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Looking for guidance, advice, C4/C5 herniation

badcaloriebbadcalorie Posts: 6
edited 06/11/2012 - 9:02 AM in Neck Pain: Cervical
Hi all,
I was in a rear-end car accident caused by a drunk driver 4 weeks ago and am suffering from a neck injury that is getting really frustrating. I am 24, female and am a college student. Basically, I have lots of dull, constant pain in my right should, which sort of morphs into numbness/tingling down into the thumb and index finger. Depending on the day and what I am doing, I have similar dull pain in the left shoulder. I also can't pick anything up over about 10 lbs. with the right arm and I get what my doctor said were spasms where my whole arm pretty much starts tremoring. I had an MRI last week and it came back as saying there is a clear herniation at C4/C5, but no significant nerve impingement. C5/C6 also is bulging but they said it was not significant (basically not important). I saw the MRI film you can see the herniation, but its not deforming the nerve cord although it looks like its just starting to touch it.

My GP referred me to another GP who then referred me to a neurosurgeon who took a look at the MRI said it was non-surgical. I've been prescribed two months of PT, two times a week. I start that tomorrow. Right now, I am on Soma to reduce the muscle tension/spasms and an NSAID for inflammation. I feel about the same 8 or 9 level pain in the shoulder with/without the muscle relaxers and it does nothing to alleviate the numbness/weakness.

The worst part about this is the frustration and the feeling that I am getting bounced around between doctors. No one seems to be able to explain to me why my arm is still numb or even give me a general timeline for recovery. They kept saying it was muscle tension and that it would go away in a couple weeks but hasn't. Is it possible that the MRI isn't showing all the details? Everyone keeps acting like if it isn't on the MRI, it isn't a problem. Should I find another doctor? Or is PT really successful for this stuff? Should I be worried about permanent damage? I'd like to be able to have my arm back sometime. All I know is that I'm young, in great health, never had a prior back/neck injury and woke up the next day feeling like this. Its not improving and seems to be getting worse.

This really is messing up my life, the medications are interfering with my school (senior year of a ecology degree) and I have had to turn down a good paying summer job in my field because it entailed carrying a 50+ pound pack 10 hours a day.. That basically put my career back another year. Additionally, I can't do my favorite things (kayak, backpack) and I can barely do household chores without aggravating it. Any advice would be greatly appreciated. Just running out of patience for doctors, insurance adjusters, lawyers, etc.


  • I am sorry, I know how you feel! Sometimes everything does not show up on the MRI. C4-5 usually does cause severe shoulder pain but does not cause the thumb issue. I believe that is caused by the c5-6. You should give PT a shot because surgery is a last resort. Have you gotten any injections? That might also help. You should see if you can go to a pain specialist that specializes in the spine. Maybe they can give you relief. If the treatments are unsuccessful they may look at surgery again. But remember, surgery is not a quick fix like many people think it is.
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
  • I had numbness in my thumb and index finger and was told it was C5/C6. It took time but it went away for now.
  • I know surgery isn't a quick fix. I just want to know why it is the way it is. If I were a doctor, I guess I would probably be a little more interested in finding the cause then prescribing a bunch of muscle relaxers and sending someone off to PT. Maybe I think a little differently then they do. I've been reading about EMG tests. Do you think those are worth it to find out more about the problem?
  • how your life has changed so quickly.

    You are only 4 weeks into recovery from a bad accident. I am neither doctor or nurse but I would assume there's bruising, strain and maybe tissue swelling from the impact on your neck. That can impinge nerves and create spasms, numbness in fingers, as well as severe shoulder pain.

    PT, injections, muscle relaxers and anti inflammatories can go a long way. You might need many months to heal.

    Try to seek out a pain management specialist and they will keep an eye on progress and treatment. Once all the conservative treatments have been tried, and were you still to be in severe pain, you might want to consider surgery.

    Most important now, give yourself plenty of time to heal.

    Wishing you all the best,
    Cause: car accident & genetics
    Effect: herniations C4-7, stenosis, osteoarthritis, myelopathy, neuropathy
    Non-invasive Treatment: everything under the sun
    Invasive Treatment: 2 level ACDF, C5 & C6, May 2012
    Moving Forward: SCS
  • I am not an expert by any means but i have been in this problem for 7 years. So i have had the vagueness of Dr's and no general timeline for recovery. I have had two neck fusions c5 to c6, c6 to c7. These are nerve roots c and c7.

    i currently am experiencing the same as you with my arms, and have been going through what I thought was a bad flare up, only to find I have a problem with c4-c5 as well. (nerve root c5)lograms in 7 years. i have found it wasn;t as painful the first time, but it was a little painful the 2nd, and the third I vowed to avoid it as much as I can. A Myelogram can pinpoint the nerve better than an MRI, and show exactly this is or something else is the cause of the problems.

