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What is the treatment for neck pain and spinal stenosis?

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Orthopaedic Surgeon
Practicing since : 1998
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My 83-year old husband's extremely painful (and stiff) neck (on the right side only) came on very suddenly about 24 hours ago. (He has severe osteoporosis [-3.6 the last we knew], spinal stenosis which causes lower back pain, type 2 diabetes, and atrial fib.) This morning it was nearly impossible for me to get him out of bed because of the neck pain, which has remained constant and now also includes his right shoulder. He is currently in a reclining chair. His temperature hasn't risen above 98.5. His is normally around 97. We have tried all the home remedies (heating pad, ice packs, prescription DermaTran cream, massage, tens unit, exercise) we can think of. Nothing has helped reduce the pain or increase his range of motion which is slight. His current meds include Coumadin, Glucophage, lisinopril, Lexapro, tamsulosin, and Xanax. What do you suggest? Of course, it would be a Sunday!
Posted Sat, 1 Feb 2014 in Back Pain
 
 
Answered by Dr. Vaibhav Gandhi 1 hour later
Brief Answer: Possibility of acute muscle spasm in neck Detailed Answer: Hello, I have studied your case with diligence. As per your husbands symptom and history there is possibility of acute muscle spasm in neck with or without cervical disc and osteoporosis is already present. Due to compression of this nerve root there is pain associated with it. For these symptoms muscle relaxant with analgesic and neurotropic medication can be started after consulting your treating doctor. Till time take rest and continue analgesic available over the counter. Physiotherapy like ultrasound and interferential therapy will give quick relief. You may need to to MRI cervical spine if symptoms persist. I will advise to check your vit B12 and vit D3 level. Check your bone strength with DEXA SCAN and you can start medication according to level of osteoporosis. At age of 83 there can be degenerative wear of bones, muscles, ligament and loss of elasticity of muscles, due to deficiency of calcium, vitamin D, Vit B12 and carnitine. So supplements of these nutrients can relieve pain. In diabetics osteoporosis is very common osteoporosis leads diffuse pain in back. You need to take diet rich in calcium and vitamin D. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.
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Follow-up: What is the treatment for neck pain and spinal stenosis? 1 hour later
Thank you very much for your quick response. What did you mean when you wrote "with or without cervical disc"? Also, what did you mean when you wrote "osteoporosis leads diffuse pain in back"? What over the counter analgesic would be safe to take with all of his other medications? I was glad to hear your opinion that my husband has an acute muscle spasm in his neck. I had begun to wonder if he had picked up something on the airplane. We flew on Wednesday and his neck had the acute pain on Saturday. I guess there probably was no connection to the plane. I should have mentioned that he does take 2,000 i.u. of vitamin D3, Os-Cal 500D (3 pills), flex support glucosamine/chondroitin (3 pills), and 4 multi-vitamin pills (with 200 i.u. Vit. D) daily. I'm not familiar with carnitine. I'll have to look it up. Spell check doesn't seem to recognize it. When we find a doctor, he may still want to check his vitamin D and B12 levels. Also, since I believe his last Dexa Scan was in November 2010, he is probably due for another. He can barely move. I'm hoping to get him some relief before tomorrow when we can look for a local doctor. In the meantime, he certainly will rest -- that's all he can do! Thank goodness he is finally asleep (in his recliner).
 
 
Answered by Dr. Vaibhav Gandhi 15 hours later
Brief Answer: Explained below Detailed Answer: Hello Cervical disc bulge [cushion between two vertebras] on spinal cord can lead to pain in neck and spasm along with it. In osteoporosis spinal vertebra are earliest and severely affected leading to weakness of spinal column. This weak vertebral spine gives to chronic back pain. You can take analgesic like paracetemol safely with all other medication. That’s good that you are already taking calcium and vit D supplement. You can use soft cervical collar if spasm symptoms persist. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.
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