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Stenosis Questions

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:19 AM in Neck Pain: Cervical
For about a month or so I've been having pretty severe pain (about 8 on a scale of 1 to 10) in my left arm and hand, from my shoulder down to my fingers. My primary care physician said I have Bursitis in my shoulder but he suspected something else was causing my arm and hand pain so he ordered an MRI of the cervical spine.

According to my MRI results:

* There is a reversal of the normal lordotic curvature of the cervical spine;

At C6-7, there is "Advanced uncovertebral endplate degenetrative changes. There is mild intervertebral disc space narrowing and cervical lordotic reversal. The degenerative uncovertebral endplate changes result in significant left foraminal and left lateral recess stenosis and mild central canal and moderate right foraminal stenosis."

* At C5-6, there is "Advanced uncovertebral endplate degenerative changes. There is mild intervertebral disc space narrowing and cervical lordotic reversal. The degenetrative uncovertebral endplate changes result in significant right foraminal, moderate central canal and bilateral lateral recess and significant left foraminal stenosis."

* At C4-5, there is "Mild intervertebral disc space narrowing and mild uncovertebral endplate degenetrative change. Intervetebral endplate degenetrative changes are present. The combination of findings results in significant right foraminal, mild central canal and mild left foraminal stenosis."

* At C4-5, there is "Generalized mild broad based disc bulging."

* At C2-3 and C3-4, there is "Minimal central broad based disc bulging."

Impression: "Multilevel degenerative uncovertebral endplate changes and broad based disc bulging resulting in variable degrees of mild to significant foraminal and mild to moderate central canal stenosis."

I'm not totally clear on what all that means (any clarification would be appreciated) but my primary care physician is recommeding that I try physical therapy for one week to see if it helps and he has prescribed Lorcet 10/650 four times a day for pain. I'm averaging only one a day (when the pain becomes absolutely unberable) because the fear of becoming addicted to pain pills scares me to death.

My first physical therapy session is today (July 23) at 2:30 p.m. Can anyone tell me what to expect? Does it hurt? Does anyone know how effective it is with ailments such as mine? If it doesn't help, what is my doctor likely to recommend? Can anyone tell me in laymen's terms what my problem is based on the MRI findings I typed above and is it something I should be concerned about?


  • with stenosis mild methods of treatment will not work. stenosis only cure is surgery.unfortunately.there are many articles on the subject. i don't know what your doctor is thinking sending you for only a week of therapy,there is no way that anyone can see one way or another how there going to be after one week of therapy. ;) i could see you seeing a surgeon to find out what he would do for your neck because you have a lot of degeneration there and narrowing. which is causing you the pain.what you have won't be cured by therapy believe me i had stenosis and i kept being sent back to therapy for more than three years while trying to get to a surgeon.The therapist would say that i needed surgery and the doctor would say i'm not sending you to a surgeon go to therapy.I finally got to a neurologist and i asked her to send me to a surgeon and she finally did and he examined me and said that he would definitely operate.I went through hell for more than three years just because my doctor was stubborn and refused to send me. Good luck to you.
  • Update:

    I had my first physical therapy session. It wasn't nearly as bad as I expected: 20 minutes of traction with 16 pounds of weight. The PT joked that I wouldn't like him very much tomorrow if he gave me more than 16 pounds of weight the first day. ;-)

    My arm does hurt more now but he told me to expect that... the good thing is, I feel like I'm a lot taller. ;-)

    The physical therapist told me it will be five or six treatments before I'll notice any difference (if at all) and there is no guarantee that it will help. He said my next step, if I don't get any relief, is a neurologist.

    Tammy, thank you for your reply. I really appreciate your insight into this. I did ask the PT today how serious my condition is and he said it is serious and there is no guarantee that PT will help.

    In defense of my primary care physician, I should disclose the fact that I told him I am afraid of surgery so that may very well have factored into his decision to recommend PT first.
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  • Atticus, surgery should always be your last resort. While it is the only cure for stenosis, you have to be ready for it. You may also want to get a second opinion. I have stenosis, and I have not had surgery. I'm not ruling it out, but not jumping into it either. Be aware of myelopathy, which is weakness in the arms or legs. Good luck, and keep us posted.--Mazy
  • Second Update: (24 hours after first physical therapy):

    Good grief this is horrible! I'm typing with one hand so please forgive me for any typos but I just started having the most horrible pain I've ever had -- easily 10 on a scale of 1-10 and the Lorecet 10/650 did not help a bit. The PT said I would hurt some after the first session (16 pounds of traction) but he didn't tell me I would want to commit hara kiri. I can't move my left hand or arm without screaming. My husband had to help me get dressed. I' just wearing a tee-shirt and jogging pants but still needed help and I couldn't tie my own shoes.

    I called the PT and he said yes I should be feeling pain but not that much. He told me to be in his office at 3 p.m. (in 25 minutes).

    What the heck is going on? I wasn't this bad before I went to the doctor! I'm ready for someone to cut my arm off!
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    PT will probably do nothing more than aggreviate your condition. With the pathology stated in your MRI you should see an qualified Orthopeadic Surgeon.

    I know ... been there .... done that.

    Pain Medication is not a long term answer, surgery is. When the pain gets bad enough ... you will go to any lengths to get it resolved. That includes surgery.

    My prayers are with you.


    My avatar is worth a thousand words.
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  • One of the physiatrist I saw said that spine/nerve pain is #3 after only childbirth and kidney stone pain. I had terrible arm/shoulder pain. I did some light PT, but no traction-type stuff. I know the pain is really bad. The only thing that ever helped my pain was something called Doan's pills and Darvocet. Good luck.---Mazy

    Metalneck--your avatar does speak a thousand words! Would be interested in your story.--Mazy
  • I don't think I got out of bed for two days.
  • Went back to the PT yesterday. He tried to do a soft massage but I couldn't stand it.

    He called my primary care physician and told him the pain had increased. My primary care physician perscribed Gabapentin. I understand it is specifically for nerve pain. Has anyone ever taken it? What is it?

    Anyway, I'm supposed to take one pill before bedtime for three days then increase it to two pills a day.

    I bumped into my doctor's nurse at Wal Mart when I was picking up my perscription and she told me to call her this morning if I didn't get any relief.

    I took one at 7 p.m. and slept like a baby... I didn't wake up until 8:30 this morning! I don't know what that stuff is but it worked like a charm.

    My arm pain is still with me but it is certainly more bearable. I'm actually typing with two hands!
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    Gabapentin aka Neurontin is an anti- seziure medication. It is also used off label to decrease "nerve pain". It didn't help me at all. Glad to hear it worked for you. Stay away from the opiate pain killers .... they are killers.

    Prayers for all off us.

  • Thank you for the explanation about Gabapentin and the warning about opiate pain killers.

    I'm so glad I found this forum!

    Thanks to all who've helped me to better understand this process I'm going through.
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