Through many late nights combing the internet for any clues as to where my pain is referring from, I have stumbled across this site many times. It appears this is a very large community with great resources so I’m hoping someone here may have an idea as to what is going on with my neck.
I am a 30yo Man and I have been suffering neck/upper back pain for the last 19 months. I am unsure wether the source of my pain is due to a specific incident or wether it is congenital. I have a lot of information to put forth so bear with me while I try and organize it as best I can.
I have had forward posture most of my life. Standing up straight was always uncomfortable. 19 months ago I found that if I stood up straight with my shoulders back, I could only tilt my head back a couple of degrees before a pinching feeling on the right side would shoot through my shoulder and down to my elbow. The same pain can be acheived if I stand up straight and move my neck and head straight back on a horizontal axis or if my head is pushed downward towards my shoulders. 12 months after the onset of original symptoms the pain has now spread below my cervical spine area to between my shoulder blades (rhomboid area). The feeling as if someone is shoving a broom handle under my scapulae. Hunching forward is the only relief I can get for my neck pain, but it worsens my rhomboid pain. Sitting up straight fixes the rhomboid pain but increased the neck pain and also radiates pain onto my chest just below my collarbone and around my sternum. If i lightly press on the left side of the C6 and C7 spinous process, I get an electrical shock that runs out to my left shoulder blade and down to my rhomboid area. the spinous process of T3 is tenter to the touch.
History of treatment:
In the last 19 months I have seen a Chiropractor 12 times.
In the last 19 months I have had 3 runs of physical therapy at 7 sessions each.
MRI CSpine - Nov 2014 (1.2T)
C3-4 Minimal bulge and right uncovertebral osteophyte with moderate foraminal narrowing.
C4-5 Minimal bulge and left uncovertebral osteophyte with moderate foraminal narrowing.
C5-6 Bilateral uncovertebral osteophytes. Mild facet osteoarthritis.
C6-7 Mild facet osteoarthritis.
MRI TSpine - Feb 2015 (1.2T)
Small central protrusions T8-9 through T10-11.
MRI LSpine - Feb 2015 (1.2T)
L4-L5 broad-based posterior disc bulge with mild bilateral foraminal stenosis.
**Consult with Neurosurgeon - Apr 2015**
Ordered following CT scan and X-rays. Said no significant problem seen and referred to pain management.
CT CSpine - Apr 2015
C3-4 Mild bilateral right greater than left uncovertebral joint hypertrophy causing mild right greater than left neural foraminal stenosis.
C4-5 Mild left neural foraminal stenosis due to combination of uncovertebral joint hypertrophy and mild hypertrophic facet disease.
C5-6 Mild left greater than right hypertrophic facet disease is present, however predominantly posteriorly. Mildly hypertrophic right uncovertebral joint is contributing to moderate right neural foraminal stenosis. Mild left foraminal stenosis.
XRAY CSpine Flexion & Extension Apr 2015
**Consult with Orthopedic Surgeon - June 2015**
Agreed with previous neurosurgeon that no significant problem is seen but strongly advised against pain management.
**Consult with Neurosurgeon out of area at a major university hospital - September 2015**
Ordered the following:
Cervical Epidural C5-T1 - September 2015
Results: No change.
Claimed problem was pinched nerves in neck and wanted to implant spacers at C3-4 and C4-5 - Surgery put on hold to seek additional opinion before committing.
**Consult with Orthopedic Surgeon - October 2015**
MRI CSpine - Oct 2015 (3.0T)
Desiccation and mild loss of height at C3-4 and C4-5
Central Canal stenosis (congenital) 12mm @ C3
C3-4 Right greater than left uncovertebral osteophyte. Moderate right foraminal narrowing.
C4-5 Bilateral uncovertebral osteophytes. Mild bilateral facet osteoarthritis. Moderate left and mild right foraminal narrowing.
C5-6 Diffuse bulge asymmetric to the right mildly narrows the right lateral recess. Uncovertebral and facet hypertrophy moderately narrows the left and mildly narrows the right foramen.
C6-7 A small focal protrusion is present in the central canal zone, eccentric to the left. Mild central canal and left lateral recess narrowing.
The first MRI of my CSpine, TSpine, and LSpine were ordered by my PCP. She then referred me to a Neurosurgeon who claimed he didn’t see anything in me that was worth him treating. My PCP then referred me to an Orthopedic Surgeon but because I live in a somewhat rural area, he worked with the Neurosurgeon I previously saw and had the same opinion as him. Upon seeking a consult out of the area, I found a Neurosurgeon that said he could treat me and ordered a cervical epidural from C5-T1. This had no change at all. Upon consulting with him again, he then wanted to put spacers in at C3-4 and C4-5. Before committing to the surgery I sought out one more opinion and found an Orthopedic Surgeon out of the area. This doctor felt very confident about giving me treatment and had me get a new 3.0 Tesla MRI and subsequently ordered a transforaminal epidural at left C6-7 and right C5-6. Both epidurals had no change to the inability to tilt my head back, the pain in my neck, upper back, right arm, or chest. On my most recent visit the doctor ordered one more transforaminal epidural (my 4th in 3 months) at right C3-4. This is the first epidural that has alleviated some pain. I am now able to tilt my head back but over the course of the day the pain will slowly return. The upper back, shoulder, and chest pain still remain.
The doctors I have seen look at my scans and are just confused at how much pain I am in. Seeings I have had 4 epidurals in the last 3 months and that is usually the max for a year, I am now left unknowing what to do without the ability to have another for diagnostic purposes. The frustrating part is that it was only my last one that I felt finally got close to the source of the problem. I know this is a lot to throw out there but I am hoping someone might have some insight on where this pain might be coming from.
Thank you so much in advance!