Excruciating pain from cervical (C7/T1) radiculopathy

Posted by mlerin @mlerin, Nov 4, 2019

I've been in excruciating pain in the right shoulder and throughout the arm and hand for months. MRI diagnosis is C7/T1 and C6-C7 severe foraminal narrowing and stenosis. Had a cervical epidural injection last Thursday and so far no relief. Is prolotherapy or PRP a good option? Any other non-surgical treatments out there that actually work?

@birdman518

Thanks again… does denial work as a strategy? 🙂

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Denial is a losing strategy… go for it ASAP…. to take good photos your arm must be steady.. Ken

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@birdman518

I recently posted about my experiences with realizing that I have (99% probability) cervical radiculopathy, plus possible ulnar nerve damage that causes pain and tingling from my neck down to my right hand. All fingers are affected, but mostly my thumb and index finger.

But the most pain I have is in my shoulder. I have assumed this was related to the neuropathy, but then I realized that the amount and intensity is almost the same as when I had a rotator cuff injury from playing tennis… probably at least 15 years ago. But I have not done anything like that to cause that problem to recur.

Does this sound to anyone here like it is part of the nerve issues? Has anyone with C6/7 nerve pain had shoulder pain?

Thanks,

Mitch

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@birdman518 I had a collapsed C5/C6 disc which did cause pain in my shoulder blade area. I also have thoracic outlet syndrome (TOS) which also affects that, and TOS does also cause the ulnar nerve to be affected. You can have issues in all of those areas adding to your pain, and it is important that your doctors figure out where your pain is coming from because surgery in the wrong place isn't going to help the entire problem. It could solve part of it and leave another cause undiagnosed. I had that situation where carpal tunnel surgery didn't fix my issues because they missed TOS. Did your neurologist discuss TOS with you? It is often misdiagnosed and missed and the doctors who are familiar with it are in paces where TOS is treated. Physical therapy helps TOS. My disc had collapsed about 50% and I also had bone spurs pushing into my spinal cord. My nerve roots were fine, no compression, but because the vertebrae were much closer together, if I side bent my neck. I sent some major pain down my arm. I had a C5/C6 fusion which resolved my spine issues and I still work on the TOS in therapy. A surgeon even told me that the shoulder pain was related to the cervical disc issue. You should ask about TOS. There are some arm nerve entrapment issues in the arm too where bending stretches the nerve that have some surgical options. Try to find out why your doctors think the problem is in your arm. That pain can be generated anywhere along the nerve path from the spine, the nerve roots, through the shoulder (where TOS can compress it) and in the arm. It could be all of those issues or just some of them. The doctors need to figure that out. Her are some links about TOS.
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

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@jenniferhunter

@birdman518 I had a collapsed C5/C6 disc which did cause pain in my shoulder blade area. I also have thoracic outlet syndrome (TOS) which also affects that, and TOS does also cause the ulnar nerve to be affected. You can have issues in all of those areas adding to your pain, and it is important that your doctors figure out where your pain is coming from because surgery in the wrong place isn't going to help the entire problem. It could solve part of it and leave another cause undiagnosed. I had that situation where carpal tunnel surgery didn't fix my issues because they missed TOS. Did your neurologist discuss TOS with you? It is often misdiagnosed and missed and the doctors who are familiar with it are in paces where TOS is treated. Physical therapy helps TOS. My disc had collapsed about 50% and I also had bone spurs pushing into my spinal cord. My nerve roots were fine, no compression, but because the vertebrae were much closer together, if I side bent my neck. I sent some major pain down my arm. I had a C5/C6 fusion which resolved my spine issues and I still work on the TOS in therapy. A surgeon even told me that the shoulder pain was related to the cervical disc issue. You should ask about TOS. There are some arm nerve entrapment issues in the arm too where bending stretches the nerve that have some surgical options. Try to find out why your doctors think the problem is in your arm. That pain can be generated anywhere along the nerve path from the spine, the nerve roots, through the shoulder (where TOS can compress it) and in the arm. It could be all of those issues or just some of them. The doctors need to figure that out. Her are some links about TOS.
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

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Thanks for your detailed explanation. I will bring all of this up to my neurologist when I see him again. I have a pacemaker, which limits my ability to get MRIs, and I am worried that will inhibit my attempts to get the exact cause.

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@birdman518

Thanks for your detailed explanation. I will bring all of this up to my neurologist when I see him again. I have a pacemaker, which limits my ability to get MRIs, and I am worried that will inhibit my attempts to get the exact cause.

