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Excruciating chronic left side neck pain plus lumbar issues
Hi Everyone,
I just joined and this is my first post.
I am a 66 year old male that lives in Melbourne Aus.
Thankfully I found this discussion forum in order to get answers in regards to my deteriorating condition.
For the last 20 years I have been an active sportsman doing long distance bicycle riding and body building, but in the last 9 years I have been hit 3 times (2013,2015,2019) by negligent drivers while riding. These accidents have caused me severe whiplash and a multitude of fractures.
Each time I recovered and went back doing my riding passion.
4 months ago I noticed a pretty strong left sided pain around C6 therefore I went to see physiotherapists and osteopaths. But 4 weeks later at the end of August, this pain got even worse when one night while lying down on my loungeroom carpet, I got up and felt multiple crackles in the spine. It didn't hurt at the time therefore I went to sleep and woke up half hour later in extreme pain going from the left side of my neck, left side of my thoracic spine. I felt as if I was twisted. I was unable to sleep or sit. Standing provided some relief but I couldn't sleep.
Things slightly improved over the next 3 weeks.
I had some MRIs done at the end of August 2022 which showed:
C2/C3:
[No protuberant osteophyte, disc bulging, spinal canal stenosis or
neural foramina stenosis.]
C3/C4:
Minimal broad base central and bilateral lateral disc bulging with
associated minimal right intervertebral foramina stenosis
C4/C5:
Broad-based central and right lateral disc bulging with associated
moderate right intervertebral foraminal stenosis
C5/C6:
Disc bulging resulting in moderate bilateral intervertebral foraminal
stenosis
C6/C7:
Right lateral/foraminal disc bulging resulting in moderate right
intervertebral foramina stenosis
C7/T1:
[No protuberant osteophyte, disc bulging, spinal canal stenosis or
neural foramina stenosis.]
Conclusion:
Multilevel disc bulging and multilevel intervertebral foraminal stenosis. To see the complete reports open the attached PDF.
I contacted TAC which in Australia stands for Transport Accident Commission. They are responsible for paying medical expenses for anyone who has been a victim of a transport accident. Every driver in Victoria pays a premium yearly when they renew their car registration.
I arranged an appointment here to see first and orthopaedic surgeon and then a neurosurgeon. The first specialist told me that I had C6 nerve root impingement and the second specialist reported facet joint syndrome in the neck.
The injury is defined as a mechanical injury.
I noticed a discrepancy between the 2 opinions which left me frustrated. None of the specialists can pin point the exact source of the pain. They both recommended pain management and I am currently on Endep 10, Catapress 100 and Targin 10/5 daily.
Also I was told that no operation for this condition was required and ultimately a fusion, if non invasive, minimally invasive therapies didn't work.
This maybe ok as a temporary solution, but it can't be a life long remedy, because these medicines have side effects and I can't even drive the car to the supermarket when I am drowsy.
In the mean time I had C6 nerve root cortisone injection at the hospital on 1 of DEC 2022, but it didn't work at all after 3 weeks.
I actually have more pain than ever before something like 30% more. I queried the hospital, but they told me that it was done correctly.
Just a few days ago I have had fresh, new MRIs of the cervical/thoracic spine and a bone scan of the whole spine.
Yesterday 23.12.2022, according to the pain management specialist and the neuro surgeon, they couldn't find a lot of difference compared to the previous MRIs taken in August. They were perplexed as to why I feel so much pain. They can't pinpoint the source of the pain.
This is not very re-assuring and I have to keep taking drugs for the next 6 weeks. If I don't take the medication I have extreme, 10 out 10 burning pain that starts around left of neck at C6 going through C7, T1, T2, T3. The pain is also spreading aggressively in the left of my trapezius muscle. I have referred pain in the left shoulder, left scapula, left bicep/triceps and in the little, medium, index finger and left thumb. Referred pain is also felt in the right but not as bad. I also get pain going into my left pec muscle but it is not related to the heart. My cardiologist told that I am fine there even though I can get high blood pressure when I am anxious and stressed out.
To make things worse I have also been getting left/right headaches, left ear ache, left sided head scalp numbness and dizziness from time to time in the last 2 months. Just 2 weeks ago I developed a ringing tone in my right ear which is hypersensitive to sounds. I am a total mess.
The mental depression has been really bad and I have been isolated at home because I am unable to enjoy life like I used to.
Recently when I sit and lie down I feel numbness in my legs and feet. When I stand the problems seems to disappear.
My main frustration is the lack of answers and solutions to fix these problems and two specialists can't agree on a course of action.
I have been doing a lot of research and learned that referred pain can be caused by pressure on neck functional nerves and by facet joints sensory nerves but I don't which one is the culprit. Not even the specialists know.
I am worried that if the compression is not removed in time from those nerves (assuming that it is nerve related) I may get a neuropathy and get paralysis.
My bladder/kidney/liver functions are currently fine.
I don't know if anyone in the Mayo community has come across this and knows something about it.
While searching I found this site which looks promising:
spineconnection org
They can fix a lot of spine related problems.
I haven't received the December MRIs/Bone Scan yet.
Thanks and regards
Alfred
summary of mri xray (summary-of-mri-xray.pdf)
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Hi Jules,
when you are talking about surgery do you mean the full fusion or just foraminotomy?
I would prefer a laminoplasty if it were suitable but I can't find much on this in Melbourne.
Thanks.
My pain management doctor wrote to my GP. He is advising this cocktail of drugs for me.
