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What if my neck isn't causing my arm pain after all?

sunny1966ssunny1966 VIRGINIAPosts: 1,385
edited 06/11/2012 - 8:44 AM in Neck Pain: Cervical
I have a lot of cervical disk problems and have had pain for years. These days my left shoulder, arm and hand hurt even more than my neck most of the time. I've had 2 mri's, a myelogram, esi's, pt and tried all kinds of meds. Now I'm contemplaing surgery. My latest worry is what if I have the surgery and find out it's some shoulder issue after all thats causing my arm pain? No one has even suggested it but sometimes I wonder. Has anyone with these symptoms had neck surgery and then found out it was your shoulder causing the pain? Just wondering...

Debbie
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13

Comments

  • :D

    My two cents (LOL!) -- I think it's your neck. Remember I had no lower back pain when I developed sciatica in my thigh and down to my foot but that's were it was coming from.

    I don't think you'd get the headaches too if it was coming from your rotator cup in your shoulder.

    We'll see what others have to say on the subject.

    Take care of you,

    Judy
  • What exactly are your symptoms?
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  • I think it can be shoulder related -- I had had an ACDF (3 levels) with hemicorpectomy, 2-1/2 years later had horrible pain in neck across shoulders, down to fingers, everything you'd think could be related to cervical. Thank heavens my surgeon decided to check out the rotator cuffs too. Yes, I had a lot of neck issues, probably always will. But he found a complete tear in one rotator cuff, and the other had a partial tear. Surgical repair (one in 12/08, the other in 12/09) solved the issue for me.

    I'd at least ask your doc if he thinks it would be helpful to order MRIs of the shoulders, especially if you work and often lift heavy objects, or lift above your head.
  • Hey Debbi,

    One thing if you are concerned about doing a surgery and if it that is the real pain generator or not they can do blocks. Because I have had so many neck surgeries the questions became how much is the new level and my nerve damage. So we blocked out the new level to be sure it was going to reduce my pain. We actually did it twice just to be sure. So you might check with your doctor about ways to verify it is your neck. Also the question is what do the emg studies show. At this point and time my surgeon wouldn't order a emg because the myelogram clearly showed the compressions. For me the question was how much pain was coming off that level. So talk it out with your surgeon, and they can double check before putting you through such a major surgery. Also you might want to look at a dermatone map and see if the level they are talking about follows those pain patterns.
  • Hi sunny,

    Have you had an EMG?? An EMG should be able to pinpoint where exactly the nerve problem occurs and can differentiate cervical nerve root problems from problems lower down in the brachial plexus and arm. I developed shoulder and arm problems last year- I'm an L-spiney so they wanted to make sure nothing was going on with my neck as well, but my EMG showed the problem originated in the trunks of the brachial plexus rather than the cervical nerve roots so it was a neurological shoulder issue.

    I'm not sure if that test would be appropriate for your specific situation or not, but it might be something to ask your doctor about to see if you can get a definitive answer, especially if the symptoms in your shoulder and arm are neurological in nature.
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  • Have you had a discogram? I've had elbow problems about the same time I had whiplash but I was given cortisone shots in my elbow for pain and swelling. Now I have impingement at C7 and I have elbow pain and numbness then I went to PT for ultrasound on my neck and she did gentle minor traction on my neck and it eased up the elbow pain so I knew the pain in my elbow was caused by the neck issues. Hope you Surgeon helps you alleviate the difference in the two. Good question. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    I'm sure my NS will discuss all of this more with me when I see him again. I've only saw this one twice and first he ordered another mri since it had been a year and next he sent me to PM for esi's. He seemed pretty sure my arm pain is from my neck as did the PM Dr. My symptoms started years ago with neck pain and headaches. Over the past two years the pain goes from my neck down to my shoulder, down the front of my arm to my middle finger more than the others. It feels like someone is driving a nail through my hand. My whole hand burns and tingles all the time. The actual shoulder pain got worse after the first cervical esi and has continued. All the symptoms are actually worse than before the injections. Here's the results of the myelogram in Jan. 2009: Disc degeneration with large posterior spur and stenosis at C5-6. Severe right and moderate to severe left foraminal narrowing due to uncovertebral joint spurring. Protrusion at C6-7 abutting the left C7 nerve root. Minor disc bulge and spur C4-5
    This dr thinks the 4-5 is causing the most trouble.
    Sorry this is so long but thanks for your help.
    Debbie
  • Lala,

