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Cervical vs Lumbar Issues- is one worse than the other?

I'm going in for a cervical MRI soon for a sudden onset of severe shoulder pain. In the past my old MRI showed severe desiccation on C5-6 and disc bulge at the same level, along with other disc bulges and mild kyphosis in C3-C7. I had a cervical epidural 2 years ago for severe shoulder pain and radiating nerve pain down my arm and hand. I also get numbness and aching between my shoulder blades, as well as occasional headaches. My shoulder this time hurt so bad I thought I had a ligament injury or something. X-rays were negative for that and labs were normal. My doctor feels it's a cervical issue. The weird thing is that I had mild swelling in my shoulder that is better now which made me think it was not cervical problems. I read online that it could happen sometimes-how I don't know. Maybe 2 separate issues happening coincidentally at once? I also wondered if small cervical disc herniations don't feel as painful as lumbar because they are not weight-bearing? If anyone has any idea or has experienced this please share your story. Much appreciated
Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.


  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    I was injured at work. I complained immediately of neck pain & shoulder pain. I was diagnosed with c4-5 herniation. I had mri of shoulder & was told there wasn't anything wrong with it. They gave me a cortisone shot & said to come back if it didn't get any better. When I went back to orthopedic doctor & told him my shoulder felt worse, he told me it was coming from my neck & there was nothing I could do about it.
    I put up with it for a year and a half. I finally saw a new orthopedic doctor. He looked at my past mri & said it shows a tear? He sent me for an arthrogram. The results from that was clear that I had a full rotator cuff tear. I had surgery 4 months ago to repair it.
    I was told that X-rays can't show ligament tears & the way to see for sure was to get an arthrogram.
    I'm not saying that you do have a shoulder injury, but I'm saying you could have 2 different issues going on?
  • I had the cervical MRI already and am waiting for results. I'm also having my shoulder done but I don't think it's a joint issue anymore. There's no stiffness, no more swelling, and I can move it. Most of my symptoms however is pain, spasm, numbness & tingling, and the occasional headache at the back of my head. It's just weird how it all transpired. We shall see...What symptoms did you have when you first herniated C4-5?
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    When I was injured, I felt & heard a pop. I had immediate pain in my neck & shoulder & down into my left arm. I couldn't turn my head at all to the left. Couldn't look up or down. I couldn't raise my left arm up without screaming in pain. My arm & hand felt tingly.
    I had to go through work comp, I had to use their doctors. I had several injections, did therapy & more injections. They finally sent me for mri & it showed c4-5 was herniated. I didn't care for the work comp neurosurgeon, so after 90 days, I was able to see a doctor of my choice.
    When do you get the results of your mri?
  • MeydeyMMeydey Posts: 209
    edited 10/14/2015 - 8:48 PM
    Thanks Motor1, I'm sorry you went through that. I know what it's like but in my lumbar spine not cervical. MRI without contrast showed cervical DDD and stable bulges on C4-5, 5-6, 6-7 and mild kyphosis, with no significant stenosis. My question for the doctor about the stenosis- the report didn't outright say "no stenosis" just no significant stenosis. I wonder if it's there very mildly so that is viewed as insignificant or no stenosis whatsoever. I've seen other MRI reports from here and other websites and when there is none, it is written as no stenosis. Maybe I needed contrast for a better picture. When I had lumbar disc herniations, the ct myelogram showed nerve impingement were more pronounced when i was put in an upright position on the table. I'm relieved I don't have a slipped in my neck- I have enough to deal with already with all my lower back problems. I notice my neck and arm bother me more when I drive or while I use a computer or using my arm.
    Yeah, WC is one big cluster [EDIT] huh? I feel bad for those who are getting messed over by them because they really don't have your best interest. I'm sorry you have to deal with them. Are you seeing a spinal specialist or plan on having surgery? I hope they are managing your pain..it's terrible to go through.
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    I'm glad your mri didn't show any problems with your discs. I'm not sure what no significant stenosis means?
    Have you tried any therapy to help your neck & shoulder? How about a tens unit?
    My injury happened in 2013. I've had 2 neck surgeries & recent shoulder surgery. My surgeon has me seeing a pain doctor now. He's done some injections & tried different meds, but my pain has never lessened?
    He wanted to do a Rhizotomy, but the medial branch block didn't work, so he said the Rhizotomy wouldn't do me any good?
    Although work comp is paying me, it is only 70% of my pay. I ended up hiring an attorney because my employer wasn't paying me properly. I'm glad I did because now he handles everything!
  • Well, 2 years ago I had a cervical epidural that was helpful for 8 months and then I would have neck pain or nerve pain on and off. I'm already on pain meds so it covered my cervical issues as well. Suddenly last month I woke up with horrific pain in my shoulder that led me to the ER. Days later I noticed aching in my neck and spasms and random nerve pains down my arm. It mostly feels sore and heavy-ish. My lower back commanded all my attention until cervical problems crept up again. I was diagnosed before with cervical radiculitis after the doctor reviewed my old MRI from 2 years ago. I also have bulging discs in the thoracic spine (can't remember which ones- haven't been reevaluated in years since all focus went to L spine).
    I have a Tens unit, I use cold packs, and I love the new Bengay Cold Therapy-cooling pain relief gel..feels great. I've had a pain pump for a few years and also take Norco and other oral meds. I have a follow up appointment next month and most likely they'll want to do another ESI or PT. Today I'm getting a double whammy from neck and lower back pain and can't get comfortable in any position. This sucks..hope you're feeling better today. It's like living on borrowed time when we feel a bit decent..enjoy it while you can because it can be gone in a New York second.
    I also had a bilateral nerve block which helped 5 days, then bilateral rhizotomy in my lower back a few months ago. My facet joints there are severely degenerated. I'd say it helped 30%..better than nothing right? Yeah I've heard if the nerve block's not helpful then the rhizotomy probably won't be. It was a longer recovery than an ESI and you'll know in 6 weeks if it took, and if so, it may last up to 2 years before the nerves grow back. The post procedure spasms were pretty bad, and I was given IV pain meds right after because it hurt so bad. The pain and spasms should ease up little by little.
    It's good to hear you have an attorney too..it's a must when dealing with WC. I hope it works out in your favor. How are you doing today?
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    You really have a full plate! I feel bad that you have so much going on. I'm sorry that you aren't having a good day.
    And you're right...everything does change in a minute!
    I had a follow up appointment with my ortho doctor today. He was following up on my new found discovery. I have ulnar nerve entrapment in my elbow. He strongly suggested surgery. I told him I'm not interested in surgery right now. I'm still in therapy 3x week for my shoulder surgery & they're working on my neck too.
    He explained to me that if I don't get it fixed, I could have permanent damage.
    I ended up agreeing to getting a new EMG & see if it is getting any worse. He said if it shows that it's worse, then I need surgery soon. That will be 4 surgeries in less than 2 years. I'm at a loss on what to do.
  • MeydeyMMeydey Posts: 209
    edited 10/15/2015 - 5:38 PM
    Sorry Motor1, I certainly understand. I don't want any more surgeries either. You're going through so much right now and I know how overwhelming it can feel. Sometimes all you can do is take care of one thing at a time. I know you'll make the right decision and do what feels right for you. I had a microdiscectomy and 2 level TLIF within 8 months..no fun at all. Does the ulnar nerve entrapment feel similar to cervical radiculolitis? Hang in there my spiney friend : )
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    I have constant nerve pain starting in my neck & going into my shoulder & down into my hand. My fingers get numb almost constantly. I can't touch my elbow without jumping.
    I was very surprised when the doctor said ulnar nerve entrapment. I still wonder if it's coming from my neck? Ever since my shoulder surgery, my neck issues have increased. I was blaming it on wearing that sling for 2 months. The sling went around my neck & it definitely wasn't good for it.
    I'll be calling to get an appointment for the EMG today.
    Then, I'm going to try to put it out of my mind. I allowed yesterday as my crying day. Today, it's a move forward day!
  • Yes, we are certainly entitled to our crying days..thank goodness we can support each other here because we're all going through this. I'm sorry you had such a hard time and hope today is better. I wore a sling for a couple weeks but my doctor said it's not good for me. It helpful because my arm hurts a little less when elevated. It's said that people with neck problems feel better when they raise their arm and touch their head because it eases pressure on the nerve. I tried it and it happened. When do you see your doctor again and what have they given you for pain, if I may ask?
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    I have a hard time taking meds. I've been on amitryptline & gabapentin for nerve pain, but I was having side effects that I couldn't deal with, so I had to stop them.
    I can't take Percocet or OxyContin or oxycodone. They give me rashes & make me itchy.
    Right now the only thing I take is Vicodin and that doesn't work on nerve pain.
    My pain doctor ordered me a cream called pennsaid? It really doesn't do much either.
    I don't have any appointments with my surgeon. I'm just seeing my pain doctor & ortho doctor for my shoulder & elbow.
    How is your shoulder feeling?
  • I had stabbing, aching pain in my forearm all day but I'll survive. Hope you're having a restful weekend. Have you tried Volteran gel? It's an anti inflammatory just like Volteran tablets. I alternate between the two when my stomach acts up.I get awful cramps and pain from Fibro. You can't do both at the same time. I never heard of Pennsaid, is it new? Next week it's my shoulder MRI but I think it's to rule out a structural problem there. I'm pretty convinced it's my neck now. I couldn't handle Neurontin because it spaced me out, and the highest dose I could take was 300mg which is pretty low.
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • ridgianrridgian Posts: 11
    edited 10/18/2015 - 8:47 AM
    Good day Meydey. I'm 55 yrs old and herniated L-4 L-5 disk when I was 24. I have had DDD problems in my lumbar spine ever since and at times the pain was so bad I could scream so I did. I worked for 30 years after mostly in construction/carpentry so it has obviously gotten worse but I've learned to live with it meaning I learned how to do things smart. I have seen surgeons both ortho and neuro many times since but no one wants to operate saying if I can live with it do so - the risks are too many. Last year I hurt my neck at work. (6 years prior I hurt my neck similarly and went on comp. it healed and back to work I went. ) anyway, I had an MRI, saw an ortho surgeon, then a neurologist who sent me to the neurosurgeon who said he wanted to operate. I had the surgery a month ago and although the pain and tingling in my right arm are gone I have severe pain in left shoulder that wasn't there before. Also it feels like there's something caught in my throat- hard to swallow and breathing is slightly laboured. It's still early in recovery so hopefully it will all pass.
    Now, with regard to the pain difference in lumbar versus cervical spine I know that lumbar spine pain and symptoms are worse. When I suffered my first lumbar spine issue it hit me like a ton of bricks; no warning and it's hurt to various degrees ever since. my neck pain started differently, just stiffness in neck area at first but days later the pain in my tricep and severe tingling in entire forearm started. On a scale of ten my back pain has reached ten but my neck pain is an eight. Not a lot of difference but ...
    Workers comp has a third party involved now trying to find me suitable work if and when the surgeon says I can go back to work. I've worked building homes most of my life with a 10 year IT/computer networking stint in between (comp retrained me back in '95 after another instance of my lower back acting up). The IT work was great but it meant sitting for extended periods which, again in my opinion, is equally as bad if not worse for the lumbar spine than being a carpenter. The comp consultant thinks I should take an office job to finish off my career but I told him how I felt about it and he took note of it. I don't want to be pensioned off. I want to do something productive so I'm researching my options. Anyway, sorry for the long rant but thanks for listening. I hope you get results and pain relief and soon. Good luck to you and everyone suffering spine related pain.
  • Sorry you've been through the ringer after having a great career. Seems like everything comes to a grinding halt when our backs go bad. I certainly understand about you struggling with IT since it requires extensive computer usage. My pain flares up more when I'm on the PC for a long time too. I've never had neck surgery, just lower back, and to me it's a bit scarier to be operated at that level. What type of surgery did you have? Yes, it makes a lot of sense that lumbar disc herniations take more of a toll because it's weight-bearing..but I can't really say unless I blew out a cervical disc to know for sure. Don't want to anyway lol. Hope you have a speedy recovery. Take care
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Thanks for the kind words Meydey. I agree with you regarding sitting at the computer. I have a desktop PC but don't use it since the surgery. I find it more comfortable using my smartphone.
    The neck surgery I had last month is called Anterior Cervical Discectomy and Fusion (ACDF). There's lots of good videos online. Using clamps and spreaders the surgeon removes the collapsed disk and replaces it with a bone graft. Then he screws a metal plate to the vertebrae above and below the replaced disk. Over time it fuses together. It can take anywhere from 6 weeks to 6 months to fuse properly so I have to be very careful.
    Have the doctors taken an MRI of your cervical spine? That would clearly show any compression of nerves in your neck.
    Have a good night and let me know how you make out.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    I have not tried Volteran gel. Since I'm on work comp, they control all decisions with my care. My doctors have tried to order me other creams, but work comp wouldn't approve them.
    Good luck with your shoulder mri. I hope for your sake it doesn't show any problems with your shoulder.
  • Nick.nyNNick.ny New York,NYPosts: 121
    Hi there and sorry for your suffering . I feel your pain since I'm one like you, I was injured in a car accident four years ago,near death collision with cervical spine injuries of C-4/5/6/7,burst fracture of C-7,broken collarbone,broken right shoulder,L-Spine injuries at L5-S1,right elbow and right hip.I had an ACDF C-4/5/6/7, repair collarbone with fixation plate and 9 screws and my worst nightmare I had four (4) shoulder surgeries 4/11,3/12,11/12,6/13. Now I have right hip and elbow pending and according to my surgeon either cast for the elbow or crutches for the hip isn't good for the shoulder yet so I'm on the wait , my L-Spine is worsening,my neck isn't 100%fused and hurting,permanent disable from my right arm,swallow problems.I'm with pain management and besides trigger point and epidural injections taking Oxymorphone,Oxycodone,Zanaflex,Gabapentin and yes Ibuprofen against fusion regulations...
    Meyday,good luck with your test,... ridgian,wish you quick and painless recovery..
    Motor1,i feel your pain since I know all of them : neck,shoulder and elbow,but be very careful with the elbow surgery.see what your surgeon thinks, mine told me very clear no until we're done with the shoulder . If you have your elbow in cast you going to damage your shoulder....good luck with your EMG and hope you won't need surgery.
    Now, between C-Spine,L-Spine and Soulder??? From my own experience ??? SHOULDER is the worst!!!
    2011 ACDF C 4/5/6/7.
    2011 repaired sternum with fixation plate and 9 screws.
    4/2011,3/2012,11/2012 and 6/2013  Rotator cuff surgeries.  
    1/6/2016 revision ACDF C4/5/6/7, plus fusing the level above that C 3-4.
    Pending L5-S1.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    edited 10/20/2015 - 2:20 AM
    I totally agree about shoulder surgery being worse! Recovery & therapy 3x a week is brutal! I am 4 months post op & I am finally seeing much improvement in my range of motion.
    I told my orthopedic surgeon that I will not even think about having surgery on my elbow until I am done with therapy on my shoulder.
  • Thanks Rigian and Nicky..Hi Motor1, sorry I've been gone a little while. Anyway I was shocked at these results. My left shoulder shows partial-thickness bursal sided fraying of posterior supraspinatus and involves 30% of tendon thickness. There's a small subacromial spur and a laterally downsloping acromion. Mild bursitis at subacromial subdeltoid bursa. Biceps tendon diminutive in size-no tear or tendinosis. Right shoulder: shallow chondral loss along anterior glenoid. Trace fluid in aterosuperior subacromial subdeltoid bursa that correlates with mild bursitis. Shallow partial-thickness chondral loss along anterior glenoid and small humeral head osteophyte- suggests mild osteoarthritis. That was a mouthful!
    I'm following up with my doctor soon. I'm sure they will deal with this too. I guess I shouldn't be surprised with my history of OA, and DJD & severe facet arthropathy in lumbar spine. On top of these new developments, I also have cervical radiculitis. Spent weekend with aching neck, headaches, and radiating arm pain. How are you guys doing?
    Nicky, that's a heck of a car accident..so sorry. I'm glad you're being well-taken care of. So much to deal with at the same time, I know it's not easy at all. A lot of us have multiple conditions aside from chronic back pain but somehow we survive each day and keep going.
    Motor1, yeah WC is so stingy. My insurance denied Lidoderm patches 3 times. 2 for lower back and once for nerve pain in my arm. I could really use it now on my neck. They paid $700 a month for Fentanyl patches before..why not Lidoderm? How is it NOT medically necessary in my case? Makes no sense.
    Rigian, I had cervical MRIs in the past and recently also. It's minor compared to my lumbar..DDD and disc bulges on C3-C7, and kyphosis in same area. I've also had a cervical ESI a couple years ago and was very helpful. I was more scared of a long needle in my neck than my lower back lol.
    Ol' Spiney...Microdiscectomy L4-L5, TLIF L4-S1 -post op central disc herniation L4-S1, sciatic nerve damage, retrolisthesis, epidural fibrosis, facet arthropathy, severe DDD & OA.FBSS- Medtronic SynchroMed II pump.
  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    It sounds like you do have issues going on in your shoulders? I'm sorry to hear that.
    I'm glad that you are following up with your doctor.
    You are right that it doesn't make any sense about the meds that work comp approves? My doctor ordered me a pain cream but comp wouldn't approve it. I have heard that it's very expensive? They did approve a different cream, but unfortunately, it didn't help me at all.
    Keep us updated with your follow up appointment.
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