Is this too much? 🤔
Recent excerpt from my pain management doctor
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ANALGESIA
• Diclofenac 50mg nocte
• Endep 10mg nocte
• Pregabalin 75mg nocte
• Clonidine 50mcg nocte
• Targin 10/5mg nocte
PROGRESS
Today, Alfred reported that current analgesic medicines are providing insufficient benefit (which is in contrast to earlier reports of 75% pain benefit). I have asked Alfred to see you for consideration of increasing Targin to 10/5mg bd, increasing Clonidine to 100mcg nocte, and increasing Endep to 25mg nocte. If increased dose of Endep is well-tolerated, then after 1 week you may consider increasing it further to 50mg nocte. Otherwise, Alfred is awaiting left C5/6 transforaminal injection through radiology services. He has cancelled this procedure on two occasion already because of uncontrollable pain which would prevent him for lying still for the procedure – accordingly, I will write to TAC requesting approval for an anaesthetist to provide sedation for Alfred to receive left C5/6 transforaminal injection .
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This is a good step for you. They’re taking into consideration your degree of pain and they want to provide you with relief so you can move onto the next steps. The inclusion of an anesthesia to help you tolerate the procedure is a plus. They will perform “conscious sedation “ where you will be awake and able to respond to them but hopefully be in less pain so you can remain still for the procedure. If the injection is effective you’ve bought some time, but if not surgical intervention might be next step. You‘ve never mentioned physician therapy? Have they prescribed this for you previously?
Way above my pay grade concerning this decision but you should absolutely be part of the decision making process. If I may ask, in Australia do they cover rehabilitation treatment afterwards and what about home care? You’ll still have limitations on some of your abilities post rehab.
Regarding the laminoplasty as Dr. Su stated not many doctors perform the procedure and living with a government subsidized health plan it might be harder. I googled laminoplasty in Australia and found a couple hits and I don’t think you’ll have any difficulty locating someone. You should look up Globusmedical.com for an in-depth view of the procedure.
Alfred, they are not going to inject you until they find the right spot, the injection is to provide you with anti-inflammation medication directly to the location of the stenosis at the levels you noted. But this is only temporary until they devise a surgical plan if that’s the route you plan on going.
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1 ReactionHi Jules,
What is physician therapy?
Physiotherapy or other?
Sorry I didn’t notice my phone changed it from physical therapy or physiotherapy as you call it.
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1 ReactionHi Jules,
Quote:
Way above my pay grade concerning this decision but you should absolutely be part of the decision making process. If I may ask, in Australia do they cover rehabilitation treatment afterwards and what about home care? You’ll still have limitations on some of your abilities post rehab.
I am not sure what the answer is in regard to your question.
As far as laminoplasty goes I would prefer to go to the US if I were loaded with a lot of money and probably get Dr Su to do it if I qualify.
I am thinking about doing a GoFund me campaign, but I am not sure if I should wait until they perform all the injections first.
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My current pain doctor is part of a group called Neuroaxis
https://www.neuroaxis.com.au
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My current pain doctor's profile:
https://neuroaxis.com.au/profiles/dr-harry-sivakumar
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My current neurosurgeon profile (I only saw him once in November 2022)
https://neuroaxis.com.au/profiles/mr-girish-nair
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The new pain management doctor belongs to group called Precision Brain, Spine and Pain (https://www.precisionhealth.com.au). I have an appointment with him on 6/4/2023.
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Following is the pain doctor's profile:
New pain management doctor profile
https://www.precisionhealth.com.au/about/who-we-are/dr-symon-mccallum
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Neurosurgeon profile
https://www.physio-pedia.com/Cyclist%27s_Neck#:~:text=Neck%20and%20back%20pain%20are,weight%20through%20the%20upper%20limbs.https://www.precisionhealth.com.au/about/who-we-are/professor-richard-g-bittar
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20 years of extreme cycling could have also caused my issues as well as the accidents:
Thank you
Best regards
Alfred
Definitely get the steroid injection to obtain some relief, hopefully. If you get no relief from the steroid injection it is a clinical sign for your treating doctors. Flying to the U.S. for the surgery is rather costly. Why wouldn’t you trust the surgeons you deal with? When deciding who to engage for the procedure find out how many procedures like yours they perform in a year, their success rate and see if you can speak with one or more of their success patients and possibly failures too. If they’re unwilling to offer this to you consider wisely.
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2 Reactions@ab6540183
Alfred,
All of your posts are telling me about constant high blood pressure, and that is to be expected because of the anxiety that you have. Have your medical providers addressed this high blood pressure? This is getting into territory that can get serious and lead to a stroke or heart problems as well as kidney damage if it high over a long period. That's why they call it a silent killer if you don't know it is happening because it may not cause symptoms. The kidneys filter the blood with blood pressure through very small vessels called capillaries formed into a ball called the glomerulus. The kidney is made of a lot of these and high pressure can destroy them and cause capillaries to be lost and the kidneys loose part of their function and become less efficient.
Will you ask your doctors about managing your blood pressure?
At one time, my doctor had prescribed Lexapro for blood pressure, but it is an antidepressant medication. I wonder if this would help you, and if it could be added to your mix? I don't know a lot about medications because I'm not taking much of any of them. I don't have high blood pressure, but that was being caused by stressful situations some years back.
Hang in there as best you can. If you can do the breathing and music therapy and lower your blood pressure, go for it! That worked for me when I was anxious before spine surgery.
Jennifer
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