Cervical Spinal Stenosis

@kellynormand I also had shoulder pain for a couple of years where I couldn’t lift my arm higher than my chin. My MRI showed bone spur as well. I did PT for 3 months. It temporarily felt good but still couldn’t move my arm. So I saw an orthopedic surgeon. He read my MRI results and xrays and could see that bone spurs were ripping my tendons in my shoulder. I had a minimally invasive outpatient surgery done. I was in at 9:00 and going home by 2:00. Turned out to have multiple bone spurs that he removed. I’m almost out 3 months now from that surgery and have regained total range of motion with no pain. I’ve also been able to return to my regular low impact exercises that I have always done.
I had tried all the PT, creams, rubs and pain pills previously to no avail. I was getting care at a pain clinic and they recommended seeing an orthopedic surgeon because they felt with my lack of motion that there was something going on that needed attention. My PCP had no idea of what to do other than the PT.
I’m 66 years old and am so glad I did this. I really recommend seeing an orthopedic surgeon. I really didn’t want to have surgery either. There are so many minimally invasive procedures now. I had three small 1” incisions with only a few stitches.
Hope this helps, best of luck to you.

Thanks so much for the reply @bonnieh218 I am 59 and have always been very active. Up until this happened I was doing P90X and running on aver 20 - 25 miles per week. I'm so frustrated at not being able to do hardly any of that any more. I'm afraid to run much because of what I've read about cervical stenosis. I guess I really should ask for a referral to an orthopedic surgeon. Thanks again for sharing your experience with me.

@kellynormand I am a Mayo cervical spine surgery patient, and I also have thoracic outlet syndrome. My surgeon is a neurosugeon and also with orthopedic spine fellowship training and is one of Mayos' best.

The pain in your upper chest and pec muscle is a common symptom of TOS and I have had that. TOS is more common in spine patients and a lot of doctors miss it. Usually physical therapy doesn't help TOS, unless the PT knows how to do myofascial release work to stretch the tight fascia that is compressing nerves and vessels as they pass through tight spaces and spasms make this worse. It sounds like you have stenosis at your nerve roots with bone spurs there. I had spinal cord compression with bone spurs and a ruptured C5/C6 disc and had the TOS complications at the same time. I had decompression surgery at Mayo and I am still in physical therapy for TOS which is improving. The surgery made it worse for awhile because of a surgical scar path through the fascia near the problem of entrapment from TOS. It's like wearing a straight jacket.

If you can come to Mayo, they are good at diagnosing TOS. Your symptoms could be more from TOS than the spine at this time. A neurologist can help figure that out. If you can come to Mayo for that, I would recommend it. Let me know if you have more questions. I would investigate TOS as a possibility, if yes, get a good PT and do myofascial work to see of you improve, and work with a spine surgeon who understands both of these issues (like mine if you are able to come to Rochester). He wouldn't jump in just to do surgery, and you would get an honest evaluation. If you look at your imaging, look for the fluid space around your spinal cord. With stenosis in the central canal, if you see no space (white space) around the cord, it will get compressed. That was my situation. If you do still have space where your cord can move with your body position, it is not as bad. If you do need spine surgery, and if you have done a lot of MFR work, it will give you an easier surgery because tissue will be more mobile. Here's my story https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

TOS causes tingling in the pinky from the ulnar nerve. It is a compression in the chest between the collar bone and ribs, or from tight scalene muscles in the neck, and there is a compression point under pectoralis minor in the chest. My PT does myofascial release work to stretch the front of my chest and neck, and exercise to strengthen the back and muscles around the shoulder blades. TOS is a positional problem. When you read or type, your head is likely forward and shoulders moved forward which puts pressure on the compression points. Sleeping does this too because of raised arm positions. One test for this is the doctor raises your arm in a bent arm position and checks for your pulse to stop, and also when turning your head. A lot of doctors miss this and don't understand TOS because it's glossed over in med school (per my neurologist). Specialists in TOS are usually at university teaching med centers that treat it (check on website for conditions treated). If you have more questions, I'd be happy to answer.

Here is some information for you about TOS and MFR.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

Directory search for MFR therapists on myofascialrelease.com
https://www.mfrtherapists.com/app/interim.asp

Problems that MFR helps
https://myofascialrelease.com/about/problems-mfr-helps.aspx

Use Fascia as a Lever John Barnes
https://myofascialrelease.com/downloads/articles/FasciaAsALever.pdf

Lumbo Sacral Decompression video with John Barnes
https://www.youtube.com/watch?v=g9v7hzr_IqE

Therapeutic Insight: The John F. Barnes' Myofascial Release Perspective—Rufus, the Cat
https://www.massagemag.com/therapeutic-insight-the-john-f-barnes-myofascial-release-perspectiverufus-the-cat-12559/

There's the Rub
https://myofascialrelease.com/downloads/articles/TheresTheRub.pdf
Therapeutic Insight: The Myofascial Release Perspective—Myofascial/Osseous Release
https://www.massagemag.com/therapeutic-insight-the-myofascial-release-perspective-myofascialosseous-release-7597/

Therapeutic Insight Articles
https://myofascialrelease.com/resources/therapeutic-insight.aspx

I would definitely see another Dr. I stayed with a Dr I liked for years only to find out later he did me no good at all. Sorry to hear your going through this.