    I'm new here. Saw your post to Sunny and wanted to thank you, you helped me out as well!

    I have had radiculopathy symtpoms for past 4 years, which have progressed to being chronic going on right side for a few months and then left side. It was strange went it went to the left side this past 4 months, the shoulder pain was so intense as well as arm/hand/ burning, numbness and weakness.

    I've had an MRI CT and flexion X-rays showing more severe narrowing where the nerve junction is bi-laterally both right and left which would confirm where I was having symptoms left arm hand / right arm hand.

    I'm waiting to see a neurosurgeon for second opinion ("too high risk candidate for second Anterior approach surgery" even though my ACDF 4/5/6 1995) and have been doing alot of reading up on nerve pathway and stumbled on it possibly being brachial plexus problem.

    I am definitely going to be sure part of the second opinion will be an assessment by having an EMG, and especially with you saying they can determine if its coming from the cervical spine junction. Thanks much.
    -----------------------------------------

    C-Spine deformity Klippel Feil top 3 levels (birth)
    C-2/3 partial hypermobile disc/vertebrae
    C-4/5/6 DDD 3 bone spurs lateral into spinal cord (left body neuropathy, numbness/weakness)
    ACDF C-4/5/6 w/bone implant fusion Mar 1995 (42 yrs old)
    C-5/6 Osteophytes Foraminal Narrowing
    C-6/7/T-1 Severe DDD multiple osteophytes, nerve impingement left/right bilaterally at nerve openings; kyphosis, stenosis, severe facet arthropy C-6/7; severe radiculopathy left shoulder/arm/hand/thumb/fingers
    MRI/CT Scans 4-27-10
    DC: ACDF surgery needed; considered "high risk" for second front approach surgery.
    Getting second opinion June, 2010 neurosurgeon
  • Charry,

    Hi, I'm new here on the board. Noticed your reply to Sunny and you also experiencing nerve problems with C-7. Mine was diagnosed to be C-7/8 (extra rib off cervical)

    Since MVA hit broadside my driver door in 2007 and my severe muscle/nerve spondylosis symptoms and pain in my neck has now evolved further with greater narrowing at the nerve root branch openings coming out of the spinal canal (special CT viewing 3 dimensional) to be the culprit. I had 2-3 months progressive worsening radiculopathy episodes off-on with activity and then the past 3 months now have been constant and off-the-charts pain.

    Was wondering what cervical traction (by a physical therapist ?) was like, how is it done, equipment? I tried wearing a cervical (philadelphia stiff foam collar) which helped at first, but then later didn't help at all, especially since the radiculopathy is now settled into my left side (shifts from right to left).

    I tried tens stimulation in the beginning, seem to aggravate the intensity on duration of the nerve spasms. Had nerve block done which got rid of pain in mid back and shoulder but aggravated with a vegence when it wore off a 4 days later the nerve spasms, burning and horrible numbness, hand became totally unable to use.

    Was wondering where are you in your process as far as doctors - - any talk of surgery? How long have you been having symptoms and needing traction?

    I unfortunately was told I needed anterior surgery but because of a previous ACDF on C-4/5/6 I'm deemed not a "good candidate for another anterior approach surgery" and this freeing up of the nerve branch openings would need to be done anteriorly from the front to be done right.

