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Pain in forearm, wrist joint, neck pain, tingling sensation in scapula. Should I undergo MRI?

Dear Doctor, I m Shalini from Bangalore aged 26 yrs.I had a fall 10 days back but left it neglected. later i ve started getting pain in the anterior part of left forearm near the wrist joint, pain in the left shoulder joint, also have severe pain in the nape of neck, left scapular region, have tingling sensation in the left scapular region and in the back( thorax region). Recenty i m also getting frequent headaches. even now there s a vague pain in the head esp. in the left part. I was asked to take X-ray of cervical spine of which the reports say that FUSION OF THE POSTERIOR SPINOUS PROCESSES C2-C5 IS SEEN. I m so tensed doctor. Should i undergo an MRI scan Dr? Is the fusion permanaent Dr?? Nothing can be done or is it only manageable or can it be corrected through surgery??
Asked On : Tue, 8 Jan 2013
Answers:  1 Views:  44
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Internal Medicine Specialist 's  Response
Hi Shalini,

Thanks for your query.

Firstly, the pain in shoulder joint, near wrist and nape of neck is apparently due to contusion of the shoulder and neck following the fall. If your range of movements at the shoulder joint are normal in all conceivable directions, there is nothing to worry about. A short course of NSAIDs (such as ibuprofen + Paracetamol combination) will give you relief. It is, however, suggested that an xray of shoulder should be done to see if there is a chip fracture or not.

Further, fusion of the posterior spinous processes C2-C5 vertebra due to cervical spondylosis is high unusual. Also, it appears that a mild concussion on the neck vertebrae following the fall may have caused a slight protrusion of the discs (something like washers/cushion) between the neck vertebra, enough to compress on the nerves supplying the upper chest and back.

An MRI should be done and a neurosurgeon consulted along with the MRI report. He is the best judge to decide if the fusion of vertebra is severe enough to cause compression over nerves. Depending on the MRI report, he will apprise you of the options available. Yes, a slight compression over the nerves frequently respond well to 2-3 weeks' of steroids in very high doses. But the neurosurgeon is definitely better placed as he can decide whether to give a trial of steroids, or defer surgery (if at all required) or use of Cervical collar trial would suffice.

Your headaches are apparently migraine attacks, since you have been under great tension since the recent past. Consult your doctor who will prescribe prophylactic treatment.

Hope you find my response as helpful and informative.

Dr. Rakesh Karanwal
Answered: Sun, 10 Nov 2013
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