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Cervical Radicalopathy -- Responsible For My Pain? Align with MRI Results?

kyoun1ekkyoun1e Posts: 5
edited 06/11/2012 - 8:48 AM in Neck Pain: Cervical
I've been experiencing very SHARP elbow pain for three weeks now. When I bend at the elbow the pain is severe to the point where I'm afraid to move my arm. Just recently, tingling in my pinky started picking up. This has been preceeded by posterior shoulder pain for about a year. I don't have any neck pain.

I've been to a neurosurgeon and had a cervical spine MRI. The initial MRI spoke to mild issues between C5-C6 and C6-C7. I also had an EMG at the same time and for the most part it was normal outside of some slight abnormaility in the ulnar nerve. I just recently went to a neurologist and he had me have an MRI of my brachial plexus. These results were normal, but what's interesting is that the MRI picked up the following on the c-spine:

* Moderate disc degeneration at C5-C6 and C6-C7 and there is posterior osteophytes and mild bulging of discs which slightly narrow the ventral thecal sac. There is no mass effect on the cervical cord at the C5-C6 or C6-C7 levels.

Is it possible that this is causing my pain?

I find it interesting that this report has my issue as "moderate" while the previous one had everything as mild.

My neurosurgeon basically kicked me out of his office previously. I'm wondering if based on these results and my ongoing pain if I should a) Seek another opinion, and b) seek out a steroid injection in the area to test and see if the pain goes away.

I'm going around in circles with neurosurgeons, neurologists, and orthos trying to figure this out. Madenning.

Any help or insight would be greatly appreciated.




  • Did you say it gets worse when you bend your elbow? That sounds like the nerve is being pinched in the elbow joint, not the neck.

    A second opinion never hurts, though.
  • Happymom,

    Yes, it gets FAR worse when I bend at the elbow. Important note: It hurts far less if I bend when my elbow is at my side. If I elevate the elbow away from my body and bend...huge pain.

    One other note on the history of my pain:

    * At times I've had an irritating almost burning sensation on my right scapula that extends sometimes to the outter armpit and into the upper arm.

    I've had this pain on and off for about six months. The elbow pain and finger tingling is only three weeks old.

    I've read that C5 - C7 can sometimes cause issues in the scap/upper arm.

    Also, this elbow pain came on suddenly. I woke up one morning...bang. There was ZERO sign of this before I woke up on that particular morning.

    Thanks for the help.

  • I just wanted to wish you well in your endeavour to find the answers to your on going pain.

    I understand how frustrating it is to keep running around to different specialists and feeling like you are never getting anywhere.

    Keep us posted, best wishes to you - your not alone.

  • I have similar pain. Issues at c6 - T1. Nothing bad enough to fix. But I recently had a fall where I came down on my palm with all my weight. It caused hairline fractures at my elbow. Now that it has healed I still have pain at my elbow. I am thinking of seeing a hand surgeon since my neurologist isn't too interested in it.

    I'm curious to hear what you find out. As HB said a second opinion can't hurt.
  • I have C6-C7 nerve impinging and I have outside elbow pain and hand weakness. I had some relief from the Physiotherapist doing gentle manual traction and ultrasound on my neck and it eased up the pain in my elbow. It's still hurts but not as bad. Getting a second opinion Surgeon is a good idea and Physiotherapy and a Pain Management Dr. Best wishes and hope you can get some relief soon. 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
  • It is sounding like (and I am not a doctor - but had what you had okay?) you might be in the beginning stages of what is called Cubital Tunnel syndrome. Your Ulnar nerve goes through your elbow and the tunnel on the medial side of the elbow traps the nerve. Pain in the elbow, sometimes the forearm, and then the pinkie and half of the ring finger begin going numb.

    As this progresses, the Intrinsic muscles in the hand start to weaken, and you start losing motor control of your other fingers. Hand weakness (grip, twisting), and clumsiness. Some also get where the dexterity starts to go. Me, I dropped things, had to roll my arm forward to turn the ignition, couldn't snap my fingers, or cross my fingers - things like that.