    Hoping to get connected with others who have similar nerve symptoms and to learn options and success of non-interventional treatment and if possible to get any improvement when severe advanced DDD diagnosed. It scares me with the severe and intense pain + weakness in muscles in my arm and big-time changes in strength in wrist, hand, thumb/fingers !

    Hope to hear from you and know what others have been doing and experiencing and drs that have helped.
    ------------------------------

    C-Spine deformity Klippel Feil top 3 levels (birth)
    C-2/3 partial hypermobile disc/vertebrae
    C-4/5/6 DDD 3 bone spurs lateral into spinal cord (left body neuropathy, numbness/weakness)
    ACDF C-4/5/6 w/bone implant fusion Mar 1995 (42 yrs old)
    C-5/6 Osteophytes Foraminal Narrowing
    C-6/7/T-1 Severe DDD multiple osteophytes, nerve impingement left/right bilaterally at nerve openings; kyphosis, stenosis, severe facet arthropy C-6/7; severe radiculopathy left shoulder/arm/hand/thumb/fingers
    MRI/CT Scans 4-27-10
    DC: ACDF surgery needed; considered "high risk" for second front approach surgery.
    Getting second opinion June, 2010 neurosurgeon
  • Hi, Debbie,

    I have same thing going on because of C-6/7 nerve openings and foraminal narrowing with severe arthropathy, shoulder pain,nerve pain down the arm, intense and severe pain and burning in hands and fingers. Which by the way, like you my symptoms got much worse following two nerve block injections, bilaterally (left and right) at C-7/8 (extra rib level) and was quite disheartening. Four weeks since the injection it is finally easing down. Double dosing on Meloxicam (anti-inflammatory) and Neurontin (anti-seizure a/k/a helping nerve pain) has finally given me some relief.

    With what your report your myelogram showing: Disc degeneration with large posterior spur and stenosis at C5-6. Severe right and moderate to severe left foraminal narrowing due to uncovertebral joint spurring. Protrusion at C6-7 abutting the left C7 nerve root. Minor disc bulge and spur C4-5.

    Sounds quite linked to nerve root problems with narrowing and the spurs. My diagnosis is quite similar to yours. I had ACDF on 4/5/6 because of spurs (no radiculopathy symptoms other than numbness) but spinal cord was encroached with 3 spurs.

    Those spurs and DDD is a real double whammy on those nerves and even if it's not doing the spinal cord, some narrowing and spurs affect that as well. Some of mine is positional with the latest MRI at the surgically fused levels C-5/6/7 with spurs and foraminal narrowing not much room.

    I would be such to have a thorough discussion with your neurosurgeon as to prognosis and and what his assessment as to the surgical procedure and what level of success for alleviating your symptoms.

    I have severe DDD, spurs, nerve impingement as well as other degenerative factors needing a posterior surgery but in the meantime the nerve impingement is the priority with chronic radiculopathy and loss of strength in wrist,hand and fingers, progressing past 6 months, which has to be an anterior surgery to be successful in opening up the nerve root openings -- however there's a dilemma now. I'm being considered "high risk" for second anterior surgery to be done and problems with successful fusion occurring 60/40 success because of immediate levels above C-4/5/6 which were surgically fused 15 years ago, and requiring a second surgery posterior approach.

    In April and into May, I've had two opinions re: risk and factors of success, with regard to nerve impingement and neuropathic symptoms reversing post-surgery and the second orthosurgeon, deemed it 50/50 and possible another 60/40 and even with having the go thru possibly two surgeries for successful fusion.

    It pays to know everything they can tell you, and depending on the spinal cord being not impinged, trying to by-pass doing surgery with non-interventional treatment (injections, meds, muscle massage, etc).

    Hope this helps, more information can complicate at times, but it makes you all the much wiser pre-surgery and making the decision as opposed to post-surgery and possibly sorry that you didn't ask or they did not give you a full assessment and fair prognosis.

    Hoping all goes well with your visit and the neurosurgeon respects your questions and concerns and is supportive to you in making this difficult decision.

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