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History of lower spine pain. Having neck shoulder area. Done with MRI and PCP. Taking Adderall. Surgery required?

Nov 2013
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Practicing since : 1994
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I have had a long history of lower spine pain. I was a very hyper child and was always getting into some sort of accident. I had a horse fall on me at 14 and my knee cap went to my ankle, was in five car accidents as a passenger with teen friends and had three roll overs on the four wheeler by the time I was 16 years old. I had my neck lock two times by the time I was 13 for no apparent reason and needed to be adjusted to get movement. The lower back pain is pretty constant, but only has needed attention for a period of weeks five times. I have never been unable to continue life with any of the back problems. I would be sore and get chiro manipulations until it felt better normally during a lunch break at work. The last time was about four years ago. 6 weeks ago I woke up and I had very bad pain in neck and shoulder area. The pain seemed to be traveling from neck shoulder area down. I went to the ER two days later and they said RYE neck. I went to PCP two days after that and they agreed. I was referred to an osteo path and got manipulations for several weeks three to four times weekly. The medications were many flexeril then changed to valium, tramadol to hydrocodone, I had anti inflammatory medications and I do not know what else. I have been home for so long and I do not leave the house unless I have an appointment because of the electric shocks in the car. The manipulations at the osteo was very painful and most times would be crying either during the visit or after. I had and continue to have sharp shocks that go from my neck down my left arm (I am left handed) when in a vehicle going over bumps. I have a loss of strength at times in that hand and appear to have gotten clumsy. Two weeks ago I went back to my previous Chiro who is a very experienced man in his eighties. He is a chiro, acupuncturist, nutritionist and specializes in supplements. I have been to him three other times for periods of adjustment. I did not originally go back to him because I do not work in this area anymore and it is an hour from home. He took x-rays from top to bottom before any adjustments. He also has my other times to compare the xrays. He stated that my bottom spine was very over extended, my vertebrae's are very uneven, one tilts left, one tilts right, my spine is twisted and that he does not understand how I am still moving around and that my spine has not locked up by now. There is very little between the bottom few vertebrae's on my spine like there is throughout my back. He states that my bottom of my spine is so messed up that the top is having difficulty because of this. He compared this to a house built on rocky foundation? Anyway my pcp does not buy anything that has been told to me by chiro. I had xray at PCP and this just showed a straight neck maybe from muscle spasm. I just went to a MRI and my PCP called to give results. She stated I had some small bone spurs between c5, c6 and c7. I had some narrowing of my spine and beginning arthritis. There was not any pinched nerve to explain the shocks down my left arm. She stated a neurologist will not take you. When asked what that meant she said surgery, I explained I did not want this. I wanted to find out why I have been in pain so much and how to fix this. She said she had nothing to tell me she guesses I can go to the chiro and work on nutrition or something. IT was so patronizing. I have been out of work for 6 weeks and need to figure something out. I still have 7 left as I have not had vacation for a long time now. However, time is ticking and I need to have some sort of direction. I go to get treatment of some sort almost everyday. PT, CHIRO, OSteo or PCP. I am going to have so many dr bills and I feel that I do not know which way to go. Any ideas? Normally I take Adderall 30 mg and prevacid because my sphincter does not close fully. During the operation when they took scar tissue off intestine. They said they saw bed dots that my have been endo in my chest cavity and may be the reason for my burning but really not worth another operation when prevacid works.
Posted Mon, 5 Aug 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 1 hour later

Thank you for posting your query.
I have gone through the detailed clinical notes, you have written. It is unfortunate that you suffer from so much pain and discomfort, despite so much treatment, including drug and non-drug treatments.
MRI needs to be looked at more closely, as that could explain the reason for the pain starting in the neck and traveling down. Sometimes, there may be disc bulges pressing on the nerves, at other times, there would be foraminal stenosis, which could cause nerve compression. A neuro radiologist would help in giving the detailed MRI reports.
You could benefit from medications, such as pregabalin or gabapentin which you can get by your treating doctor's prescription. These medications are specific for nerve pain (pain of nerve origin).
In some cases, epidural injections are also useful.
I think you should XXXXXXX up with a neurologist who can guide you for future treatments.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
Follow-up: History of lower spine pain. Having neck shoulder area. Done with MRI and PCP. Taking Adderall. Surgery required? 3 hours later
Would the hospital have a neuro radiologist read the MRI or who would have read this to begin with to send the report to my PCP? IF not I should request a copy and give this to someone? From what I understand MRI tests are very good and if the things mentioned were not reported it would appear that they are not there. Do problems with the lower spine ever affect the arms or just the neck area? Thanks, XXXX
Answered by Dr. Sudhir Kumar 3 hours later

Thank you for getting back.
Generally, a radiologist would be able to pick up most of the major findings on MRI, however, minor or subtle findings may get missed. A neuro radiologist, on the other hand, is an expert, and would pick up all abnormalities, including minor ones. Other option is to discuss the clinical findings and what to look for in the MRI with the radiologist. This information can be provided to the radiologist by the neurologist.
Abnormalites in the lower (lumbar) spine would lead to symptoms in lower back and legs, and abnormalities in upper back (cervical region) would lead to symptoms in neck and arms.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
Follow-up: History of lower spine pain. Having neck shoulder area. Done with MRI and PCP. Taking Adderall. Surgery required? 24 hours later
Okay I went and got the results for my MRI. XXXXXXX J. Hintz, MD read MRI results for Inland Hospital in Waterville, ME.

MR Cervical Spine (0000)
Indication: Neck, left head and shoulder pain.
Comparison: cervical spine radiographs 6-17-13.
Technique: Standard, variable echo protocol in axial, coronal and sagittal planes. Findings: Normal vertebral body height and alignment. The spinal cord is seen well from the cervicomedullary junction in to the upper thoracic spine and the cord demonstrates normal morphology and signal tendency. At c5-c6 level, mold posterior degenerative disk space narrowing with osteophyte-disk complex. Minimal asymmetric uncovertebral spurring on the left. The thecal sac remains widely patent. The other cervical levels, and the visualized upper thoracic levels are negative.
1. Near normal study.
2. At C-5 and C-6 minimal posterior degenerative disk space narrowing and diffuse osteophyte-disk complex, with slight asymmetric prominence of mild uncovertebral spurring on the left. The thecal sac is widely patent.
3. Otherwise, negative study, with multiple specific pertinent negatives above.

Can you tell me what this means in ENGLISH? Does the scan see any problems and if so are they concerning and relate to what is happening now with my symptoms?

Do you still think I should seek another opinion and if so how do I go about this? Do you have anyone in Maine you would suggest? You have been very informative and I do not want to waste your time, but suggestions would be very much appreciated.
Thank you, XXXX
Answered by Dr. Sudhir Kumar 12 minutes later

Thank you for getting back and providing the detailed MRI reports.
Putting simply, there are no significant abnormalities in the report to be concerned about.
There are minor disc bulges at two levels, which may pinch the nerve intermittently. However, as per the report, there is no significant pinching of the nerve.
The report is quite detailed, and there is no need to go for another opinion on this MRI.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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