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Hi, I Have Been Dealing With Chronic Neck Pain For
Question: Hi, I have been dealing with chronic neck pain for about 2 years, it has progressively gotten worse. I have extreme pain bending my head side to side. I have constant pain in both shoulder blades and the pain on my left side goes into my forearm. I have been going to pt for over 3 months and it just makes the pain worse. I underwent an mri yesterday here are results if you can just me what you would recommend a patient to do that would be great, thanks in advance.
Pt Name: Grillo, Timothy DOB:2127h988
MRN: 0000
Referring: XXXXXXX Hsiao-Liang Lin CC Recipient(s):
Pt Phone: 7 1.8-984-2406
Accession Number(s) Date of Service 160961s0 9l24lLB
IMPRESSION:
Diffuse d egenerative cervica I disc cha nge/disc protrusions.
Central left C4-5 disc herniation with partial encroachment upon the left anterior subarachnoid space. Left C4-5 foraminal narrowing.
Central right C6-7 disc protrusion with partialencroachment upon the right anterior subarachnoid space. Right C6-7 foraminal narrowing,
Punctate increased T2 signal, lateral right cervicalcord at C5-6 of questionable significance. Myelomalacia, demyelination and artifact are considered.
No significant cervical spinal canal stenosis.
The right-sided C4-5 protruding component on the prior study has resolved consistent with improvement. No significant change in the above findings otherwise.
FINDINGS:
CLINICAL INDICATION: Neck pain, bilateralshoulder, upper extremity radiculopathy x2 years.
MRI OF THE CERVICAL SPINE WITHOUT IV CONTRAST:
TECHNIQUE: Multiplanar multisequence MR imaging of the cervicalspine was performed without the administration of intravenous contrast.
Grillo, Timothy MRN
The second part
COMPARISON:2/17.
FINDINGS:
ALIGNMENT: Alignment is maintained. Minimal mid cervical levoscoliosis.
VERTEBRAE: Vertebral height is maintained. No marrow signal abnormality.
DISCS: Minimal loss of disc height at C6-7,T2-3..
CoRD: Punctate increased T2 signal in the region of the right cervicalcord at C5-6 is possibly artifactualalthough present previously. No definite cervical cord signal abnormality otherwise. No intradural abnormality. Normal cra niocervica I junction.
PARAVERTEBRAL SOFT TTSSUES: No paraspinal abnormality.
EVALUATION OF I N DIVI DUAL LEVE LS DE MONSTRATES: c2-3: central c2-3 disc protrusion. Minimal anterior thecal sac effacement. euestion of left c2-3 facet hypertrophy.
C3-4: No spinal canal or neural foraminal stenosis.
C4-5: Central left posterolateral C4-5 disc protrusion. Partial encroachment upon the left anterior subarachnoid space. Left C4-5 foraminal involvement. The right-sided component is diminished consistent with improvement,
c5-6: central c5-6 disc bulge. Minimal anterior thecal sac effacement.
c6-7: Central right c6-7 disc protrusion. Partial encroachment upon the right anterior subarachnoid space. Right c6-7 foramina I involvement.
C7-T1" - T3-4: No spinal canal or neuralforaminal stenosis,.
Electronic Signature: I personally reviewed the images and agree with this report. Final Report: Dictated by and Signed by Attending XXXXXXX Stern MD g/ZS/ZOlgt:42 AM
Pt Name: Grillo, Timothy DOB:2127h988
MRN: 0000
Referring: XXXXXXX Hsiao-Liang Lin CC Recipient(s):
Pt Phone: 7 1.8-984-2406
Accession Number(s) Date of Service 160961s0 9l24lLB
IMPRESSION:
Diffuse d egenerative cervica I disc cha nge/disc protrusions.
Central left C4-5 disc herniation with partial encroachment upon the left anterior subarachnoid space. Left C4-5 foraminal narrowing.
Central right C6-7 disc protrusion with partialencroachment upon the right anterior subarachnoid space. Right C6-7 foraminal narrowing,
Punctate increased T2 signal, lateral right cervicalcord at C5-6 of questionable significance. Myelomalacia, demyelination and artifact are considered.
No significant cervical spinal canal stenosis.
The right-sided C4-5 protruding component on the prior study has resolved consistent with improvement. No significant change in the above findings otherwise.
FINDINGS:
CLINICAL INDICATION: Neck pain, bilateralshoulder, upper extremity radiculopathy x2 years.
MRI OF THE CERVICAL SPINE WITHOUT IV CONTRAST:
TECHNIQUE: Multiplanar multisequence MR imaging of the cervicalspine was performed without the administration of intravenous contrast.
Grillo, Timothy MRN
The second part
COMPARISON:2/17.
FINDINGS:
ALIGNMENT: Alignment is maintained. Minimal mid cervical levoscoliosis.
VERTEBRAE: Vertebral height is maintained. No marrow signal abnormality.
DISCS: Minimal loss of disc height at C6-7,T2-3..
CoRD: Punctate increased T2 signal in the region of the right cervicalcord at C5-6 is possibly artifactualalthough present previously. No definite cervical cord signal abnormality otherwise. No intradural abnormality. Normal cra niocervica I junction.
PARAVERTEBRAL SOFT TTSSUES: No paraspinal abnormality.
EVALUATION OF I N DIVI DUAL LEVE LS DE MONSTRATES: c2-3: central c2-3 disc protrusion. Minimal anterior thecal sac effacement. euestion of left c2-3 facet hypertrophy.
C3-4: No spinal canal or neural foraminal stenosis.
C4-5: Central left posterolateral C4-5 disc protrusion. Partial encroachment upon the left anterior subarachnoid space. Left C4-5 foraminal involvement. The right-sided component is diminished consistent with improvement,
c5-6: central c5-6 disc bulge. Minimal anterior thecal sac effacement.
c6-7: Central right c6-7 disc protrusion. Partial encroachment upon the right anterior subarachnoid space. Right c6-7 foramina I involvement.
C7-T1" - T3-4: No spinal canal or neuralforaminal stenosis,.
Electronic Signature: I personally reviewed the images and agree with this report. Final Report: Dictated by and Signed by Attending XXXXXXX Stern MD g/ZS/ZOlgt:42 AM
Brief Answer:
Traction therapy, local injections, surgery remain
Detailed Answer:
I read your query carefully and I understand your difficult situation.
Even though you feel no improvement it was right to go through physical therapy as it is always the first choice aiming to increase long term stability of the spine by strengthening muscles. I suppose you have also used common medications such as non-steroid anti-inflammatory medication, muscle relaxants and chronic pain medication (pregabalin, gabapentin, amitriptylin or duloxetin).
The remaining options would include local injections of steroids and anesthetics. They may offer an improvement which may last for several months.
Another optionwould be tr
Traction therapy, local injections, surgery remain
Detailed Answer:
I read your query carefully and I understand your difficult situation.
Even though you feel no improvement it was right to go through physical therapy as it is always the first choice aiming to increase long term stability of the spine by strengthening muscles. I suppose you have also used common medications such as non-steroid anti-inflammatory medication, muscle relaxants and chronic pain medication (pregabalin, gabapentin, amitriptylin or duloxetin).
The remaining options would include local injections of steroids and anesthetics. They may offer an improvement which may last for several months.
Another optionwould be tr
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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