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Pain in neck, hand, shoulder. Diagnosed as double crush syndrome. MRI shows annular bulging

I have had right neck to hand pain off and on for about 6 years. Originally it was just right hand numbness. I had carpal tunnel release at that time and then the pain went away. It flared up again within the last 2 years but with only pain, no numbness this time. I usually have pain in my neck through my shoulder and downward into my hand. I have been seeing a chiropractor since the flareup. He told me I had double crush syndrome, which makes sense. In the last month I have had new symptoms and he wanted me to get an MRI. The new symptoms were no grip or grip strength in my right hand. I also have a burning sensation in my neck. I just got the results of the MRI today: At C4-C5 and C5-C6 there is minimal annular bulging barely indenting the ventral thecal sac. AP diameter measures 1.1cm. It says there is no canal stenosis or neural foraminal narrowing.
Asked On : Fri, 12 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

The symptoms in your description suggests that you have CERVICAL DISC DISEASE with RADICULOPATHY.

The initial management of the condition is as follows -

Rest: A collar will prevent unguarded movement; A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.

Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms which generally follows acute pain.

Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful

Epidural steroids: are useful for patients with severe radicular pains in the limbs

If the symptoms do not resolve with the above measures, consult an orthosurgeon and follow his advice.

Hope this information is helpful . Good day

Answered: Thu, 18 Jul 2013
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