    Things that may help? Wearing a brace on your arm (at the elbow) at night to prevent your arm from folding or curling (adding to entrapment), heat and ice, ulnar stretches etc. Reducing how much bending you do of that arm, and too try not to lean on it if possible.

    The cervical level for what your describing is the C7/T1 (C8 nerve root). And from what you're describing to us, that level is fine via your MRI. You could have issues in the shoulder on down, so just giving you what I went through, and the result you can see if you click my name.

    What you might want to do is get with an orthopedist, as most neurologists can also diagnose, more of these surgeries - if it comes to that, seems to be the ortho-surgeons. Try a search for Cubital Tunnel syndrome. But really, for what you're describing, I would get with either your GP, or if your insurance allows, and orthopedic doctor. Please keep us posted. Take care.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Aviatrix / All,

    Thanks for the replies.

    I talked to the neurologist last night and the brachial plexus MRI along with an xray are clean. Not causing the elbow pain. Also, he more or less brushed off (just as my neurosurgeon did) the C5-C7 issues as "normal for a 42 year old."

    On cubital tunnel syndrome...I don't have any hand weakness whatsoever. Maybe this is coming. Also, I find it odd that there wasn't a gradual build up of symptoms for me. I woke up one morning and BAM. It's now been with me for three weeks.

    As for seeing an ortho, been there done that. My story is a bit more involved and there's more than just an elbow story here. About a year ago, I went bezerk on a weight lifting program. Lots of repetitive stress. A lat pulldown triggered something that I thought was a muscle pull in my trap area. Three months later I gave in and had an MRI which showed some partial posterior tears in my capsule ligaments.

    Two different orthos deemed the above shoulder issues as pretty insignificant and ordered thereapy. PT created new symptoms -- burning or irritation on my right scapula, to outter armpit, to upper arm. I also felt weird sensations in my hand /fingers which led to a cervical MRI and EMG (which proved normal). In early October, I basically had thrown in the towel and I made a decision to have arthoscopic shoulder surgery...and literally the next day I got this elbow pain. Surgery was cancelled since I couldn't execute the rehab with this severe elbow pain.

    I also seeked out a third shoulder opinion from a shoulder specialist at EDITED in Boston. He indicated a) Don't see much wrong with the shoulder, and b) the symptoms seem more nervy. So, I've been on neurontin since and I'm still trying to figure out what's going on.

    So frustrating. It's been a year + and just when I gave in for surgery, this new (or related?) elbow issue crops up.

    So many possibilities it seems, but no clear diagnosis:

    * Cervical spine issue?
    * Thoracic Outlet Syndrome?
    * Ulnar Nerve Entrapement?
    * Cubital Tunnel Syndrome?
    * Shoulder issues actually causing pain?

    This is an endless investigation.


    Standards agreement and posting rules.
    Naming specific institution or doctor names is not permitted in the Spine-Health.com forums.
    Edited by Authority Member Cath111.

  • I just have to chime in here that about one month prior to my ACDF surgery at C4-7, I began to have severe tennis elbow symptoms that included having the worst pain when bending my arm. With that said, my cervical problems were severe and had three bone spurs pushing on my spinal cord and of course I had all sorts of symptoms from that in addition to the elbow pain - upper back pain, tingling 24/7, weakness, numbness, etc.

    So I just wanted to say that it is possible to get tennis elbow-type symptoms from cervical problems, but like I said, my cervical condition was severe and required surgery within months at the risk of paralysis from a fall or accident.

  • From seeing your list at the bottom, and too your descriptions of what you've had tested and such, you are educating yourself well, and it seems you're being a very good advocate for yourself. :)

    I did a little thinking as to how mine came on as no accident or (as I thought at the time) repetitive actions should have caused it. I learned later that the posture I held when I flew helicopters was the culprit! Constant bent elbow, leaning on it as I flew, and the arched back wrist on the cyclic stick! :)

    Mine started off pretty benign actually. The outer tip of my ring finger, and very tip of my pinkie for months - annoying yes, but nothing that made me think anything was wrong. I then realized that subconsciously while flying, I would take the cyclic with my left hand, wiggle my right (as it was tingling), and then continue flying - again not thinking about it. After about a year, I started waking with my arm 'asleep.' It would wake up pretty fast, but one morning, it didn't.

