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Is Chronic Burning Pain In The Back, Neck And Right Arm Curable Long After Disc Replacement At Neck And Right Arm Ulnar Nerve Surgeries?
Question: Hello, I am curious of thoughts, 2013 I had disc replacement surgery in my neck and then 2014 I had my right arm ulnar nerve surgery, they relocated it. i have Since then have had chronic pain in my back, neck, and all down my right arm. It feels like a burning pain that never goes away. Is there anything else I should have my doctors look for?
Brief Answer:
Spinal origin seems clear, but tests for rheumatological issues may be done
Detailed Answer:
Hi,
If by look for you mean for another cause for your neck and right arm pain then I do not think that there is a reason to search for another cause. I imagine since you've had these surgical procedures you've had tests like MRI and nerve conduction studies. Those are the best tests for your clinical manifestations so I wouldn't look for other causes on that regard, only continue physical therapy and pain medication, perhaps adding medication for neuropathic pain if you aren't taking any (pregabalin, gabapentin, amitriptyline would be some examples).
What I would want to look into though is what brought these spinal issues in the first place. Since you do not have only neck but also back pain it is likely that there are spinal degenerative changes in the rest of the spine as well. While degenerative spinal disease is a very common condition, it usually is related to aging. It is not common at the age of 37 (or 32 rather since you had surgery in 2013). So unless there is some clear cause for that such as a trauma.
I would consult a rheumatologist for the possibility of a systemic connective tissue condition like for example rheumatoid arthritis. For that some blood tests for inflammation markers and autoimmune antibodies commonly found in these conditions may be required.
Mind you that won't change the management of current symptoms as I described above, but if something turns out may help in taking measures to prevent more issues in the future.
I remain at your disposal for other questions.
Spinal origin seems clear, but tests for rheumatological issues may be done
Detailed Answer:
Hi,
If by look for you mean for another cause for your neck and right arm pain then I do not think that there is a reason to search for another cause. I imagine since you've had these surgical procedures you've had tests like MRI and nerve conduction studies. Those are the best tests for your clinical manifestations so I wouldn't look for other causes on that regard, only continue physical therapy and pain medication, perhaps adding medication for neuropathic pain if you aren't taking any (pregabalin, gabapentin, amitriptyline would be some examples).
What I would want to look into though is what brought these spinal issues in the first place. Since you do not have only neck but also back pain it is likely that there are spinal degenerative changes in the rest of the spine as well. While degenerative spinal disease is a very common condition, it usually is related to aging. It is not common at the age of 37 (or 32 rather since you had surgery in 2013). So unless there is some clear cause for that such as a trauma.
I would consult a rheumatologist for the possibility of a systemic connective tissue condition like for example rheumatoid arthritis. For that some blood tests for inflammation markers and autoimmune antibodies commonly found in these conditions may be required.
Mind you that won't change the management of current symptoms as I described above, but if something turns out may help in taking measures to prevent more issues in the future.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. My daughter at 10 was just diagnosed with Chiari Malformation, and I wonder if a doctor can miss that in MRI. I have tried the Nero path medication and I take no pain medication, that near a pet medication did not help me. I have done Cortizone shots and nothing worked. When we did the testing for the nerves my right arm tested stronger than my left but I sometimes just drop things randomly with my right without any control and lose complete feeling in that arm. I am so tired of being in pain all the time. Did physical therapy for two years and no improvement.
Brief Answer:
Read below.
Detailed Answer:
Hi,
A Chiari malformation is well visible on MRIs, it is the best test for that, so it is unlikely the radiologist has missed it. Also it wouldn't explain your symptoms which seem to involve lower levels of the spine than those involved in Chiari.
It would be useful to know what type of neuropathic pain treatment you got. There are several drugs out there, of different classes, some may be more effective than others. Dosages matter as well, increasing the dosage may be necessary, you may have not been taking an adequate dose.
Other options to alleviate the pain would include injections including not only steroids like cortisone but anesthetic substances as well. Traction therapy a form of decompression therapy which relieves pressure on the spine may also be considered.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Hi,
A Chiari malformation is well visible on MRIs, it is the best test for that, so it is unlikely the radiologist has missed it. Also it wouldn't explain your symptoms which seem to involve lower levels of the spine than those involved in Chiari.
It would be useful to know what type of neuropathic pain treatment you got. There are several drugs out there, of different classes, some may be more effective than others. Dosages matter as well, increasing the dosage may be necessary, you may have not been taking an adequate dose.
Other options to alleviate the pain would include injections including not only steroids like cortisone but anesthetic substances as well. Traction therapy a form of decompression therapy which relieves pressure on the spine may also be considered.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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