C5-C6 issue affecting my shoulder?
Hello! According to my MRI, I have a bulge with a small annular fissure (noting it can be symptomatic) at the C5-C6, DDD and a small bone spur causing foraminal narrowing on the right side and foraminal stenosis of the right. I also have some slight reversal of the normal curve that I think has to do with the osteophytic change at the C5-C6 level. I have battled this issue for over 7 years and during that time it has come and gone. It is back and causing some left hand tingles and a bit of numbness, although if you scratch the hand I still have feeling in it and can use it. I also have a painful spot near the shoulder blade and can even get discomfort at the front of the shoulder near the armpit. Most of this is on the left arm/upper back, yet the narrowing is on the right foramen. I don't know if the bulge is centrally located or to one side. I do get a few tingles on the right hand but it's less frequent than the left. For a while now I was chasing the issue of if my left shoulder issue was from the shoulder or the neck. I had a MRI with contrast done on that shoulder and the only thing it showed was a low grade partial tear of the infraspinatus, most likely from weight lifting and just wear and tear being that I am 43. Shoulder doc said that many have these small tears and they do not cause pain. Because of the hand issue and how I did fine with the in-office shoulder manipulation, he feels my issue is from the cervical spine. He didn't even want to try a cortisone injection into the shoulder to see if it would help, noting he really things the shoulder is not the issue. I have had one cortisone injection into the neck without any relief. I am getting a second one next week. I see a neurosurgeon in November. Here is where I get pretty confused. I know the C5-C6 innervates the infraspinatus (ironic that is where my partial tear is) and from what the pain doc noted when getting the first injection, the pain around the shoulder blade is common. Does disc issues like this actually cause the shoulder to not function quite like it should or does it just cause it to hurt? Example: went to physical therapy this morning and had traction done on the cervical spine for the second time. Came home and as I was reaching down to pick up a cat bowl of water from the floor with the left arm I heard a clunk, which sounded like it was coming from the back of the shoulder. Then I felt discomfort in that one spot near the shoulder blade and some hand tingles. Can these disc issues cause the shoulder blade not to work quite like it should? Is the C5-C6 issue what cause this to happen? Because I know there is a low grade partial tear in that shoulder anytime it makes a weird noise or I get an odd discomfort my mind wants to blame it on that even though the shoulder doc says it's not the issue. Kinda of wish I didn't know about it, as it has really been exhausting mentally. I can't stop questioning things. Anyway, was just curious as to how these disc issues/nerve issues actually affect the movement of extremities. I hear people say that the C5-C6 can cause shoulder pain but I've not really heard much about how it can affect the movement of it. Side note, I also have an issue at my L4-L5 and L5-SI. I will be coming to the Rochester Mayo on Oct 1st for the first time to be seen for my PKD/PLD. I wanted to have a specialist there go over my cervical spine and lower lumbar MRIs but from what I was told, you can only see two docs per visit. I have already been scheduled with two doctors for the PKD/PLD so that's my limit. Where I live PKD and PLD isn't as common so traveling out of state for that reason is much more important than having my spine images looked at. Would have been neat though since I will be there anyway. 🙂
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@jenniferhunter THANK YOU for all of this! As I have been researching possibilities, TOS was one that I have been wondering so we are on the same page there. When I see the specialist the first part of November I certainly plan to ask about it. I've even mentioned that one to my husband. He doesn't understand or care to research medical stuff so he usually doesn't have anything to add. None of this was from whiplash or any sort of an accident. I used to be a runner and then when I started having knee surgeries starting in 2008-2016 (lateral release on both knees and then three additional surgeries on the right for scar tissue) I turned to weight lifting. Had a hip labrum repair in 2016 as well so I focused a lot on upper body since lower body was out for a while. Seems everything we do causes neck movement and with weight lifting, it's a given. When I am at Mayo next week for my PKD/PLD I have on my list of questions the lower lumbar issues I have and what role, if any, the PKD/PLD is playing with the disc issues there. I am blessed at this point that I don't have an enlarged abdomen from the disease and actually, am doing pretty well. I do have some large cysts in my liver which is one reason I am coming to Mayo. Liver docs here don't know from it and the two I have seen said there is nothing they can do for me. I do know my liver is big and that is probably pushing on things, with the kidneys could be too. I will slip in the cervical spine issues too. In fact, I was planning on bringing my recent imaging in the off chance they let me meet with someone there in the spine area. I know as far as setting an actual appointment, they would not let me do so UNLESS I met with an internal medicine doc, as that is who I was told they would set me up with if I had more than two issues to be addressed. I would have lost the appointment with the kidney doctor that I have really been wanting to see. Of course the internal medicine specialist probably would have consulted with her or others but I didn't want to risk it. She is the reason I am coming to the Rochester location, as quite a few in a Facebook group I am in for the disease have seen her and rave about her. She's very popular in that group. She is the one that also scheduled me with the liver specialist, as those appointments are pretty much back to back on Tuesday. But yeah, I am not giving up and I will go to specialist after specialist if I have to until I feel like I am being heard and all possibilities are being looked at. I am one that believes we have to be our own healthcare advocate. It would be wonderful if the spine specialist here locally I will be seeing can figure all of this out. This neuroscience center is the best in our state, which is another reason it takes so long to get an appointment there. It is taking me just as long to get in there as it was to get in with the kidney specialist at Mayo. LOL.
