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Car injury, neck pain, have bone spures, no hypertrophy or loss of muscle strength, CT showed spondylosis. Want second opinion.

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Orthopaedic Surgeon
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I need to talk to a cervical spine specialist or radiologist about getting an opinion about my condition. I was facing my children in the back seat when we hit the car head on from out point. Car sped in front of us trying to make a left turn in front of us. We flipped their car. They did not try to stop. We put on breaks going from 35 to probably somewhere around 20 mph - no head trauma, no air bag deployment. Wearing seat belt. I had significant rotational movement in my neck - head wiped from looking back to front about 215 degrees. and from up to down about 150 degrees. Went to emergency room from accident. Got CT at about midnight. MRI three days later. I had MRI and X-rays 6 months later. I have had severe neck pain. I had burning pain and numbness in right arm but that did resolve after about 3 months. Neck pain is only present when doing activities or sleeping in any position where my neck is even slightly twisted. GP, Radiologist, and recent Orthopedic Surgeon (via PA) all say it is minor. Neck pain is now only neck and upper shoulders but feels worse pain 7-9 after stretching or activity. I did rest, limited activity, and double dose of Alieve first 6 months which helped but did not relieve pain. Tried PT yesterday and they were gentle but I was crying and in pain at the end. I have more severe pain after stretching or being active and they say that is not usual. I don't know if this is all in my head or maybe due to something not healing or bone spurs developing. This week Ortopaedic Surgeon mentioned I had some bone spurs but they were mild and did not bother to mention where they were. As no hypertrophy or loss of muscle strength in arms etc. They say all is fine. FIrst CT at emergency room mentioned C1-C2 articulation normal and mild spondylosis from C4 to C7. No mention of C2 - C4. MRI 3 days later mentioned C2-C3 dis dehydration and C3-C4 disc dehydraion and bulging with partial effacement of anterior subarachnoid space . C5-C6 had mild impingement along with bulging reduction of sagittal diamater 8.5mm and mild narrowing of right neural foramen. Last months MRI mentioned C2-C3 mild disc bulge with mild left XXXXXXX facet join hypertrophy. C3-C4 mild disc space narrowing. Disc is desiccated. Mild disc buldge. C4 - C7 read about same as first one. Could bone spurs or facet joint hypertrophty or disc desiccation in the C2-C4 area be from healing and could any of that cause pain to continue or be worse when being active? Would second opinion help and if so who could I go to that would take the time to do a more through review of the current state and changes?
Posted Sun, 15 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 9 hours later

Thanks for posting your query.

The mild disc herniation that you are having is likely to be responsible for the pain you are having after the activity. The herniated disc produces pressure on the nerve roots causing symptoms of paresthesias.

All these changes are reversible with proper treatment.

Pain killers, muscle relaxants, hot fomentation, using a cervical collar and physiotherapy are the main treatment.

Taking a second opinion from a neurologist will be helpful in the treatment.

Methylcobalamin supplements are also recommended for nerve compression symptoms.

Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist.

You can avoid using a pillow.

I hope this answers your query effectively. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Please accept my answer in case you do not have further queries.

Wishing you good health.

Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Car injury, neck pain, have bone spures, no hypertrophy or loss of muscle strength, CT showed spondylosis. Want second opinion. 13 hours later
Dr Tayal,

Thank you so much for your insight. I have two quick followup questions. First, I personally would like to get an understanding of the changes between 6 months ago and now. The time I get from a specialist seems to be quite short as my injuries appear minor. Who could I ask to review all four of my sets of CT, MRI, and x-ray to get a more consistant view of what is seen and what if anything has changed.

From your knowledge, could bone spurs develop within 6 months of an injury?
Answered by Dr. Praveen Tayal 5 hours later
Thanks for writing again.
I have seen both the reports carefully in detail. There is no significant change in these six months. All these are degenerative age related changes of the cervical spine. These are not serious and do progress very slowly.
If you feel then you can ask for a second opinion from another orthopedician.
The bone spurs can develop in six months after injury. Injury can hasten the development of degenerative changes of the spine.
Hope my answer is helpful.
Please accept my answer in case you do not have further queries.
Above answer was peer-reviewed by
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