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Persistent pain post-anterior cervical fusion C4-C7?
Summer '22 I had C4-C7 fusion due to a variety of pathologies including arthritis, herniated disk, and C6 pinching in foraminal space. Waited several years until function was being affected. Pre-surgery, ,y pain was predominantly in the location of the bad disc, on the left side of my neck. However, awakening from surgery, I noticed pain on the back right side of my neck, which is still present. I am told the paraspinal muscles, scalenes, among others, are still very tight and adjusting to the new physics post-surgery. I have had trigger point injection and am still taking (per pain management) tylenol, gabapentin, tizanidine (originally flexeril, switched by pain management due to upper trapezius pain on R), and celecoxib as an anti-inflammatory. It has been 11 months, I've been to PT, am limited in neck stretching due to physical constraints of the fusion, so most of what I have been getting is manual therapy. I will receive another trigger point injection. The switch from the muscle relaxant to the anti-spasmodic helped the trapezius pain, but made occipital pain and behind-the-ear (presumably at muscle attachment points) pain begin or worsen. I've been told 12-15 months can be required with some patients. I have a history of breast cancer and have had a mastectomy with reconstruction involving implants placed underneath my pectorals. I have had shoulder issues since that time (2017, final surgery for the reconstruction was 2018), also had aggressive chemo and radiation. I am wondering if anyone else has experienced this persistent pain after a cervical fusion and has any advice. Thank you.
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Hello @deacra07 . Welcome to Connect. I am a cervical fusion patient with C5/C6 fused. I get muscle spasms that can twist vertebrae above my fused levels and that tends to happen if I don’t have enough neck support when I sleep. I also have thoracic outlet syndrome or TOS which makes one side of my neck tighter which makes it easier for vertebrae to rotate. I recognize when this happens because of getting an occipital headache on one side, ear or jaw pain and even pain into the shoulder blade. Once I get this straightened out again, it resolves. I try not to do things that trigger it.
Does your PT check to see if your vertebrae are staying aligned? They can feel to see if the spinous processes are in line. My PT also does myofascial release to release the tightness in muscles that are pulling the bones out of alignment.
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1 ReactionHello – I’m sorry to hear you are experiencing these issues. I also had ACDF C4-C7 surgery in October 2022. Like yourself this was due to a myriad of issues involving foraminal stenosis, degenerative disc disease with bilateral pinched nerves at C6-C7.
At 6 months post op I am still in physical therapy, and for the past month have begun myofascial release treatment weekly. I have to say I have had days that I’ve felt like my old self, however continue to suffer from muscle spasms that are now in my shoulder blade. I tried trigger point injections that were of no benefit and continue to occasionally take muscle relaxants.
I recovered from a torn rotator cuff injury in 2018. It seems any area of my body that has scar tissue is needing release. I had a successful hip replacement in 2017 that it seems that scar tissue acted up and now I’m dealing with a Piriformis muscle on my right side that I’m convinced is connected to this right shoulder spasm.
Have you tried myofascial release & also do you know if you are fused at all levels? My heart goes out to you. I’ve always been such an active person and this situation has been a challenging one to say the least. Sending healing thoughts and good wishes to you
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3 ReactionsHi Jennifer!
I wrote to you after my surgery at ochsner, not sure if you saw it. For what it is worth I was told to expect the recovery process to take at least a year and it may take up to 2 years for the spinal cord to fully heal, possibly leading to feeling again in my hands and fingers. They have prescribed a device to wear around my neck 4 hours a day that increases success of fusion by 38%. It's an Orthofix Cervical Stim.
Deacra, I hope they find an answer for you and that you are pain free soon.
All the best,
Robert
@hodinator
Hello Robert!
Yes, I did see your wonderful message about how well your surgery went for you, and I loved seeing your joy. I hadn't been able to properly respond yet because of a commitment I had for an art competition where artists need to paint on location, and I wanted to take time in writing back to you. I have to get my work delivered by tomorrow. It is good to see you here again in the community.
Jennifer
Hi I have had C-4to C-7 also.What kind of neck support do you use at night?
Thank you
@dlgreene1 I just use firm pillows. I am a side sleeper, and I have 2 pillows under my chest, and 3 under my head, and a couple between my knees to try to keep my pelvis from twisting. It is trial and error to find the right height, so I don't have pain from my body weight or that my neck gets bent sideways. That seems to produce a muscle spasm that starts my neck vertebrae twisting and gives me a headache. I also have thoracic outlet syndrome which makes my neck tighter on one side and makes me prone to this. I have to keep my shoulder from compressing and producing arm symptoms, and this seems to support my head and my body well, and give me a space to put my shoulder into.