How did they repair your labrum? I have a tear in one labrum and detached on the other and my local docs are only offering hip replacement. Really don't want to do that but the groin pain is killing me. Luckily the pain in my back and butt are about 2 points higher on the scale so distract me from it :-).
@feckert52 It was done via arthroscopy. The other hip also has a torn labrum but it is not causing issues so we are leaving it as is. Make sure you find a good orthopedic doctor that specializes in hip scopes if you end up having it done instead of the replacement. Not all are overly good with repairing the labrum via scope, as I think that it's only become more common over the past 12 years or so.
Thank you for the info!!!
@jenniferhunter I still have a few weeks before my appointment with the spine doc. I looked at the links you included and found the training and rehabilitation one very interesting. Although the shoulder on the affected side has had issues in the past, it seems they really flared up when I was in PT for the other shoulder that has the full thickness tear. The physical therapist kept having me do the retract and down with my shoulder blades. I then started doing that when weight lifting and have to wonder if I do have TOS, as from what that article suggests, doing that makes the symptoms worse. I have not been doing any shoulder exercises recently, as I don't know what is wrong and don't want to cause harm. Well this afternoon I did a few external rotations with a stretchy band (physical therapist thought it would be good to do to help strengthen the infraspinatus) and it did not feel good. I had the shoulder blade down and back, as the PT said to do it that way to keep the traps from firing (and I hadn't read the article yet). Caused the spot in the upper back to really ache and even had some aches around the back of the neck. Do you think that movement would cause an issue if it is indeed TOS even if I didn't do the down and back? I keep thinking in the back of my mind that I do have that low-grade partial tear of the infraspinatus and maybe that is why it ached. I iced it but that seemed to make it worse.
The other interesting thing in that article was how raising the arm up can also cause it to hurt worse. I noticed that when I was lying in bed and put my arm above my head while on my back. Do you know if lying on your back would cause TOS symptoms? I noticed sometimes when I am in the recliner it will ache and even bring about muscle spasms, sometimes even on both sides. I will say I am at such a loss as I wait to get in with the specialist here. I need to get it figured out so I can get the right shoulder operated on to fix the full thickness supraspinatus tear. I wasn't having much discomfort with it but for the past week and a half or so I am feeling it in the front of the shoulder. That's the only spot it hurts though.
Mentally, I have not been doing well with this. I keep thinking about the possibility that the left side stuff will be determined to be from the shoulder and that the MRA on it missed something big. The thought of both shoulders needing surgery brings on so much anxiety. Both hurt but in different ways. I wouldn't know which to do first. But, then I have the hand tingles and it makes me think it's not the shoulder…unless I have two separate issues.
I'm also having issues with the left ankle/foot, as it tingles and has on and off for several months. I finally had it looked at and the urgent care doc (couldn't get in with my regular doc) x-rayed it. Nothing found so there isn't a fracture. He suggest an ultrasound (can't remember what it's called but it starts with a M). I am waiting for the scheduler to call to get it set up. I am hoping to have it done and with results before I see the spine doc. I was going to mention it to him. And as if that wasn't fun enough, I am scheduled to have a right knee scope to remove scar tissue on the 8th, just a few days after the appointment with the spine doc. I wanted to get it done before shoulder surgery so at least I could walk comfortably afterwards while I can't do much of anything else. That is why I decided to finally have the other ankle/foot looked at. If there is an issue there and I have to stay off of it, I won't be able to have knee surgery. I know once I have shoulder surgery it will be a very long time before I could get the knee scoped due to having to use crutches for a few days. Knee doc mentioned that. Really wanted to get it done but now I just don't know. So yeah, I am a little stressed with so many uncertainties.
