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Sever Neck Pain And Giddiness. Had MRI Scan. What Are The Findings From The Report?

Posted on Tue, 3 Dec 2013

Question: Sever neck pain from last one year and giddiness from last few weeks unable to stand for long time feel like as if i will fall down and i feel like i am spinning some times Please advice Mild Loss of normal cervical lordosis noted. Verterbral bodies are normal in height and signal intesity pattern. Early marginal osteophytes are noted Dessication of c4-c5 intevertebral disc noted. Rest of visulised cervic-dorsal intervetebral disc shows normal height and hydration. Diffuse posterior disc-osteophyte complex is noted at c4-c5 level causing mild indentation over thecal sac and bilateral traversing c5 nerve roots (Rt>LT) pedicles, lamiane and spnous processes are normal facet joints are normal spinal cord is normal craniovertebral junction is normal pre & paravertebral soft tissue appers normal. lumbar spine reveals no abnormality Impression Diffuse posterior disc-osteophyte complex at c4-c5 level causing mild indentation over thecal sac and bilateral travesing c5 nerve roots (Rt>LT) no other significant abnormality noted

Answered by Dr. K. Naga Ravi Prasad (35 minutes later)

Brief Answer: Initial management is conservative. Detailed Answer: Hi, thanks for writing to XXXXXXX All your MRI findings are suggestive of early degenerative changes (MILD wear & tear changes). The giddiness & the sensation of loss of balance in your case is termed as CERVICAL VERTIGO. This is generally a benign condition and is usually self limiting. The general treatment guidelines for your condition is as follows - Use a soft cervical Collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles. Medicines: Analgesic are needed in the acute phase (Ibuprofen, Diclofenac, Naproxen etc). Muscle relaxants are essential for relieving muscle spasm. Neurotropic vitamins like METHYLCOBALAMINE or PREGABALIN will help in alleviating the neuropathic pain. Cervical traction: may enlarge the disc space, permitting the disc protrusions to regress back. Intermittent cervical traction for not more than 30 minutes at a time will suffice. Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started, under the supervision of a qualified physiotherapist . Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful. Antihistamine preparations - Symptomatic relief from the spinning sensation & losing balance can be achieved by taking antihistamines like BETAHISTINE, after consulting a physician. Hope I have addressed your query. Happy to help further Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. K. Naga Ravi Prasad (31 minutes later)

Hi Doctor, Thanks for the quick reply. I would like to understand few things like in the case of mild changes why do i have heavy pain when i move neck up and down? any sleeping postures you suggest for me Also does it requires any surgical intervention, and currently i am taking few medicines like gabintine 300mg and rejnouran for the same, is there a possibility that cervical changes goes on progressing and make thing more difficult for, please suggest some precautions for me. I am software professional have to sit 8 hrs before system. previously i used to travel 60kms daily to office now i have shifted to near by location to avoid travel. Please advice Thanks

Answered by Dr. K. Naga Ravi Prasad (39 minutes later)

Brief Answer: Please find the answer below. Detailed Answer: Hi, Nice to hear from you. - During movements of the neck (especially during bending down) the mild osteophytic projections and the protruding disc (which bulges more during bending) will cause pressure on the adjacent nerve root producing severe pain. Avoid using BULKY pillow underneath your head while sleeping, as this will worsen your condition and causes more symptoms. - There is absolutely no need even to think of any surgical intervention at this point of time. You can continue taking Gabantin & Rejunuron, as they will benefit you to some extent. Yes, there is a possibility that the degenerative changes will progress fast, if appropriate precautions are not taken which worsens your situation. A few precaution to be followed are : - Avoid abrupt jerks to the neck region during travel, so a cervical collar is recommended during transits. - Avoid keeping your head & neck in a particular position for prolonged periods of time (as in case of staring at a computer monitor) - Avoid deep flexion of neck (as in case of working with a notebook in your lap) So, these minor precautions in correcting your posture when standing and sitting will prevent the further progression of your symptoms. Hope I have justified your query. Good day

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. K. Naga Ravi Prasad (16 minutes later)

Thanks for the information i will go with your suggestion... one last question i missed to ask you... does the symptoms increases when i sit in A/C for long period of time can this be cause for my pain other symptoms to aggravate ?

Answered by Dr. K. Naga Ravi Prasad (16 minutes later)

Brief Answer: Yes, there is a possibility. Detailed Answer: Hi, Generally, in cooler climatic conditions the sensitivity of the nerve endings to pain stimulus will be much more than in warmer locations. So, naturally the pain perception will be more when the surroundings are cooler. Have a great day.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar