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Can't figure it out

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:18 AM in Neck Pain: Cervical
Title says it all.

Had a very bad accident while I was driving to a call (I'm a large animal surgeon) where I was minding my own business driving in my own lane and some (let's call (s)he a Person) t-boned me (didn't look right before pulling out across several traffic lanes)

My head got the side to side whiplash, slammed into the door pillar, etc.

I've had just about every test I can think of-CTs, MRIs, Rads, "nerve function" tests (I think it was an e-stim, we don't do those in vet med so I forget the name) trigger point injections, voodoo, etc. They all show...NOTHING. (not that I want them to show something bad, but at least then it would explain my symptoms)

The accident was several years ago, and things have progressed over time to where I have extreme neck pain frequently. Starts out in the neck at about C7/T1 and runs up to my head and down my arm. Arm is tingly and numb on one side-it's that firey tingly burning pain too, not just tingly and fun haha.

I've tried lots of meds. The only thing that helps (temporarily) are ESIs. In between times I take muscle relaxers, gabapentin, and sometimes pain killers (but I can't take those during the day, who wants their daughter's favourite horse operated on by some guy in a drug fog?)

I have acquired over time significant weakness on the affected side-my nurses are getting really po'd about me dropping the expensive surgical instruments-mostly I compensate by only holding the expensive stuff in my dominant hand, but it was nice to be semi-ambidextrous before the accident)

It has gotten to the point lately where this might be career-ending-or at least severely career altering.

I finally convinced the lovely worker's comp doc (yay, it's WC because I was at work when it happened) to schedule me a myelogram when I told him of a classmate that had a similar accident and history and test results-but finally after a myelogram they discovered she needed a laminectomey-now post surgery she is better than before.

I am just wondering if anyone else has had a similar experience and if they were able to find something on myelogram that was fixable?

I absolutely cannot do chiropractic-tried it and it made the pain unbearably worse (I asked my husband to shoot me apparently. Thankfully he declined) I've tried PT, but WC won't pay for any more and it had plateaued anyway-I still do the stretching and strengthening exercises though because those can't hurt and the doc said that it was OK to continue them.

any suggestions? comments?

I need help-I absolutely love what I do and I can't imagine doing anything else-and people depend on me. help!


  • You guys are fast lol!

    Thanks for the quick reply.

    I've had cervical MRIs with and without IV contrast, multiple different ones (same deal with the CT scans, multiples with and without contrast)
  • Just a thought...

    Did the same doc read your films?

    After my first ACDF in Jan. my surgeon insisted that there was nothing wrong even though I had developed a myriad of new symptoms after surgery, including the arm pain/ burning that you are describing. After several months of declining health my surgeon wanted to do a mylegram and I asked him to wait. I took a copy of my recent MRI to my neurologist to look at and she clearly saw that I had spinal cord and nerve root impingements and that my spine was going in the wrong direction, causing my cord to be stretched. She told me that at that point a mylegram would possibly have caused more damage because of the lack of space in the spinal canal. I also had the nerve conduction tests- they were negative! I subsequently had a revision surgery to correct all of the problems and are currently recovering from that surgery.

    It may be in your best interests to get another opinion. I'm not familiar with WC issues but know that you may have to go out of pocket for it. You're right, waiting may cost you dearly. I live in a rural area and had hunting dogs and a small farm. It's a life I can no longer lead because of the damage to my cervical spine.

    Good luck to you. If I can help you in any way please let me know. We need our rural Vets and I'll do what I can!


  • After my MRI the sureon could not tell what level my problem was on so he said he had to order a myleogram. He said its a better test to see nerve impingment if not obivous on MRI. Worked for me he saw exactly where the problem was with myleogram and fixed it.
  • Things do progress with time....10 yrs ago I was rear ended whild sitting on the interstate....knocked me into the car in front of me. At that time I felt fine except for a sore neck.....fast forward 10 years....severe arm pain and weakness....MRI showed that my neck was a mess....surgery with a corpectomy and fused C4-C7....had to have a revision surgery 5 months later....now I have perm nerve damage from waiting too long. If only I could go back 10 years.....don't wait too long on anything to do with the neck....it is connected to everything in your body.

  • Yes, the mylegram is a better test than the MRI or others but is also less comfortable. It is more invasive and the potential headache is really bad! The pictures, though, are very good so they may be able to find something in those that are not apparent in the MRI, CT. Best of luck to you.

  • Hey Doc,

    Sorry about your issues. I found out last year that whiplash injuries can take a LOOONG time to manifest symptoms. 10 years ago I started getting headaches that are a result of a motorcycle accident in the early 80's. After multiple years of trying every type of drug and ablation and injection, I had a ganglionectomy with laminotomy. It was a tremendous help with my headaches. The strength loss in my arm/hand isn't enough to warrant the risk of any more surgery. I did have to go to a spinal cord stimulator to take care of my neck, shoulder, arm and hand pain though.


    The deal is, don't give up! Go for the myleogram. It's not a big horrible event as long as you do as the doc directs. Think about how many of your clients don't follow your directions and you see their pet back in soon after sending them home. Especially the ones that feel an E-collar is just too cruel. :) Follow the directions given and you will do fine and they can get a better look at your neck.