@amywood20 Sometimes we have to take things one day at a time. TOS requires patience for recovery, and there is surgery for TOS, but my doctor advised against it because creating scar tissue there will just add to the tightness that already exists, so I wouldn't assume a diagnosis of TOS would automatically indicate surgery. My therapy is myofascial release for TOS, and some strength training, but limited, so as not to kick up symptoms. I would think that using crutches will hurt in your present condition, so think that over if you really want to do a surgery that will require crutches for a while. Also, don't diagnose yourself. No doctor will want a patient telling them how to do their job. the Mayo doctors can take care of things, and your job is to explain your symptoms. They can easily test for TOS by listening to your pulse in your neck and have you turn your head. When you have TOS along with a cervical spine issue, you have overlapping symptoms.
Yes, you can have TOS symptoms while on your back. It is raising the arm that brings it on. The problem is the front of the chest is too tight and it causes the shoulder blades to wing out. Bad slouching posture causes symptoms too.
The tingling in your leg can be from a pelvis dysfunction and it can seem like a lower spine problem. My TOS causes tightness from my jaw to my pelvis on one side and it causes my pelvis to twist out of shape. You might want to read the training and Rehabilitation article on that. https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
Good luck with appointments.
@jenniferhunter I know, one day at a time. I need to figure out how to get out of my head. That's my personality and once I fixate on something it is hard to put it down, so to speak. The spine specialist I will be seeing is not at Mayo since I live nine hours away but if I don't get answers here, I will definitely go to Mayo. My foot is in the door since I had one of their rehab docs look at my imagines and do a few in office tests. She felt an EMG would be the next step since she wasn't able to draw any firm conclusions. Mayo could have done it a few days later but I was flying back home the next day. We'll see what the spine doc wants to do. My fear is that he will think it's the shoulder. The shoulder doc thinks it's the cervical spine so if that were to happen I am left in the middle. I will say the full thickness tear in the other shoulder feels nothing like the other one. I need to get all of this figured out soon since the full tear is starting to give me grief whereas a month ago it was pretty mild. As far as the crutches, that should only be for a few days and I can start walking normally as tolerated. There isn't a tear or anything to repair as it's just cleaning up scar tissue. I've had it done before but can't remember how much I used the crutches. I want to say not much at all. I do have a walker from a hip scope three years ago and could use it, putting the weight on my hands. Probably not much better but maybe some. I need to dig it out and try. I just know if I don't do it now it will be many, many months before I will be able to due to shoulder surgery. I've been dealing with it for a year and a half already. I'm leaving the door open to canceling it but very well may not. At least it would be one thing fixed I could check off. Thanks for the link and all of your responses!
@amywood20 I understand the frustration of being caught in the middle when doctors think it is something else. I went through that too. I always had a plan B for the next doctor I would try if things didn't work out. I went through 5 spine surgeons who could all read my MRI, but none would help me because they didn't understand how to connect my symptoms to the imaging. Don't stress, just move on and start over with a new opinion if that happens. Things happen in time, and we can't control when it will work out, or in what order or what other thing could change our plans. What seems right at the beginning, may not be, and a new day could bring a different answer that no one thought about before and a better solution. Sometimes you have to choose your priority.
My two years of searching for and not finding help gave me more time to be with my dad as he was dying, and I was taking care of him and my mom. If I had surgery and was in recovery, I would not have been able to be there, and missed the last time with him. It was the hardest 2 years of my life and I was in a lot of pain because I needed spine surgery. Right after my dad passed, I got the call from Mayo for appointments, and I was able to take care of myself. Remember to breathe, and savor every day even when the days are challenging. There is always a lesson there, if you can quiet your mind and listen.
@jenniferhunter I am sorry to hear about your dad. That must have been a very difficult time with all that was going on. My parents also have health issues and it seems my dad ends up in the hospital every winter due to COPD complications. That is why I am living here. The husband is retiring from the military and could easily get quality work as a contractor but it's not here. I don't want to move so that's been a challenge. I know things will all work out in the end. It's just getting to those points. And yes…your story about your dad reminded me of when I broke and said we could move but only three hours away. It was a few years ago and would have had us closer to where the husband was working so that he didn't have to commute. I prayed the house wouldn't sell, as deep down I still didn't want to move. We gave it a few months and then pulled it off the market. A few months later my dad ended up in the hospital. Had it sold I would not have been living here to readily help. But again, thank you for your words. I need to hear this stuff. I am usually one of the most organized, detailed, knows what needs to get done, when and how. This has taken me out of my comfort zone as so much of what happens is out of my control.
