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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Pain Neck, Shoulder, Arms Due To An Accident. Done With Acupuncture And Physiotherapy. Treatment?

Hi. I had a car accident 5 years ago and since then I started gettin neck pains. I ignored them at first but slowly my shoulder was also aching along with pain down my left arm. The pain is so severe I had to leave my job. I also get pins and needles in my arm, my arm goes numb a lot too and I am unable to do any simple chores. the pain gets worse at night and I can't sleep. My shoulder blades are very sore too. Can u please tel me what it may be? I have been to doctors, physio and Accupuncture and nothing helps.
Tue, 24 Sep 2013
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Spine Surgeon 's  Response
Hi
Thank you for your question to HCM.

The symptoms you have described are of cervical spondylosis. The process of degeneration in the intervertebral discs and joints between the neck vertebrae lead to this problem. Bulging discs, bone spurs and thickened ligament narrow the spinal canal and compromise the space available for the nerves and eventually the spinal cord causing the nerve and cord compression.

First thing I would suggest is getting Xrays and MRI of the cervical spine since you have been suffering from all this for so long. The MRI will point out the areas of narrowing. The treatment for such problems is

1 Pain killers like ibuprofen, meloxicam and tramadol.
2 Correct posturing of the neck and lifestyle modification e.g. avoiding sitting in front of a computer continuously for a long time.
3 Soft collar for the neck is supportive.
4 Muscle relaxants cyclobenzaprine or tizanidine help relieve muscle spasms.
5 Nerve specific medications like pregabalin and gabapentin.
Regarding these there is no fixed formula and all can be tried in combination.

Depending upon the MRI findings local injections in spine under image guidance by an experienced pain specialist are helpful if all the above measures fail to relieve the pain adequately.

Hope this is helpful. I would be happy to answer any question you may have.
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Hi, thanks for writing to HCM.

Based on your description, I suspect that you might have suffered a traumatic disc rupture causing compression over the nerve roots resulting in pins and needle sensation along with numbness.

An MRI scan of the cervical spine will diagnose the condition.

The general conservative line of management of this condition involves -

- Use of Soft Collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement.

- Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

- Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time.

- Physiotherapy: Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful

- Epidural steroids: are useful for patients with severe radicular pains in the limbs

If your symptoms are not improving , then you may need a surgical decompression of the involved disc.
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Physical Therapist or Physiotherapist Mathew Varghese's  Response
Hello,You have not mentioned your age nor Profession.Physiotherapy done in a Scientific manner under the guidance of a expert physiotherapist can help to solve your problem. Anyway clinical evaluation is a must before starting therapy.Postural corrective therapeutic exercise, strengthening exercises to muscles around the neck and shoulder girdle and deep heat therapy can be added.
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Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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Severe Pain Neck, Shoulder, Arms Due To An Accident. Done With Acupuncture And Physiotherapy. Treatment?

Hi Thank you for your question to HCM. The symptoms you have described are of cervical spondylosis. The process of degeneration in the intervertebral discs and joints between the neck vertebrae lead to this problem. Bulging discs, bone spurs and thickened ligament narrow the spinal canal and compromise the space available for the nerves and eventually the spinal cord causing the nerve and cord compression. First thing I would suggest is getting Xrays and MRI of the cervical spine since you have been suffering from all this for so long. The MRI will point out the areas of narrowing. The treatment for such problems is 1 Pain killers like ibuprofen, meloxicam and tramadol. 2 Correct posturing of the neck and lifestyle modification e.g. avoiding sitting in front of a computer continuously for a long time. 3 Soft collar for the neck is supportive. 4 Muscle relaxants cyclobenzaprine or tizanidine help relieve muscle spasms. 5 Nerve specific medications like pregabalin and gabapentin. Regarding these there is no fixed formula and all can be tried in combination. Depending upon the MRI findings local injections in spine under image guidance by an experienced pain specialist are helpful if all the above measures fail to relieve the pain adequately. Hope this is helpful. I would be happy to answer any question you may have.