    Have they done an EMG yet? Sorry this new forum format won't let me go back and see your original post to see if you listed this.

    Hang in there. If it comes to it, just hire a good tech that can help you hold the expensive equipment. They will get a rush out of it and feel totally important!

  • Sorry to hear about your problems and not being able to find a answer to your pain. I have had multiple neck surgeries caused from a MVA and I as well was working. I just had a recent myloegram in April which did detect my issues. The c3 was moving on the c4. They say it is rather difficult to detect as most films won't show the movement. It didn't show in a standard flex film or not to the degree that anyone would say was causing the problem. I have to say in order to get the test completed at took a lot of effort and time. I just recently went through surgery for it and some other issues and we hope this is going to take and relieve the problems. However some of the nerve damage is permanent given the link of time and the amount of impingement. Good luck and hope you can get work comp to order the test for you and something else that has helped others is a discogram if all else fails to find the pain generator. Good luck and keep us posted on your progress. Welcome to spine health.
  • I'm not sure if the same MD/DO is reading the films or not-they have all been at the same medical group (except for the CT scan immediately following the MVA), so it is possible that the same radiologist reads the films-but it is definitely the same MD interpreting the results. I may just suck it up and go pay for a private neuro consult (I already see a neuro for my migraines, which are different than the headaches I still get from the MVA, isn't it wonderful having multiple issues? lol) I know I can get a referral from my PMD and my private insurance will cover most of it.

    I can't say that I'm glad that I'm not the only person with a similar experience, but it is nice to know that I'm not alone in the world.

    I have wonderful CVTs (the closest in human med is a combo of an RN, RT, Surgical Tech, Rad Tech, and FNP) that are my left hands during surgery, but there are some things only the DVM can do-like pregnancy palpation in dairy cows.

    A new question-

    Did any of you require sedation? I have a control problem, if I'm not the one doing the procedure I tend to be extremely nervous and fidgety. It's kind of embarrassing because I can do some procedures on horses and they just stand there like rocks but when someone tries to do the same to me I wiggle too much lol.
  • No sedation for the myleogram, but lots of time spent lying around afterwards.

    I would definitely look into getting a neurosurgeon to look at your films. A radiologist unless he is a specifically trained neuro-radiologist, just looks for the glaringly obvious stuff. An MD and a DO aren't trained in that arena either and a neurologist will only be one step shy of where you really need to have your films looked at.

    No worries about not being the only one suffering similarly. It's just nice to have a place to meet and discuss it so that we can discover that we aren't going nuts and that we aren't the only one with multiple issues. I hate to say welcome to the club .... but ....

    It's awesome that you have some great CVT's! We deal with small animals here, so no dairy cow pregnancies. lol Do seem to be getting more exotics lately though.

    Best wishes,

  • Are you having just your regular family MD/DO read these films? If so, I would definitely suggest that you get to a NS or ortho who specializes in the spine.

    Most family docs rely heavily on the radiology report, whereas most spine specialists like to read the films themselves, and often disagree with the written report. Given the extent of your problems and the fact that you haven't gotten a proper diagnosis yet, please schedule an appointment with a spine specialist. They may be able to see something that your MD/DO is missing, and you may not even need the myelogram.

    I may have misunderstood and you are already seeing a specialist. If this is the case, just ignore my post. Keep pushing for answers, and I hope you get some help soon.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • :) Please keep pursuing treatment even if you have to pay for it yourself.

    I was in a few minor fender benders over the past 25 years, and a couple really tough ones. Then after giving birth to a 8.9 lb boy 14 years ago, my neck starting hurting. I noticed it while holding him and feeding him his bottle. I always jokingly said that I pushed so hard I must have popped something. Long story short - in 2001 I has a MRI and saw a well respected neurosurgeron who told me to give myself cervical traction over the door at home.... I had bulding discs and bone spurs and spinal compression. I bought the equipment and tried it and got NO relief and was self treating with muscle relaxers and OTC pain meds for years and years. Learned to live with it and tried not to cry.

    Then last summer, episodes of extreme pain ran thru my arms followed by big time weakness. My arms would just stop working and I'd drop whatever I was holding and it happened several times while driving. Something was wrong, and I got an appt. with my IM asap. He order the MRI and got me in to see another neurosurgeon ASAP... a 3 month wait. Once they (he and his P.A.) saw the films, they got really serious. They said I needed surgery. And told me that if I were to be involved in an auto accident in this condition, I could be paralyzed. My cord impingement was very bad. I had the drop-sies all the time, pain radiating down my arms and numbness in my neck and shoulders for YEARS and YEARS.

    SOOOOO - please, you need to take this very seriously !! Its been several days since your blog began, so I hope you are pursuing it.

    BTW - my recovery from ACDF is going well. I am limited to non-bouncy car rides... we own an old Jeep that I cannot drive for 6 more months - as it toss you around quiet a bit... no rollercoasters, no skiing or snow skiing etc. I have pain here and there but they said it is all part of the process of healing and the tendons etc must adjust to the new length of my neck etc.

    Best of luck to you!
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