I have experienced debilitating nerve pain shooting through my entire right arm to the tips of my fourth and fifth fingers for over 3 weeks, doctors have yet to diagnose. In addition to that shooting pain, I have a constant ache in my right scapula area that transfers to my chest, as well, as discomfort and pain when turning my head to my right shoulder. An MRI has been ordered, but due to the holidays and waiting on insurance approval, it’s not yet scheduled. Doctors have prescribed gabapentin, tramadol, and I am currently finishing up a Medrol Pack. My orthopedic physician, specializes in hand and arms, so I have been referred to a spinal surgeon. While I wait for MRI, can you share your thoughts with me? I am desperate for relief of the excruciating, shooting pain throughout my entire right arm.

@franmarz Welcome to Connect. I know it is difficult to be in pain, and sharing knowledge with others can help you get control of your health and advocate for what you need with your doctors. I have had a spine problem with cervical spinal stenosis, thoracic outlet syndrome, and carpal tunnel syndrome affecting the same arm at the same time. I did have a C5/C6 spinal fusion surgery at Mayo that relieved the spine generated pain and dysfunction.

Questions like these can help your doctors figure out where the issues are. How did your pain come about? Did you have a recent injury or fall? Is this a new pain or something that you've had before? Have you ever had a whiplash?

All the symptoms you mention could be associated to thoracic outlet syndrome, or a spine problem with nerve roots getting pinched, spinal cord compression, or compressed nerves further down the pathway to your arm and hand or any/all of the above. The MRI should show something if it is a spine problem and they are looking at your neck. If it is TOS, often that doesn't show on an MRI. That is a compression of nerves after leaving the spine that happens between the collar bone and rib cage. I have had times when I could not turn my head because of TOS. Has this changed your breathing or your heart rate? Do you also have neck pain?

Do your symptoms get better or worse when you lay down? Does your hand turn bluish and get cold? When did this problem start? Was there an event that started it, and was there any sound associated with that in your neck? Does an ice pack or a heat wrap help the pain?

When you have shooting pain like a burning stabbing electric pain, that often is a sign of a nerve compression. Nerves travel through some pretty small spaces in the body. Does it help to prop up your arm of support your neck and not move? Does change of body or neck position increase or decrease your pain? Does bending your elbow or wrist increase the pain? Do you have headaches, and where? Are there other symptoms that I didn't ask about?

Have you looked up the spine surgeon that you will be seeing?

Thank you for your reply, this is all very helpful.
Since posting yesterday, I have been able to confirm MRI C1 - T1 on Thurs 1/5/23 morning. It is difficult to type and I had a headache yesterday, so I waited to reply. Concerning questions in your reply:
1. How did your pain come about? While addressing a partial tendon tear near my Rt elbow with PRP, I started to experience tingling throughout my Rt arm. Every day the tingling got stronger until I wasn't able to function due to extreme nerve pain in whole arm and intense ache in all arm joints.
2. Did you have a recent injury or fall? Not recently.
3. Is this a new pain or something that you've had before? Never had this before.
4. Have you ever had a whiplash? Yes, very bad whiplash while in high school 1975-76 (gymnastics fall) that was only treated with collar and Tylenol 3.
5. Has this changed your breathing or your heart rate? Yes, I have times of elevated temperature (hot and cold sweats), with increased heart rate, and labored breathing.
6. Do you also have neck pain? Only when turning my head to the right, looking over my shoulder. I've been applying cold gel packs to my Rt scapular area whenever possible during the day and pretty much every night, that helps me to fall asleep.
7. Do your symptoms get better or worse when you lay down? Cannot lay flat, need to elevate my upper back, neck & head. But laying down does not change the symptoms.
8. Does your hand turn bluish and get cold? I did notice my hand being somewhat bluish, but I've been living with a heating pad wrapped around my arm, elbow to hand, so not sure if it was colder.
9. When did this problem start? Thanksgiving weekend.
10. Was there an event that started it, and was there any sound associated with that in your neck? Not that I recall. It started slow with only tingling.
11. Does an ice pack or a heat wrap help the pain? Ice seems to sooth my back and heat soothes my arm, but pain is still present.
12. Does it help to prop up your arm of support your neck and not move? Yes, I've been resting my arm on a pillow next to me with another supporting my head, and I limit movement.
13. Does change of body or neck position increase or decrease your pain? Both, depending on the movement.
14. Does bending your elbow or wrist increase the pain? It did increase the pain, but now after Medrol Pack, it only increases the tingling...and this morning my last 3 fingers (middle, ring, pinky) have stiffness and locking when typing.
15. Do you have headaches, and where? Yes, around my forehead and the top of my head.
16. Are there other symptoms that I didn't ask about? Yes, just the finger stiffness and locking that started this morning, mentioned in #14. I've also felt nauseous since this all began, more so the last 3 weeks, so I've lost my appetite...and lost 6 pounds.
17. Have you looked up the spine surgeon that you will be seeing? Yes, and I feel good with him but haven't met him yet. I also have a friend who is a spinal pain management physician in the same practice who is tracking with me and will review the surgeon's notes after the 1/10/23 visit. If I can find help/healing without surgery, that's my preference.

Thanks again Jennifer, I truly appreciate your input.