Thanks
Physiotherapist
If no prior neck injury that could suggest any possible cervical disc/joint trauma resulting in spinal nerve impingement, with your description and response to treatment on your neck (ineffective), it's quite straight forward that you've developed carpel tunnel syndrome. Other possible causes are far less likely unless you are assessed for but cleared of carpel tunnel syndrome. I would suggest you see another physio for 2nd opinion because at the end of the day, only physio and surgery can address carpel tunnel syndrome, but you don't want to delay it to the point that surgery becomes unavoidable. I hope this helps
You must be a HealthShare member to report this post.
to your account or now (it's free).HealthShare Member
After stuggling with pain for about 10 months and several physio visits, my GP finally ordered for a MRI of cervical spine and here are the results.
Symptoms were Tingling and pain in both the arms and fingers. I am going to see my doc again in 2 weeks but great if any thoughts around how serious this issue is and what are the possible treatment options. Any suggestions is much appreciated.
Findings
There is loss of the normal cervical lordosis with a slight kyphosis present centred on the C4-5 disc. At C3-4 there is loss of disc signal and height. There is a diffuse disc bulge present more prominent in the left lateral position but no significant foraminal stenosis. No central canal stenosis.
At C5-6 there is also loss of disc signal and height with mild bulging of the intervertebral disc. Due to a combination of uncovertebral osteophytes and some facet joint productive changes there is moderate left foraminal stenosis with mild narrowing only on the right. Despite this there is no evidence of nerve root compression.
The remainder of the cervical intervertebral disc demonstrate normal signal in appearance. The cord is of normal signal and appearance. No abnormality is seen at the craniocervical junction.
Impression
Cervical spondylosis at C4-5 and C5-6 with mild left foraminal narrowing at C4-5 and moderate left foraminal narrowing at C5-6 with mild foraminal narrowing on the right at this level.
You must be a HealthShare member to report this post.
to your account or now (it's free).Agree
Thanks
Physiotherapist
Just to give you some idea:
1. moderate foraminal stenosis at the age of 30 is not a good thing, coz degeneration is a continuous progress, severity of stenosis will gradually worsen.
2. Cervical kyphosis may be reversed to 'a degree', but it won't be siginficant, coz as a grown up adult, length and tension of all the connecting muscles and ligaments are relatively fixed.
3. again, tingling in hands may or may not be neck related, it needs to be assessed to see whether it matches dermatome mapping.
4. If you have already seen different physio for second opinion and that provided you no relief, then the next step will be cortisone injection +/- pain control by stronger medication, and if that fails too, then depending on surgeon's assessment, you may be offered a choice for operation.
Your issue is getting more specific and it will be inappropriate to give more specific advice without proper assessment. Healthcare isn't black and white, same conditions on different people would have different response to same treatment. Hope you will get better soon, best of luck
You must be a HealthShare member to report this post.
to your account or now (it's free).HealthShare Member
Hi Doc, Thanks for answering patiently to the questions. I have now started stretching and exercising regularly and the pain cycle/frequency has reduced from every week to a 3 week cycle. I have also got the RH factor tested and it has come negative. All the other blood numbers looks normal.
Also, I have had the nerve conduction test on my both arms and they look normal as well.
The pain specialist I am seeing (one of the best in the country) has shrugged off my case saying its very minor and he stills believes its occupational overuse syndrome.
I am also getting dry/blurry eyes whenever I get pain in the fingers. Could issue with the c4/c5 discs can also cause eye issues?
Looking forward to hearing from you and thanks for your time
You must be a HealthShare member to report this post.
to your account or now (it's free).Thanks
Physiotherapist
Hi Srini.
It's difficult to make a conclusive view on conditions that I didn't assess, but honestly, neck and arm aren't really that challenging to diagnose. Once correrctly diganosed, depending on whether it's permanent damage or not (disc damage is permanent, but what causes pain in your fingers still needs a proper diagnosis, which I emphasized before) and how physio implement treatments (every physio has his own method of treatment approach based on his clinical experience), it really shouldn't take long for you to see the result.
and yes, blurred vision can 'sometimes' be caused by neck problem, but depends on case to case. You can't just say every blurred vision in a person with neck pain is all caused by his neck problem.
You should really search and find an experienced physio, otherwise all this time and money wasted, and still not moving forward after months of stress. Our discussion will not help you make progressive improvement, as my advice can not be converted to treatments without assessing and treating you. You should refer your queries to your treating physio, coz only he can give you a definite answer after assessment. If there is no improvement seen and your treating physio can't justify why you need to return for review appointment, then you obviously want to get a second opinion.
You must be a HealthShare member to report this post.
to your account or now (it's free).Thanks
Massage Therapist
There are no dates on post on this site! Not sure how long ago the question was asked and answered.
It's possible that the nerves for the fingers can be very slightly impinged anywhere from the neck to the wrist, including at the elbow. Tight pecs, traps, front deltoid are some common muscles. Make sure your elbow isn't wresting on a hard surface, and that your wrists have a soft support for keyboard use. When your sitting at your desk think about where your shoulder blades are, squeeze them together a few times. Shoulder often are hunched up and forward. Your head should be above your body, use a mirror to check your actually doing this. Your computer monitor should be high enough so that you look across at it, and it should be close enough to allow you to easily read from the screen. Do the stretches your physio gave you regularly.
You don't have to have perfect posture all day, but each hour you should bring it back to an ideal position. Move your shoulders up and down, and back. Start to become aware of when your tired or stressed what your body does, do you lean on the desk and hunch forward.
Try all these things. It won't improve instantly but if you keep up with it, your likely to see some results (since you mentioned that stretching helped).
You must be a HealthShare member to report this post.
to your account or now (it's free).HealthShare Member
Thank you for taking time to respond. Last 3 months I have seen improvements as I am exercising reguarly (Running and Light weights and stretching). What i have noticed is as long as I am constantly monitor my posture and exercise, I do not get any pain. But, as soon as I dont exercise for couple of days or not maintain posture for few hours, it comes back. Just a bit scared, as I am reading it can only get worse(stenoisis) and these is no cure :(
You must be a HealthShare member to report this post.
to your account or now (it's free).Thanks
Massage Therapist
Not really. Things that could make it worse might be a lot of weight gain or bone degeneration. For women fluid retention during pregnancy can be an issue.
Keep a mirror or something reflective on your desk to look at how your sitting. Learn to become aware of what you do with your body when something is difficult or your tired. You don't have to have perfect posture all day, but gradually you want to have mostly balanced (head above body, not in front of body).
Also outside of work hours you might not realise your doing things which agravate the feeling in the hands, maybe texting or tablet use sitting in a sofa. You don't have to not do that but just be aware of hours spent in the day, where your sitting, not moving much and the position irritates your hands and wrists. Being up and walking and moving all your body regularly reduces hours spent in a position causing discomfort.
When they do autopsies on people they often find all sorts of non ideal bone placement and compressions that apparently never caused the person pain or complaint. The body mostly is super adaptive. People can have really severe scoliosis and some of them get along fine.
You must be a HealthShare member to report this post.
to your account or now (it's free).