Suggest treatment for severe neck, shoulder and back pain

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Posted on Thu, 11 Jun 2015 in Brain and Spine
Question: hi Dr. i have neck, shoulder and back pain from last 6 yrs. In my latest MRI report it is mild disc bulge at c3,c4,c5,c6,c7 causing thecal sac identation. It is loss of cervical and lumbar lordosis. I took physiotherapy and consulted with lot of drs. But not very relief in pain. From last 1 yr severe pain in back.In case of forward bending pain increases. So plz tell me the cure of it.
doctor
Answered by Dr. Ajay Panwar 18 minutes later
Brief Answer:
Proper spinal exercises will help/Upload MRI

Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.

I want to stress upon a few points here-
1)Mild disc bulge should not cause much pain.Please upload your MRI images of MRI CD(please upload it on google drive as the rar archived file and share the link here in follow up query)so that,I can actually see what is the degree of severity of disc changes and are they compressing nerve radicles or not?
2)If spine disc changes are causing this pain,then probably,you have not done proper spinal exercises.Please consult an expert physiotherapist,learn spinal exercises from him and do them regularly at home.Dedicated spinal exercises along with medicines like pregabalin,methylcobalamin,duloxetine,calcium and vitamin D supplements will likely bring improvement.

Please follow up with further queries.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar 2 hours later
Dr. XXXXXXX my name is XXXXXXX actually XXXX is name of my wife. I am sending my MRI image and report. Actually i am a teacher and teaching from last 14 yrs. 6 yrs back it started with neck pain and numbness in right arm. i took physiotherapy no of times but it relieves temporarily.from last one year pain started in back and it becomes more severe when i lift any thing or bend forward. In toes always i felt stiffness. I m using back belt from last 6 months. initially my teaching hrs were more than 7..but now i reduces to 6hr ( in 2 slots of 3 hr). So plz advice me proper spinal exercises, therapy and medicine if needed.
doctor
Answered by Dr. Ajay Panwar 9 hours later
Brief Answer:
Regular spinal exercises/Repeat MRI spine

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
I have gone through the MRI images uploaded by you.Disc bulges in these images are not significant enough to cause severe symptoms.But then,MRI is dated for April 2014.So,possibly degeneration and disc bulges have increased causing nerve radicles compression.It can be confirmed by getting a repeat MRI spine.

'Taking physiotherapy' is a misnomer.Physiotherapy is not taken but done regularly by the patient himself.I think you are mistaken about the meaning of term physiotherapy. Physiotherapy simply means physical exercises.So,please learn them from an expert physiotherapist(as he is the specialist who knows them best) and keep doing them regularly at home.You don't need to take sessions of physiotherapy at a clinic or something like that.

Rule of management is simple-learn spinal exercises.Do them everyday.Improvement will show in a few weeks to months time.Meanwhile,continue the medicines-

1)Tab.Pregabalin 75 mg once a day
2)Tab Duloxetine 30 mg once a day
3)Tab methylcobalamin 1500 mcg per day
4)Calcium and vitamin D supplements.

PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE ONLY.

I am sure,that if you do the exercises as a routine,you will get better.Simultaneously,also ask the physiotherapist about ergonomics adaptations to be done in everyday life-like how to sit,how to lie,how to stand from supine position and like wise.In simple words,posture training is also crucial for treatment.

Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajay Panwar 2 days later
Hi Dr. As per ur advice i took MRI of my whole spine. I m sending images and its report. Finally advice me for proper treatment and exercise. XXXXXXX XXXXXXX
doctor
Answered by Dr. Ajay Panwar 4 hours later
Brief Answer:
Treatment as discussed above.

Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up.
I appreciate the great efforts you have made in clicking decent quality images of all sections of MRI and putting them here.I have gone through them.Degenerative changes are definitely there,but not of advanced nature.

Treatment plan remains the same as I have elaborated in detail in the above discussion.Please follow the same treatment plan and I am hopeful that you will show good improvement in symptoms.Be patient and do regular exercises as I said that improvement may take weeks to months time,on a gradual course.

Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

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