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Terrible Neck Pain

bobh1982bbobh1982 Posts: 14
edited 06/11/2012 - 8:37 AM in Neck Pain: Cervical
I have been in progressively worse neck pain for the past 4 years, which do cause migraine headaches. I have seen doctors, neurologist, and a rheumetologist. Finally after fighting to get an MRI I got one which showed cervical facet arthritis at C4-5, with uncinate hypertrophy. C5-6 I have right foraminal narrowing on the basis of uncicate arthritis with hypertrophy.On the C7-T1 the again is factet arthritis. They say the canal (I assume spinal) is narrow on a congenital basis, but say I don't have stenosis, however for the past year and a half I have had tingling and numbness in my right hand. I also have narrowing of the foramina at at all cervical levels. My neurologist and rhuemy say these shouldn't be causing me pain, and I've gotten the muscle pain explanation. The muscle relaxers have done nothing for me but make me groggy. I am however under the treatment of a wonderful PM doctor who keeps my pain manageable with narcotics. If it wasn't for her I don't know what I would do because the pain was on a 8-10 basis. I have tried one facet injection with medial branch block that did not help. I did the trigger point diagnostics which helped but my insurance denied that treatment, which included injecting botox for long term relief. I am thinking about paying for the trigger points myself. I would like to find some treatment that would either augment the medication, lower my dose, or even get me off the narcotics. Do you guys think I should try the facet injections again, or at different levels. It would be nice if they helped so I could get the nerves burned. I am young would like to be more active. Any suggestions would be greatly appreciated.


  • Maybe my post above was too technical. Do you think I should ask my PM doc for a referal for a surgeon. How many of you guys have somewhat normal MRIs saying discs are fine but have severe pain. I am in the process of applying the pharmacology school (Pharm D), but am considering medical school. I wonder can I practice under narcotics. I sure would like to take less medicine, (plus I have a huge tolerance due to years taking narcotics from the ravages of migraine and Crohn's disease. Any ideas would be greatly appreciated.
  • what are trigger point injections?
  • dilaurodilauro ConnecticutPosts: 9,837
    Injections are non-steroidal and contain Lidocaine. The basis behind this is to break down 'knots' and other trouble areas by injecting lidocaine. Unlike ESI's which generally have a limit to 3 a year, Trigger points are basically open ended.

    The process can be done in a doctors office vs the operating like room used for ESIs

    The doctor will first numb the area with an spray. Then the injections start. When I have had them in my cervical region, as she is insert and injecting the liquid, she will come across the knots. Basically, its like a nerve just jump out. After the procedure, you need to ICE the area for at least 20 minutes. Failure to do that might leave you with a pretty sore sport

    For bobh1982:

    Have any of your doctors given you an action plan? Aggressive meaning surgery, Conservative , such as Physical Therapy, Injections, etc
    I agree that you dont want to have to depend on narcotic pain medications for ever.
    MRI report readings are very difficult to interpret.
    That is why I always tell members NOT to provide answers regarding someone's MRI. Even doctors can differ on what they see and read. In general, it didn't seem like anything stuck on with your report. MRIs and other spinal diagnostic testing concentrate on your Spine, Discs, and nerves. But many times, you may not have any of those, but in fact you have a very bad muscle condition that is placing undo stress on your spine.
    I am interested as to WHY your doctor says what you have is not stenosis, yet some of the words you put down describe some of the symptons a person with stenosis has.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • The radiologist said that there is no stenosis. The area where I have the worst pain is in the dead center of my neck more on the right side than the left. Even when I take my full dose of medication,including break through,if I move my head backward I have shooting pain straight down my spine into my chest. As far as a treatment plan, everything lays in my PM docs hands because I am kind of caught in the system. I fired my neurologist who was also a PM doctor because he prescribed meds that almost killed me. So my current neurologist just treats my migraines, he has never looked at my MRI. My rhumy is a friend of the family and read my MRI. He said it shouldn't causes me any pain, so I have never had a surgical consult. I see my PM doc on Thursday so I am going to discuss the best options with her. By the way, I got a call from my PM doc's nurse saying my injections were approved after they resumited them.
  • You need to find a NS or OS and start finding the reason behind your pain. The Pain Manager wants to manage not cure.

    On my lumbar- I was told my bulges were not big enough to cause problems. After spending thousands and suffering for months and months I returned to my PCP and said I want to see a NS. This is ridiculus. She referred me to who I see now. The first Pain manager injected and injected and said if this doesn't work then we will do a micro d.... That would have been a huge waste since he wasn't addressing the problem. The NS ordered the flexion/extension xrays and we discovered the issue causing the pain.

    With my neck the I have a simialr problem. Not huge herniations, but collapsed disc and when I bend I have the same kind of instability symptoms.

    So to answer yorur question YES. A NS/OS will look at your films, order more tests and test your senses etc, not just read a mri report or take some one elses recomendations. They want to find a mechanical/surgical fix.

  • Bobh-
    I've had problems going on for about 9 yrs and finally met with a neurologist today who seemed to "get it" that despite 4 surgeries on my cervical and lumbar spine, I'm still in pain 24/7.

    Neurologist is going to do an EMG and in the meantime would like to try the lidocaine trigger point injections.
    All of my pain has always been and still is on the left side of my body despite herniations on the right. My MRI's read mild and minimal on every level for DDD and stenosis.

    My neuro's tentative diagnose is myofacial pain dysfunction syndrome which is similiar to fibromyalgia and from what I have read, can be triggered by trauma from surgeries and other things.

    From what I've read, the risks with the lidocaine injections are pretty low and if it can help get me off even some of the meds I'm currently on and functional again, I think it's worth a shot.

    Your neck and migrain pain sound very familiar as do your arm tingling and nerve type pain.

    My neurologist was shocked that in 4 yrs of ACDF, laminectomies, fusions, discetomies, etc, I was never once referred for physical therapy. HIs feeling is my muscles and nerves have likely become dysfunctional due to all of this and at this point, his answers make far more sense then my surgeon's who says "You must just have very hyper active and sensitive nerves". In essence, telling me to live on narcotics and deal with it.

    Don't give up!!! PM me if you'd like to talk more.
  • A lot of rest will help on your recovery. Be always aware of what you take and make sure about your diet.
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