    Dr's tend to be vague I believe for many reasons. Some are unsure because many people can heal and never have other problems, while other's don't seem to be so lucky. I hapen to be one of the unlucky one's. I also happen to be an injured federal Worker, so there's a lot of bias out in this as well.

    There is a generalized bias against people who are injured and then through no fault of their own find themselves having to file an injury claim.

    We probably all know of cases where someone was obviously fraudulent. These are the cases we remember. However, medical studies show that the majority of injured ( people )workers are very legitimate and are actually reluctant to complain because they do not want to be thought of as malingering or asking for more than they deserve.

    The same fellow , friends family or Doctors, that might pass the hat and personally bring canned goods and blankets for someone who is injured in a home fire may unconsciously act just the opposite towards an (injured person) or employee that has had an on the job injury. This antagonistic reaction occurs because injury involves the concept of fault. Our response to fault starts at an early age with “Its not my fault.” This antagonistic attitude psychologically harms the injured (person) employee and interferes with the smooth administration of an injury claim, healing and thier future.

    I say all this because its all true and you need to be mindful of only two things. Your health and a Dr who cares about your health. Find one, they are there, it may very well be your current Doctor. But I would ask your GP to order two test asap. An EMG, and a myelogram. You might have to wait for the myelogram to see the results of the EMG to justify the test. If you have a nerve impingment it will show up on the EMG, most of the time. Sometimes it doesn't. Reasearch EMG false negatives, and you will find there are many factors is why it comes up false. The person who did the test, time frame of the nerve impingment to show up etc....

    I wish you the best of blessings and prayer. I do hope you get to feeling better, and I do hpe you can convince your Dr that you want to know exactly what is wrong with you and it;s in both of your best interests to get whatever test needed to find out.

    If you need anything else email me. I am very sorry your going through this, and I do hope that watever is wrong, that you are able to get a resolution rather than the run around. Don't accept it, stand up for yourself and do it with humblessness, kindness and truthfulness. You will find, there is help. You just have to be open and honest. This is a drunk driving insurance nightmare, so you might better get representation for yourself, because it will help.

    God bless you.....
  • Just want to say thank you for the advice/kind words. The PT has already accomplished one thing, the strain in my neck and shoulder is improving immensely. Unfortunately, my fingers are still numb and the pain in my shoulder is still there, ugh. Zero improvement on that front. I see my GP again tomorrow, so I'm going to do a little urging for her to maybe investigate the cause a little more. My college's hospital is very pill happy, so I'm still worried thats the treatment she will keep giving me. I'll ask about the EMG and see what she says. I understand them wanting to avoid unnecessary tests/treatments, because it does seem like the majority of people with herniations improve with very conservative treatment. Hopefully I'm one. At least I'm feeling a little better that the PT isn't completely in vain. The ultrasound treatment is extremely relaxing and while its not solving everything, it feels darn good on the muscles :)
  • Badcal,

    I like you had a bunch of running around, different Dr's telling me different things, never knowing who to listen to.

    I had ruptured discs, but was also in a collision from behind as a separate issue. Numbness, pain, and tingling can be caused by the just whiplash from the accident, or nerve impingement from a herniated disc. A great number of people have disc protrusions, and never have pain. The reason I say that is you might have had a small protrusion before the impact and now the MRI was done it can be seen so now it's a concern.

    I was in the accident on 10/28/11, and it took time for the whiplash to improve. I actually saw a chiropractor who did soft tissue massage, and"Instrumentation." It sounds like it could be either the collision caused soft tissue strain, or the disc issue.

    I am NO DOCTOR, but I do know what you are describing can be from strain, or disc issues. I would do the PT, and also look into soft tissue treatments, like light massage, instrumentation, and the use of hot or cold compresses (DO WHAT YOUR DR SAYS ON ALL.)

    Take care and IM me if you want more input.
    Left foramina stenosis of L3/L4 (retrolisthesis)
    L2-ilaic revision fusion ( loose screws) with a laminectomy at L3 (cage at L3-L4)
    (PLIF) -@ L4/ L/5 - S1 (cage at L4/L5)
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