Suggest Treatment For Neck Pain

Posted on Fri, 30 May 2014

Question: Hi XXXXXXX
Thanks for coming back to me. I attended Physio again this week.. it can be so painful at times because my physio is working on both neck and the back..i am going back to visit my surgeon next week. Do you think it would worth asking him to do another scan on my back and neck.. The most recent back scan was in November 2013 and the Neck scan was in February 2014. On my neck scan it states that there is significant spondolytis c5c6..is this arthrisis..is it worth getting a bone density test done for osteoporosis...It is three months since my condition.. it definitely is improving.. my physio still wants to continue seeing me and states that it is showing all the signs of improving.. her name is Doctor XXXXXXX XXXXXXX . she is excellent

Answered by Dr. Karl Logan (9 hours later)

Brief Answer:
Each questions addressed separately

Detailed Answer:
Hi XXXXXXX

Thanks for your further questions.

I do not think it would be worth a further scan of your neck and or back at present. A repeat scan will likely give no further useful information about your condition at this stage.

The spondylitis is arthritis at the C5/6 level. This is the commonest level in the neck to develop arthritis.

The changes in your neck and back are not the result of osteoporosis which tends to cause wedge compression fractures under normal physiologic loading. If you are concerned about osteoporosis then you could take vitamin D and calcium supplements. A DEXA scan would give information regarding the mineralization of your bones. If you were osteoporotic your Dr would likely start you on a bisphosphonate drug. I do not necessarily think that investigation for osteoporosis is warranted based on the information you have shared with me.

I am pleased you have a good relationship with your therapist that is very important. I am also pleased that you continue to see improvements in your condition.

I hope this answers your current questions.

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Karl Logan (2 hours later)

Thanks XXXXXXX .. this is a brilliant services.. are there different types of arthrisis for the neck? Could this be rhuem. arthris. or is there a way of finding out... still continuing the exercise...neck definitely improving... three months now but I trust it will all settle giving what my physio is saying. do you think at this present time I am wasting my time going to see my orthopead. surgeon.. he is a very buzy man.. meant to be seeing him on thurs..back can be very tender..as a disc issue there but no leg and for that matter arm weakness.. he is quite anti surgery unless it is absolutely necessary...

Answered by Dr. Karl Logan (5 hours later)

Brief Answer:
Osteoarthritis. Continue to see your surgeon

Detailed Answer:
Hi XXXXXXX

This is unlikely to be rheumatoid arthritis, more likely a variation of osteoarthritis. Rheumatoid arthritis is an autoimmune condition where the body attacks the lining to the synovial joints. The discs in the back are not synovial joints. Many joints usually become inflammed and swollen particularly the hands, elbows, knees, ankles and feet. The sacroiliac joints at the base of the spine are usually affected.

I would encourage you to see your surgeon. He sounds very sensible. You always would want a surgeon who is reluctant to operate unless absolutely necessary. It's important to maintain and build your relationship with him and for him to see how your symptoms and condition evolve over time.

I hope this answers your questions.

best wishes

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad