Persistent pain post-anterior cervical fusion C4-C7?

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.

Hello - 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

Hi 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.

I had a cervical fusion on C5,C6,C7 over 10 years ago and still experience pain across back of shoulder and down left arm, I have been under pain management for 10 years and would love to figure out how to get off pain killers which just mask over the pain or get my pain management doctor to try some different meds that work better but so far nothing that makes pain go away completely. I have had every type of injection there is and they have not helped for more than a couple days. The cold weather kills my neck and shoulder so I dread winter. It has effected my quality of life extremely because oof limited movement in neck and pain that goes along with it, if I have to be at my desk and on computer with arms lifted up for long periods of time I can't hardly stand it.

@jfd1969 The pain you are describing sounds a lot like thoracic outlet syndrome, and basically that is caused by tightness of muscles and scar tissue that compresses nerves that go into the arms between the neck and shoulder. Your surgical scar tissue will also have gotten tight and can be pulling into all of this. My treatment of choice which helps a lot is Myofascial Release done by my physical therapist. It is similar to massage except that the therapist holds the stretch with their hands and waits for the tissue to release. Here is a discussion where you can learn about all of this. The first pages have many links to resources.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

The best part of this is is works and there are no drugs involved, and it will get the body moving better and help get back into good body alignment. Any waste products held in the tight dehydrated muscle will get released when it can move correctly again and body fluids can circulate. It may take a series of sessions and patience to work through all the layers of restricted tissue, but it is worth doing. You don't need a diagnosis of thoracic outlet syndrome to do MFR, just your pain and restricted movement is enough.

There is an MFR provider search at https://www.mfrtherapists.com/.

I actually tried this several years ago and then again about two years ago with two separate therapist and it didn't give me much relief. It does feel like something squeezing the fusion area especially when it is cold or stressful situation when the muscles tighten up in that area. I have talked with my pain management doctor about this a few times but he just prescribes something different to mask the problem when I want something to actually fix the problem not just cover it up. I appreciate you replying to this very much because I am willing to try anything because it has been a long 10 years of chronic pain 24/7.

@jfd1969 Look for a therapist who is certified in the John Barnes methods. My PT is an expert level therapist with John Barnes training. She can feel the pathways of tightness with her hands on my body even before I am aware of it while she is stretching it out. It takes patience to do this. Years of tightness won't be solved in a couple weeks. You can do some self stretching at home to help by laying on a foam roller on your back and doing airplane wings with your arms, etc. That will help a lot and I have to do that frequently. Many therapists will tell you they do this MFR work, but don't take the time to wait for it. The fascia has to change states from semi solid to a liquid crystal state, then unwind, and then it will re-solidify when you take the pressure off. I started MFR in 2010 and have done it ever since to maintain what I have in terms of function and flexibility while avoiding the pain down my arms.