    I went to my Orthopedist who at that time wasn't really too worried about it. Maybe 6 months later (still numb), I started getting "funny bone" electric pain from the elbow down just putting the slightest pressure on it. My Ortho took interest then. NCV/EMG were unremarkable, no MRI was taken. I did have an MRI for my neck, but that was due to my neck starting to go, and was from the Neurologist. My Ortho did see my C7/T1 was fine, so did more physical testing of the elbow and hand.

    In the end, I did have surgery to transpose the Ulnar at the elbow, and too due to compression, he gave my Ulnar more room in my wrist and palm. It took over a year for the nerve to fully recover as I was told the nerve regenerates at a rate of about 10mm's or so a month. The only leftover symptom was the very outer tip of my ring finger remained numb.

    I've got it all back now thanks to my C7/T1 now going..sigh. Nerves are fickle little critters aren't they? I hope you find answers soon KY. *HUGZ* You seem a lot more educated on your situation than I was at that stage. Bravo for that!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Aviatrix,

    Your symptoms seem to come on gradually. Mine are just completely out of left field. For a year I think I'm dealing with a shoulder injury and then BAM my elbow is giving severe pain. I wish I could trade this pain for my "old" shoulder pain.

    Also, this isn't just about the ulnar nerve I'm finding out. I definitely get pain on the inside part of the elbow and sensatinos in the pinkie...clear ulnar involvement. What I also get is pain on the lateral side of the elbow, above the elbow where the triceps are...this has got to be radial nerve. And it's quite tender in the spot above the elbow where the tricep muscle starts.

    This makes little sense to me. I find it hard to believe that TWO nerves are trapped, SUDDENLY, at the same time, with no traumatic event within sight.

    Whatever is causing this is causing a situation in both of those nerves. The question is where?

    * Cervical Spine: Moderate issues C5-C6-C7 but everyone dismisses.
    * Brachial Plexus: Zippo
    * Entrapement in Shoulder? I wonder. This is where my posterior shoulder pain has been. Where I've had nervy pain.

    Feel like a detective here since the local police (orthos, neurosurgeons, neurologists) are coming up empty.

  • KY,

    Yes, on the first go around, my symptoms did come on gradually - which *I* think helped in their being able to narrow in pretty fast what was going on. Only 2 years later, bing overnight lost it all and then some! An MRI now shows my adjacent level (C7/T1) failing, hence the enhanced symptoms.

    I am now numb above the elbow where as before it was the elbow and down. I'm hoping to get with my favorite Neurologist shortly to get all my images updated, and too a brain scan (lesions) to see what's going on, and what is the next (blah) step!! :)

    I hear ya on being your own detective here. I'm sure you've seen the show "Mystery Diagnosis?" Some of those folks went through like 70 different doctors to find out what was going on, and too doing this over a course of years! That show inspired me to be more of an advocate for my health than ever before. :)

    Have you had a recent NCV/EMG done to include checking the spine? It seems like you've narrowed down to either the shoulder, or the brain *could* be another place to look I hate to say. I bring that up because I have lesions (from what I have no idea) that mirror what my cervical levels are doing! I have issues C5-8, and the lesions affect those very levels! Now we are trying to find out which is driving my symptoms before any surgery is offered.

    Hopefully your brain isn't in the equation, but if they don't find anything in your shoulder... Fingers crossed for ya!! *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Aviatrix/Anyone,

    Did any of you have tremors or twitching in your fingers?

    In the last 48 hours a new symptom has emerged -- my middle finger is twitching unvoluntarily at rest.

    You've got to be kidding.

    Happens maybe once per hour.

    Just another piece of evidence that I need to weave in here.



  • I just wanted to let you know that you are not alone in the twitching finger!!

    The middle finger on my right hand occassionally twitches when I am lying or sitting. It doesn't happen as often as yours, but it does look strange.

    I can't tell you what is causing it as I haven't been diagnosed yet. It is just another symptom to add to my list!

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