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@birdman518 The tests for TOS do not need to be MRIs. At Mayo, they confirmed my TOS with small blood pressure cuffs on my fingers and had me move my arm into different positions. They also did doppler readings to see how blood flow changes with different arm positions and with turning your head. The doctor also listened to my pulse in my neck and had me turn my head. What happens is that cuts off blood flow with raising your arm or turning your head. There are several places of compression with TOS between scalene muscles, between the collar bone and rib cage, and under pec minor. I did have an MRI years ago that showed some inflammation in the area where the brachial plexus (nerve bundle) passes through the thoracic outlet. There wasn't a lot visible on the MRI, so the diagnosis is made through testing and exams. If your neurologist doesn't seem familiar with this, you need to get an opinion somewhere else where there are specialists for TOS. If your doctor has confirmed a nerve problem in your arm that is urgent, you can wait on testing for TOS. I wanted you to be aware that it's possible to be misdiagnosed which could put you through an unnecessary surgery that doesn't fix the problem. I read that TOS patients can go many years before getting a correct diagnosis and I was blamed for malingering after carpal tunnel surgery by a hand surgeon who missed it completely. It is glossed over in medical school (according to my neurologist) in a day and many doctors think it is rare. It's not rare, but getting the correct diagnosis can be. It can be caused by a whiplash and for that reason it is probably more common among people with spine issues. You might want to search for some providers who treat TOS in your area so you are prepared just in case.

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@jenniferhunter

@birdman518 The tests for TOS do not need to be MRIs. At Mayo, they confirmed my TOS with small blood pressure cuffs on my fingers and had me move my arm into different positions. They also did doppler readings to see how blood flow changes with different arm positions and with turning your head. The doctor also listened to my pulse in my neck and had me turn my head. What happens is that cuts off blood flow with raising your arm or turning your head. There are several places of compression with TOS between scalene muscles, between the collar bone and rib cage, and under pec minor. I did have an MRI years ago that showed some inflammation in the area where the brachial plexus (nerve bundle) passes through the thoracic outlet. There wasn't a lot visible on the MRI, so the diagnosis is made through testing and exams. If your neurologist doesn't seem familiar with this, you need to get an opinion somewhere else where there are specialists for TOS. If your doctor has confirmed a nerve problem in your arm that is urgent, you can wait on testing for TOS. I wanted you to be aware that it's possible to be misdiagnosed which could put you through an unnecessary surgery that doesn't fix the problem. I read that TOS patients can go many years before getting a correct diagnosis and I was blamed for malingering after carpal tunnel surgery by a hand surgeon who missed it completely. It is glossed over in medical school (according to my neurologist) in a day and many doctors think it is rare. It's not rare, but getting the correct diagnosis can be. It can be caused by a whiplash and for that reason it is probably more common among people with spine issues. You might want to search for some providers who treat TOS in your area so you are prepared just in case.

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Thanks again.. I will keep this in mind. It seems to be a recurring theme here, about things being mis-diagnosed.

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@birdman518

I recently posted about my experiences with realizing that I have (99% probability) cervical radiculopathy, plus possible ulnar nerve damage that causes pain and tingling from my neck down to my right hand. All fingers are affected, but mostly my thumb and index finger.

But the most pain I have is in my shoulder. I have assumed this was related to the neuropathy, but then I realized that the amount and intensity is almost the same as when I had a rotator cuff injury from playing tennis… probably at least 15 years ago. But I have not done anything like that to cause that problem to recur.

Does this sound to anyone here like it is part of the nerve issues? Has anyone with C6/7 nerve pain had shoulder pain?

Thanks,

Mitch

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I have a C6 herniation with severe pain going down into my shoulder that continues down my arm, forearm, into my thumb and index finger. My shoulder pain is so severe they checked to make sure I didn’t injure my shoulder or rotator cuff when I went to the ER (there was not). The shoulder pain is deep and intense.

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Hello @caroline321 and welcome to Mayo Clinic Connect, an online community for members to share experiences and provide support to one another. I am sorry to hear you are dealing with this pain.

Following your ER visit, can you share what you were recommended for follow up care? Have you seen anyone since that ER visit?

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@caroline321

I have a C6 herniation with severe pain going down into my shoulder that continues down my arm, forearm, into my thumb and index finger. My shoulder pain is so severe they checked to make sure I didn’t injure my shoulder or rotator cuff when I went to the ER (there was not). The shoulder pain is deep and intense.

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@caroline321 I could have (probably did) write the exact same description. I even used to be a tennis player, and had a rotator cuff injury that felt the same in my shoulder. Let us know if you get any treatment or relief. Good luck!

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@caroline321

I have a C6 herniation with severe pain going down into my shoulder that continues down my arm, forearm, into my thumb and index finger. My shoulder pain is so severe they checked to make sure I didn’t injure my shoulder or rotator cuff when I went to the ER (there was not). The shoulder pain is deep and intense.

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I've been in the same situation and lost the use of my left arm. Steroid shots to my cervical spine and the first lumbar disk and oral steroids helped followed by PT. Unfortunately I put on 25 pounds in a month . Dr said it was all the steroids. I'll only do the shots again if I lose the ability to use the arm
Good luck!

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@caroline321

I have a C6 herniation with severe pain going down into my shoulder that continues down my arm, forearm, into my thumb and index finger. My shoulder pain is so severe they checked to make sure I didn’t injure my shoulder or rotator cuff when I went to the ER (there was not). The shoulder pain is deep and intense.

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I had C-7 nerve damage, and it was extremely painful. What got me through was Tizanidine 3x/day and Lyrica 75 mg.

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