Cervical C5-6 Nerve
Sorry about length, but I just wanted to provide some background, 67-year-old male.
I have had a serious cervical spine issue going on over 16 months, last imaging was August 2023 and consultation with an Orthopedic Surgeon. I had been experiencing a dull burning ear pain that was mostly positional when seated for an extended period. At the time, Orthopedic Surgeon seen most issues in the C5-6 and recommended pain management and consultation with a Neurologist. Unfortunately, I went the Neurologist route first. My actual symptoms were totally ignored.
Now after over a year later, symptoms became even more severe. Was seen by a pain management Dr, without updated imaging, he wanted to address C1-4 without Cervical Radio Frequency Ablation. Did not believe C5-6 would be causing the dull burning ear pain. After going through 2 test lidocaine injections over a 2-week period, I am scheduled for the procedure on Wednesday, October 16. I was concerned as to exactly what was going on in my cervical and on 2 different occasions over the last 3 to 4 weeks, my primary care refused to order any updated imaging, after a third try recently, he was not available, and I talked my pain management Dr into ordering a cervical and lumbar MRI, done on Thursday October 10. Obtained results and Radiologist report the following day. Among other items noted, the following was the worse (copied directly from report:
C5-6: Shelflike posterior disc-osteophyte complex flattens the ventral thecal sac. Advanced bilateral uncovertebral and facet arthropathy causes extremely severe right and severe left foraminal narrowing with severe AP canal stenosis, little to no CSF anterior posterior to the cord. There is mild ventral cord flattening.
This sounds really serious to me; although I must admit that I really do not fully understand any of the terminology. My symptoms have gotten really bad over last 3 to 4 weeks. Difficult sitting, standing or lying down. I am asking the Orthopedic Surgeon that I was seen by last August 2023 to review this MRI. His nurse I spoke with, discouraged Ablation. Considering going to ER on Monday morning, which I have never done in almost 20 years.
Also, depending on who you believe or what you read, I seen literature that compressed nerves can cause chills, restricts blood flow to brain impacting body temperature regulation. I do have severe almost constant chills most when lying down and when I wake up in the morning, but Dr (s) respond to me like I am crazy when I mention it. Dismissed as an undetermined auto immune disease (subject of another group).
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My PT left last year and I have not found a good one. @jenniferhunter it looks like you got lucky. I had sort of given up looking for help and relief but lately symptoms are worse enough to pursue again.
@windyshores Try a search at http://mfrtherapists.com/. These are PTs and massage therapists who trained with John Barnes in Myofascial Release. If a PT has some of these certifications in training with John Barnes, they have some good tools in their toolbox.
@dstone501957 Consider how your spine shifts position between standing or laying down. The spinal cord floats inside fluid and has to shift like a rope inside a garden hose if you bend, that is.... except when the spinal cord is tethered by compression and there is no space left for the spinal fluid. There may be some instability causing a vertebrae to slip past another one that changes when you change position ( called listhesis). It could effectively make your spinal canal smaller because alignment of the "spinal canal hole" is offset, so it narrows the space. That also changes the amount of the pressure on the spinal cord. You must tell this to your spine surgeon about what changes these symptoms.
When my spinal canal was offset (by 2 mm), I had trouble emptying my bladder. I would get half done and it would stop, but I could force it to empty. You have retention until you lay down. It sounds like a more advanced condition to what I had. I was working with a PT who was realigning my spine, and she corrected those bladder issues and my walking with a limp until the next muscle spasm moved the vertebrae and started it up again. That is how I know it was related. I have no problems since my surgery. These problems can become permanent if permanent damage occurs. There was another member on here and his doctors were about to do a colostomy because of severe constipation issues. He didn't know it was spinal cord compression causing it. He was bad enough that he was wheelchair bound and could not walk. Since spine surgery, he began walking again and did not need a colostomy. He was about to go down the wrong path and then he talked to me. Surprise, he did have an un-diagnosed spine problem and I don't know why his doctors didn't question that possibility.
I don't know about your eye, but the optic nerves do not come out of the neck, they are under the brain at the base of the skull.
