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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Neck Pain. Had Epidural Steroid Injection. MRI Showed Uncovertable Arthropathy. Any Further Test Needed?

Hello. I have had neck pain for over a year now. The last few months it has began to involve my left shoulder and left arm and hand. In the last month or two is has spread to the feeling of my nerves in the back of my head feeling like a vice on my head. I have had one epidural steroid injection at the lower neck region five days ago. I am unsure if I should be feeling improvement by now. My question is really about my MRI findings. My pain management specialist is the only one that has really looked at the MRI results and he is...well...a very unresponsive individual that has not explained the results...perhaps that because he is hoping the injections will shed more light on the results? Either way, I am wondering if I might find more information here. The MRI report impression section is as follows:
1. Uncovertable arthropathy result in moderate to severe left foraminal stenosis at C5-C6 and mild to moderate left foraminal stenosis at C6-7.
2. No spinal stenosis.
3. Focal T2 hyperintensive nodules within the strap muscles are nonspecific. Consider ultrasound for further evaluation.

My pain management Dr. said that the epidural injection I got was more for the arm pain and numbness and not specifically for the severe pain I feel at the top of my neck right under my skull on the left side. He said the pain higher up was probably more from arthritis. What does this mean for treatment? My arm bothers me but not near the pain from the upper part of my neck. What specifically does the MRI suggest for the upper area of my neck if anything? What does #3 mean? What is a hyperintense nodule of the strap muscle? I assumed this just meant random inflammation bc my Dr. never mentioned it...but I began to worry I was overlooking something and I called and asked the Dr and he said he did not mention it because it would be something for my primary care Dr. to look at and I have no primary care Dr...while I look for a primary Dr. I am curious why this would require an ultrasound? What the the possibilities that it might be? Thank you for any information. If there are any questions I should be asking my pain specialist Dr. you can think of I would appreciate any advice. Also, should I be seeing a rhuematologist for the neck arthritis in addition to the pain management Dr? Thanks!
Sat, 15 Jun 2013
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Orthopaedic Surgeon 's  Response
Hello.
Thanks for writing to us.
The arthropathy dectected on MRI scan is causing you the neck pain. The treatment is done according to the severity of the symptoms. If the medicines do not help then surgical treatment may be needed.
I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/Dr-Praveen-Tayal
Regards,
Dr. Praveen Tayal
drtayal72@gmail.com
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Neck Pain. Had Epidural Steroid Injection. MRI Showed Uncovertable Arthropathy. Any Further Test Needed?

Hello. Thanks for writing to us. The arthropathy dectected on MRI scan is causing you the neck pain. The treatment is done according to the severity of the symptoms. If the medicines do not help then surgical treatment may be needed. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/Dr-Praveen-Tayal Regards, Dr. Praveen Tayal drtayal72@gmail.com