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Suggest treatment for stabbing pain after spinal cord contusion

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Posted on Mon, 18 May 2015
Question: I suffered a spinal cord contusion at the C2-3 level, that my treating neurologist considered to be mild due to the evidence on an MRI (I was in an accident with a XXXXXXX Truck, side impact). It has been 6 months since the injury and I still get stabbing pains and shooting pains up to my head and across my back. I take 150 mg Lyrica daily. I have received 4 rounds of Novocaine injections to aid in painful muscle spasms that developed on my sholder and whatever the levator muscle is. What kind of prognosis am I looking at from this point forward. Could it be permanent?
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Answered by Dr. Sudhir Kumar (13 minutes later)
Brief Answer:
You would gradually improve.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your clinical details and treatment received.

You are on correct treatment, however, the injury to spinal cord results in some degree of permanent damage.

However, you would continue to improve over time. Maximum recovery occurs in the first two years after the injury.

In addition to your current medications, you could also add baclofen tablets, which would help reduce the spasms.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (31 hours later)
Another symptom I am curious if it has anything to do with the injury is that I get muscle twitches all over the body (mostly quad and shoulder) throughout the day, sometimes they end up completely locking up the muscle. Is that a sign of healing or is that something to be worried about?

Lastly, are there any type of surgical procedures for my type of injury? It has been six months and I must say I have recovered tremendously, but I still have really bad days of pain and limitations of my daily life when I do regular activities. The kind that make me stay at home all day.
doctor
Answered by Dr. Sudhir Kumar (7 hours later)
Brief Answer:
Muscle twitches are related to the injury.

Detailed Answer:
Thank you for getting back.

Muscle twitches are related to the cervical cord injury and would reduce over time.

There are no surgical procedures needed at present or in future.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Follow up: Dr. Sudhir Kumar (11 hours later)
I appreciate you answering these questions for me. The one thing that has changed since the injury is that I get radiating nerve pain (I assume its nerve pain) up to the back of my skull. Is that just common with an injury at C2 level? Are there even nerves up there?

Also, its not like I can't bend over and lift objects or move around, but once I do decide to bend over a couple times in a row the stabbing pains ensue and then my muscles around my neck start to tense up and cause pain. When you said permanent earlier, could this be the type of permanent pain I have for the rest of my life (after the initial 2 years post injury)?

I know it is a tough question, I would greatly appreciate it if you answered.
doctor
Answered by Dr. Sudhir Kumar (3 hours later)
Brief Answer:
The pain is nerve pain.

Detailed Answer:
Thank you for getting back.

The pain at the back of skull is related to cervical cord injury, as the nerves from that region of spinal cord supplies the base of skull and upper neck region.

This pain would reduce over time and in many cases, it resolves completely in two years. However, in some people, mild pain may remain.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (19 hours later)
In addition to the spinal cord injury, I noticed that something was off. Things just took me longer to complete and I am always tired. At first, my doctor thought it may have just been the medications, but symptoms continued to linger well past 3 months.

I had a neuropsychological examination done about a month ago, and it determined that I had several deficits in short term memory, working memory and attention deficits (for someone with an MBA). They started me on neuro cognitive therapy.

I just want to know how conclusive are these tests, because I was honestly slightly shocked.
doctor
Answered by Dr. Sudhir Kumar (5 hours later)
Brief Answer:
These tests are fairly standardised.

Detailed Answer:
Thank you for getting back.

The neuro-psychological tests are fairly standardised, and the findings are more or less accurate. However, these tests do not tell much about the cause of these deficits. In other words, even anxiety or depression can lead to severe deficits in these scores.

So, I would suggest that you undergo a repeat of the neuro-psychological tests in order to confirm them, when you are emotionally feeling well.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Suggest treatment for stabbing pain after spinal cord contusion

Brief Answer: You would gradually improve. Detailed Answer: Hi, Thank you for posting your query. I have noted your clinical details and treatment received. You are on correct treatment, however, the injury to spinal cord results in some degree of permanent damage. However, you would continue to improve over time. Maximum recovery occurs in the first two years after the injury. In addition to your current medications, you could also add baclofen tablets, which would help reduce the spasms. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in