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Have pain in neck and left arm and numbness in thumb. MRI shows multilevel Spondylosis. Recommendations?

My MRI Impression : Multilevel spondylosis , most severe at c5-6, extending to the left, with moderate to severe left neural foramina stenosis . My symptoms : pain lower left posterior neck when turning left, attempting to touch chin to chest or opposite, pain in left arm like a vice on mid-upper, and moderate numbness in left thumb , very painful to lay down for rest, most comfortable position sitting upright. Initial symptoms started 1 month ago while at work. To date I have had a steroid dose pak after inintial injury along with hydrocodone , and muscle relaxer. I ve been off work for a week now, no pain just occasional discomfort especially when waking. What is your recommended course of action at this point?
Asked On : Sat, 16 Mar 2013
Answers:  4 Views:  87
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Radiologist 's  Response
Apr 2014
Thanks for writing to HCM

You have age related degenerative changes of spine with intervertebral disc prolapse more at C5-6 level.
Treatment modalities are physiotherapy and surgery.
For pain relief, ultrasound therapy and transcutaneous electric nerve stimulation (TENS) can be given. Exercises can follow that.
Ozone ablation and radiofrequency ablation can also be done.
Cutaneous endoscopic disectomy can also be done.
Long term benefits of surgery and physiotherapy are same.
Get well soon.

Take Care
Dr.Indu Bhushan
Answered: Fri, 2 Aug 2013
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General & Family Physician Dr. Vakul Aren's  Response
Welcome to HCM.I would suggest that you use gabapentin/Pregabalin for the neuropathic pain,Physiotherapy and use of ultrasonic massage,Short wave diathermy and other procedures will help reduce the pain.use of low dose Amitriptyline has helped.I would further like to remove the narcotic analgesic for a NSAID which can be used for a longer period of time.Advice from a Neurosurgeon should be sought.
Answered: Fri, 2 Aug 2013
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Feb 2014
Thanks for writing to us.
Your multilevel spondylosis is due to degenerative scanges in your cervical spine.I suggest you to consult a physical therapist.. The physical therapist will help you reduce your pain using stretches. The therapist will show you how to do exercises that make your neck muscles stronger.
You can take analgesic and muscle relaxant after discussing with your doctor.
You also need some life style modification like-
Do not sit for prolonged period of time in stressful postures
Do use firm collars while traveling
Do not lift heavy weights on head or back
Do not turn from your body but turn your body moving your feet first
Do turn to one side while getting up from lying down
Do the exercises prescribed regularly
Do use firm mattress, thin pillow or butterfly shaped pillow
Do not lie flat on your stomach.

Hope this helps you.You can cosult me again directly through my profile

Answered: Sat, 3 Aug 2013
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Jul 2013
Hi, thanks for writing to HCM.

Your entire description suggests that you have CERVICAL DISC DISEASE with RADICULOPATHY.

The initial management of this problem is as follows -

* Rest: A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.

* Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides.

* Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

* Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful

* Epidural steroids: are useful for patients with severe radicular pains in the limbs

Hope this information is helpful. Good day
Answered: Fri, 2 Aug 2013
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