60% to 65% is not a good statistic for surgical success. With my TOS condition, there is surgery for it with that same statistic and the specialist recommended against it because it could make things worse. I think your orthopedic nurse is giving you good advice. Surgeons are very busy, so she has to get the doctor to look at your imaging around the schedule he already has doing surgery and appointments. You will need some patience, but I think you should have an answer soon about a next step. I am so glad you are reconsidering the ablations. A doctor told you they thought it was Parkinsons. I was told I could have MS, but there was no evidence on imaging of any of that. If they don't know, they take a guess. Arm weakness is related to spinal compression at C5/C6 and I also had that. You need a doctor who knows and does not guess. Do you see how easy it is to get a wrong diagnosis, and perhaps unnecessary treatment that could have an adverse effect? Knowledge is power.
all I can offer is that you have come to the right place and there are advances in science moment to moment so hang in there!
my brother showed me a documentary on James McMan??? Not sure but it was VERY interesting and I believe that his spine may have been affected in the same location as yours - best of relief to you! feel better!
@dstone501957
What you describe as symptoms and what your MRI supports is that you seem to have cervical spondylotic myelopathy which is spinal cord compression injury. You may need to consider cervical spine surgery to relieve pressure from your spinal cord and nerve roots.
I am a 55 year old female and had ACDF surgery on C5-C6 because I was finally diagnosed with myelopathy after seeing multiple doctors for a variety of symptoms (told I had congenital spinal stenosis, degenerative disc disease and I had bone spurs). My symptoms included daily headaches, tinnitus, hearing loss, neck/shoulder pain, swallowing/speaking problems, weakness in arms/hands (dropped things and handwriting worsened), bladder control issues and difficulty walking (felt like I was wearing heavy cement boots). I had to fire a couple doctors that ignored my symptoms and offered no treatment or made me feel like I was a hypochondriac.
After my cervical spine surgery, many of my symptoms improved but I do have some residual symptoms due to delayed diagnosis and treatment. Spinal cord flattening can cause permanent damage so it is important you get a really good orthopedic spine specialist and surgeon to properly diagnose and treat you.
Where can I locate this James McMan Documentary? Is it on a particular streaming service? Thanks for all of your input.
@dlydailyhope I have had a diagnosis of myelopathy for years. The posts by you and by @jenniferhunter about not waiting too long for surgery due to the potential for permanent damage, are concerning. @dstone501957 apologies for inserting myself here but I am at kind of a crossroads as well.
@dlydailyhope do you believe your tinnitus and hearing loss are related to your neck? My neuro keeps making that connection and I have been skeptical. Along with the usual neck symptoms (migration of pain to shoulder, headache, dizziness and so on) I have had a big increase in tinnitus, hyperacusis with facial pain and numbness. Could these really be from my neck? (I am selling a recently purchased condo because noise is making me ill.)
You're fine with your discussion, I too have had severe right ear issues, dull burning pain and loss of hearing in the right ear. All started with an inner ear issue that was largely ignored. The Radiologist's report from my recent MRI on October 10 indicated Sinus/mastoid disease noted. While my most severe cervical issue is at C5-6, the C1-4 impacts the ear the most, but I did come across artificial intelligence (AI) that indicated C5-6 can impact tthe ear. I am also sensitive to loud noises. Little pieces of information obtained and shared are very helpful. It is really difficult when it takes over 2 months to see a specialist and they only give you 10 to 15 minutes of their time.
The connection of neck stenosis with tinnitus/noise sensitivity/hearing loss/ear or facial pain and in my case numbness is intriguing. I cannot get any MD's to connect them except for neuro who is, um, a little laid back (but I have seen him for 23 years so trust his concern). He says I have "made it this far" but am having "increasing difficulty managing pain." Yup. Going to try myofascial release next.
http://mfrtherapists.com/
@windyshores
I do believe my cervical stenosis and myelopathy caused many symptoms that were relieved after I had C5-C6 ACDF surgery. The tinnitus has improved and daily headaches gone. Keep in mind that compression on your spinal cord not only affect signals from brain to body/body to brain to be affected (sort of like bending/constricting a power cord) but it also affects blood flow in your spinal cord which could cause nerve cells to die (from micro compression/injury). I had weird symptoms in my neck after I got 2 COVID shots in 2021 and not sure if it affected blood flow in my cranial nerves at the base of my skull. This happened before my cervical spine surgery which I had January 2021.
I do have idiopathic small fiber neuropathy and not sure if this added to my hearing loss.
My spine specialist surgeon told me that if myelopathy pressure in spinal cord is not relieved, I could have permanent damage. I was able to recover some bladder control and walking improved but I do have some permanent damage that causes weakness and numbness in my hands/arms/shoulders. My diagnosis and treatment was delayed a couple years because I kept getting misdiagnosed and then COVID hit. My suggestion is to have a surgeon listen to all of your current symptoms, do an office evaluation for myelopathy and then review current MRI to determine if surgery would help you and if a more time sensitive case.