@amywood20 I'm sorry I missed your response. I've been traveling and not online.
I know from my own experience with TOS, that overdoing any strength training resistance or weight lifting can kick up the symptoms. I have had the unbalanced chest tightness on one side be enough to cause a functional scoliosis and rotate my chest out of shape. It has caused me to loose complete feeling in my left arm below the elbow on one side of the forearm, and that was only relieved when therapeutic stretching rotated the thoracic vertebrae back in line, and my therapist stretched the tight areas on the front of my chest and neck with myofascial release. I get ribs that twist out of position. I was worried about loosing complete feeling because at the time, I still had spinal cord compression and was still looking for a surgeon willing to help me, so it made that seem like it was spine related, but it wasn't; it was the TOS doing that.
When you describe TOS symptoms laying on your back, that says to me that the front of your chest might be to tight, and that might be what you are feeling. If you stand sideways and look in a mirror, do your shoulders line up under the center of your neck or are they forward? When I first started laying on a foam roller, and stretching my arms out perpendicular to my body, they were so tight, they could not stretch to touch the floor. Doing this over time got them to the floor, and they are even better now because slowly I work at all the tight areas that are resisting that movement.
The ankle pain you mentioned can be caused by nerve compression anywhere along the path to the ankle. It can even be from overly tight muscles in your hips and pelvis. For me, I had a similar pain in my ankle that felt like a dog was biting me that was caused by bone spurs contacting my spinal cord in my neck. I could turn that pain on and off just by rotating my head. That was my first symptom of cervical stenosis before anyone diagnosed the spine problem, and that connection was missed by all the doctors I saw before I came to Mayo as being related to the cervical stenosis. I found medical literature with a case similar to mine, and I wrote to a surgeon at Mayo with that and he took me as a patient.
Here's a link about lots of pelvis alignment issues
Lumbar plexus Compression https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/
I see from the calendar, that you have probably had your knee scoped by now and met a spine surgeon. You do have a lot on your plate right now with possible shoulder surgery too. Any surgery will create scar tissue that will tighten your fascia and can make symptoms worse, and recovery is better when you can stretch this out with MFR therapy. It seems like you may need to choose your priorities of what should be addressed first. If you have TOS, most often MFR therapy is best over a long term because surgery for TOS can create more scar tissue that just adds to the problem. I was advised against surgery for TOS. I know a lot of this can be overwhelming, and the tricky part is when the pain originates somewhere else, and you had all this testing on your ankle. With knee problems, you can have issues with your pelvis and it's alignment which can cause sciatic pain and it seems like a spine problem. That is very treatable with physical therapy and MFR, and I've had pelvis alignment issues too and it all connects through my body as tightness from my neck and chest to my hips and pelvis. You'll need an expert level MFR therapist to figure all that out when you are able to work on it with your doctor's blessings. It takes a lot of patience when you are recovering from surgery and can't do therapy, but it's all part of a good recovery and following post op instructions. I went through that too when I was waiting for my spine to fuse and everything tightened up from surgical scar tissue. Work out your plan and in what order you need to do things to recover. Set your goals, and then you will take baby steps for awhile until you can get there, but you will get there. Believe that, and you can do it. Pay attention and get sensitive to the nuances of your symptoms and your progress. It helps to write it all down so you can chart your progress. You might not be able to continue with weight lifting as a regular routine. You'll need to listen to your body on that after you have recovered from any procedures. Work with a physical therapist and discuss that when the time comes.
As for anxiety, I've been there too. I was terrified of spine surgery, but I worked through that, and facing all my fears and learning from them changed my life. There is always a lesson in the adversity we face if we are open to learning from it. Fear can sneak up on you and be there in the background distracting you in your decision making. I've learned how to manage fear, but I'm not immune to it; I just recognize it sooner now and can take steps toward overcoming it. Just prior to my travels, about the time of your response, I was dealing with a dental issue that sent my anxiety upward again. We all are affected by our fears early in life and the patterns we learn, and I still have work to do. Work out whatever you need to do to ease your stress. For me that was using music and art as therapy.
Hopefully by now you have some more answers, and a better path toward your decisions. Let me know if I can help any further.