Suggest Treatment For Pain In The Upper Back And Arms

Posted on Tue, 6 Sep 2016

Question: Hello - I have various issues going on. I was having upper back pain and pain down the arms and in my hands (I may also have carpal tunnel syndrome) Was diagnosed with various bulging discs in my neck and a herniated disc c5/c6. I was seeing a chiropractor who suggested I see a Neurologist. The Neurologist took one look at me an said I have a "shoulder" problem going on as well. An MRI on my left shoulder confirmed I have a focal full thickness tear in my Left Shoulder and tendonitis, I saw a "sports medicine" doctor today who told me because of the c5/c6 issue, he would not consider any surgery on the shoulder... that I should see a spine specialist and start with the neck. He feels I might not be able to do the rehab from a shoulder surgery if my neck issue isn't resolved. He feels I would have an issue doing the rehab. He also told me that right now tendon is not retracted that far and to be careful with the left side so i don't retract the tendon further. - Just on the surface, do you agree this theory and for a full thickness tear like this is surgery the only answer? I am 48 years old.

Answered by Dr. S K Mishra (56 minutes later)

Brief Answer:
In such cases treatment is followed as top to bottom approach

Detailed Answer:
Hi

As you have described well your problem is not simple and straightforward creating dilemma regarding treatment.

In such cases treatment is followed as top to bottom approach ie neck first then shoulder if required.

From your descrription there looks problem with C56 disc. Now to comment on whether you need surgery for C5 6 PIVD I need MRI images and detailed report. You should also send NCV report if done. One thing you have told that pain is going to hand,so this can not be explained by shoulder problem. You are saying carpal tunnel on basis of NCV or what please send NCV report.
Otherway is you can consult spine specialist.

I hope I was able to answer your query, you can send images of cervical spine for further comments and advice, but right now I agree strongly with your sports medicine doctor. As for my knowledge goes about shoulder every tear does not require surgery but I am a spine and not a shoulder specialist.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. S K Mishra (7 hours later)

I realize you are not a shoulder specialist but I thought when it said "orthopedic" I could get an answer to find out if this type of focal full thickness tear generally requires surgery? It is not that large but they told me to be careful so it does not retract further. Is it possible to have somebody answer that?

Answered by Dr. S K Mishra (10 minutes later)

Brief Answer:
decisions in shouder problems are more taken on basis of clinical findings

Detailed Answer:
While answering first time I already discussed your problem with my shoulder specialist friend Dr Abhik XXXXXXX , what he replied hearing your report
that decisions in shouder problems are more taken on basis of clinical findings and less on basis of radiological findings. He especially commented that you should consult shoulder specialist and get clinically examined to find answer to that.I thought you will be sharing MRI pictures of cervical spine to get an advice on that.

thanks

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

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar