Excruciating chronic left side neck pain plus lumbar issues

@jenniferhunter @jm1

Hi jm1,

nice to hear from you again.

How are you?

Now the problem is that I am getting pain on both sides just as bad, but more on the right.
Plenty of referred pain all over the body also due to the impingement of right nerve root in the neural foramina at L2/3, L3/4 levels and potential for impingement at L4/5 level.

The spine is messed up due to all the accidents that I had in the past when riding the bike, drivers' fault.

I feel pain starting from C4 and possibly going up to T5 bilaterally.

Sleeping is impossible. I can't sleep on my left/right side or on my back. Standing is the only position that reduces the pain. When I walk I limp due to the pain in the right lumbar region.

Recently the pain medication is not working at times. For example 2 days ago I managed to sleep well, got up and was feeling nearly normal for the rest of the day. Last night I had a horrible night with a lot of burning pain in that area that I mentioned. Since 2 months ago I developed right ear tinnitus. I already had left sided tinnitus due to an acoustic neuroma and I am basically deaf in the left ear. I have all these stressors which are consuming me.
The classical music eased my mind a bit by distracting me for a while.

I have booked the following based on the DR's requests:
1) cervicothoracic injections based on pain mapping
2)Left C5/6 transforaminal injection to treat bone scan report of increased disc degenerative activity at C5/6 with less-marked disc degenerative activity at C4/5, as well as severe left C5/6 foraminal stenosis.
This will be happening in the next 2 weeks.

I hope that this will help identify the source of the pain. There could be more nerve blocks because pain is a strange beast.

If I have to go to the surgery path, I would prefer an artificial disc replacement (expensive) rather than a fusion which would make me lose quite a bit of flexibility.

If I had fusion does this mean a a 4 vertebrae fusion? Would this would be restrictive?
Would I still be able to drive a car, reverse, tie my shoe lace or cut my toe nails?

Has anyone had a multi level fusion in the cervical spine?

In the latest MRI they detected:

Approximately 2mm retrolisthesis of C4 on C5 and 1.5mm retrolisthesis of the C5 on C6 vertebral body
noted.

C5/6: Spondylolisthesis and uncovering of the intervertebral disc in conjunction with discophytic lipping associated with mild spinal canal narrowing along with moderate left neural foraminal narrowing seen impinging the exiting left C6 nerve root. Mild right neural foraminal narrowing contacting the exiting right

Anyway that's all from me today and that the Lord will look after me.
I am 66 and I have sons and grandchildren that I want to see grow up.

Thank you

Best regards

Alfred

Hi Alfred,
Last I read , The artificial disc for neck or lumbar is not recommended for more than one level. Artifical discs for neck work ok and lumbar they dont , they fail.
There are many blogs to read on Mayo Connect about cervical surgeries and multiple levels. Just go back to the home screen under Spine health. DON'T OVER DUE , being online and typing make you worse.

Glad the classical music helped.
Found great videos on Utube of underwater coral reefs, if you can watch a screen. https://youtu.be/gwZB5j016Es.
Try not to overdue on the days you feel good , as you said "felt normal all day after sleeping good" That was one of my issues, I would feel good and do too much and then feel worse again.

Transforaminal injections are a blessing for me and really work well. Sometimes it takes 2 -3 days sometimes it takes 2 weeks to feel the relief. I got great thoracic relief from intralaminar and epidural injections there.
Be patient with the process. Follow the post injection rules.

I can't cut my toenails so I get medicare pedicures or go to nail salon. Use my mirrors when driving. They make great gym shoes that you can pull the laces with sliding clip or use slip ons. ADAPTATION WILL BE KEY TO YOUR SUCCESS. Nothing will ever be the same, it's up to you to find the workarounds, like I never bend, I squat from my knees, I always move my body so I dont twist, I never extend my arms , it's a neck killer so I keep my elbows glued to waist, I have grab bars in my shower. Once you are less acute , a PT can show you proper body mechanics.
Keep taking your meds on a regular and consistent basis and use the prune juice and milk of magnesia for constipation and Biotene gel for dry mouth and ICE many times per day.
Don't reply to me, just rest.

I desperately need relief from a pinched nerve in L4.
After brain surgery last spring, I was transferred to a rehab for OT and PT to gain strength back in my leg. (Brain surgery causes temporary weakness in one arm and one leg).
I was in this rehab for 10 days and never had nerve pain until the night before I was being discharged. Earlier that day, the PT dept. gave me 3 hrs of PT. They wanted to rack up billing time the last day I was there.
I told them I had severe pain in my groin and it felt like a very tight rope was wrapped around my upper thigh. I thought it was a blood clot and felt like I was sitting on a pile of rocks They told me, it’s just a muscle sprain.
I could not continue with any kind of pt when I went home

I have severe tightness in my
Leg from my groin to my calf.
Shooting knife like pains and burning. Limited range of motion in my leg. Cannot lift leg up to put socks on or put pants on. When I sit or lie down, I feel like I’m sitting on a pile of rocks.
I live on XStrength Excedrin and Tylenol 650.
Pain and tightness has traveled down to my calf too.
Muscle relaxers didn’t work.
My orthopedist has me take MRIs of thoracic and lumbar and that’s where it showed I had a v

Con’d
That’s where it showed I had a pinched nerve in my L4.
Next week, MRI of Femur and lumbar and thoracic again.
Night time is the worst!
The nerve pain accelerates and I cannot sleep on my sides, only my back.
Excruciating pain getting up from bed. Have to urinate many times with such urgency during the night because it’s pressing on my bladder when I’m lying down.
To make matters worse, I have spinal stenosis too.
I’m 73 and don’t know how I’m going to live out my life with this terrible pain.
Next week I’m trying acupuncture.
Would appreciate advice.

Hello Alfred,

I can only speak to your question whether anyone has had a multi-level fusion of the cervical spine. I had C1 through C5 fused on November 25th, 2022 following a body surfing accident. It has been 11 weeks, so I’m fairly new to this.
The fusion has severely affected my capability to drive. I can move my head vertically about 30 degrees, but maybe 10 degrees horizontally. So checking for traffic flow at stop signs is difficult at best. I lift myself out of the seat to turn at the torso when checking for traffic coming from the right and left at a stop sign. I just bought a car with blind spot monitoring to be a bit safer. Otherwise I can care for myself, but have not ventured to bike or play tennis, which are/were my passions. It is not pleasant to have a fixated head and neck but I don’t know how things may improve since I’m only in my 11th week and start PT on Tuesday. Feel free to ask specific questions.

Hi viehberg25,

How are you?

Thanks for the feedback. Hopefully with the physiotherapy and the rehabilitation it may become more flexible in the next few months.

So it feels pretty tight.

Did the doctor warn you about this before the operation?

Has the pain gone at least or reduced a lot?

Currently I have constant pain. My mri shows stage 1 c4/c5 Retrolisthesis and c6 Spondylolisthesis plus have facet joint issues and also in the top of the mid spine. I think I am getting some compression of my cervical spinal cord in some points.

I have been told the fusion is the better option by someone but I am also aware of artificial disk replacement. I watched a good video on laminoplasty but it will be up to the surgeon to decide which is the most suitable.

I fear that I may need a two level fusion. I was hoping that my problem was only at one level.

All the best for you

Best regards

Alfred

Hi Jennifer @jenniferhunter

How are you?

I have been reading your very informative ADR vs fusion posts.

I remember that you said the ADR can have problems (calcification and screws) as well as fusion (Adjacent segment disease).

Obviously it will be up to my neurosurgeon to decide if he will do surgery or not. If he does decide to go ahead with it, he will have to take into consideration my specific, unique condition's factors before he will select one type of surgery or the other.

In my latest cervical spine MRI dated 28 of Jan 2023 the report states the following:

Approximately 2mm retrolisthesis of C4 on C5 and 1.5mm retrolisthesis
of the C5 on C6 vertebral body noted.

C5/6: Spondylolisthesis and uncovering of the intervertebral disc in
conjunction with discophytic lipping associated with mild spinal canal
narrowing along with moderate left neural foraminal narrowing seen
impinging the exiting left C6 nerve root. Mild right neural foraminal
narrowing contacting the exiting right C6 nerve root also noted.

I am no expert, but does it mean that I may need a fusion from C4 to C6?
If so would I lose flexibility? Probably a YES?

I couldn't help noticing that there are some areas pretty close to my cervical spinal cord?
How serious is this?
Some times when I slightly bend I feel pain in the neck then leg and foot for a few seconds before it stops.

I have attached 2 images: Cervical and top of upper thoracic.

What do you think?

Thank you.

Best regards

Alfred

@ab6540183
Good morning Alfred,
In my surgical case, my retrolisthesis was 2mm at C5/C6. My surgeon said he could do an artificial disc there or a fusion, but that I was not the best candidate for ADR because of the slipping. At 4mm of retrolisthesis a patient would be disqualified from a clinical trial for ADR.

From your image, I can see that you do still have fluid space around your spinal cord where you have marked the red arrows to indicate the bulging or herniated discs and the enlarged ligamentum flavum that extend toward the spinal cord. The fluid space in white. The reason you are having symptoms on flexing is because it's like bending a rubber hose with a rope inside which makes fluid space a bit more narrow when you do that. The spinal cord is like the rope that has to move within the space when you bend, and is probably contacting the discs or ligament and generating the symptoms. I had a similar thing when I could bend or turn my head and produce symptoms.

My fluid space was completely gone on imaging, although a neurologist said there probably was still a little bit of space that wasn't visible, but I got to the point where I could flex my neck forward and send an electric shock down my entire body. I was on the surgery list at that time just a couple weeks before my procedure.

If C4 through C6 are fused, you'll loose some flexibility. I have only C5/C6 fused and my range of motion for turning my head is normal. Head turning is mostly C1 & C2, with some help from C3 & C4. If your C4 is fused to C5 and C6, you might loose a little bit of head turning range, but how much is a question for your surgeon. You may not have that range now because of muscle spasms. I cannot touch my chin to my chest anymore, but it is very close.

I hope that information helps.

Jennifer

Thanks for you incredible help.

Last night I could sleep despite the meds. I didn't even get drowsy. My neck was as rigid as a tree trunk.
I felt massive pain going through both sides of the neck, then down in part of my thoracic spine, pain in groin, back of legs, calves, feet, toes. Plenty of refereed pain in left hand fingers. Didn't matter how I turned my body on the mattress. It felt like a biting, burning sensation as if something if pulling hard inside. On top of all this I developed right ear loud tinnitus 2 months ago out of the blu. I don't know if it is caused by the nerves, the medicines that I am taking. I also have ear sound hypersensitivity as of 2 months ago. The pain, the whistling is driving me crazy. I told my pain management doctors and haven't had any response from him. Probably busy making a lot of money. By the way did your fusion resolve your pain? Thank you.
Alfred

I worry about you lifting yourself from the carseat to check for traffic. They make a “lazy Susan” type disk to sit on to allow your body to move without the lifting. I can’t speak to its use or comfort. Early after hip replacement, I used a plastic bag on my carseat which allowed me to move as needed without lifting off the seat. I’d hate for you to cause damage elsewhere with the lifting.

This my first post and my first time reading “mayo connect.” I hope my response is helpful and appropriate! I imagine there are rules and tips I should peruse! Happy healing!