of left side of neck from where the nerves pass. This is a potential risk for nerve compression and pain.

Needs surgery if not responding to physiotherapy
Score 8/10.

Hope this answers your query.

Take care

Dr Kiran
Above answer was peer-reviewed by
 
Follow-up: How is neck stiffness and soreness treated ? 18 hours later
2ND FOLLOWUP QUESTION:
What type of physiotherapy should I be doing for my neck? I know all kinds of exercises for my back, but none for my neck.
Thank you.
 
 
Answered by Dr. Kiran Kumar 7 hours later
Hi,

Good to hear from you again.

There are multiple exercises for neck. But the physiotherapist would be the best person to explain and opt exercises for you according to your symptoms.

Please follow this link which would explain the procedure of the exercises with the help of videos and diagrams: WWW.WWWW.WW
Hope this helps you.

Wish you a speedy recovery.

Take Care,

Dr Kiran.
Above answer was peer-reviewed by
 
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