Nerve Issues in the Cervical Spine After Trauma

Cervical spine nerve issues?

I would like to consult a physician.
Recently, I had a conflict with a classmate that resulted in being hit.
Prior to that, I had also been hit on the back.
Each time, the hits were spaced out by one to two seconds, and the pain from the previous hit would noticeably diminish before the next one.
I did not experience any neurological issues related to my cervical spine.
However, on one occasion, I was hit on my back multiple times (the force was similar, with noticeable pain that also faded after one to two seconds), but this time I was hit continuously for 20 to 30 punches.
The difference was that the pain did not completely subside before the next punch.
The pain increased continuously until the last one or two punches, when suddenly I felt no pain in my back.
After that, I frequently experienced significant abnormal pressure and a feeling of tightness in my neck and back.
I often unconsciously twisted at the tight spots, and when I did, I could hear a popping sound from my neck.
Sometimes, when the popping occurred, I felt a sensation as if a nerve in my right hand and head was being pulled.
Additionally, after the incident, my shoulder noticeably dropped, and I developed a hunchback appearance along with a feeling of slumping.

When I bend my head down, such as when looking down, I feel a significant pulling sensation in my cervical spine, and my neck sometimes automatically tilts forward.
There is also a noticeable protrusion near the junction of my thoracic and cervical spine, with a clear difference above and below this point.
Above, I particularly feel a sensation of neck tightness and pressure, along with the cervical spine tilting forward; below, there is none of that, but I do feel pressure in my lumbar spine, although it is not as intense as in my cervical spine.
Sometimes, my lumbar spine makes a popping sound, and I feel a significant movement in the bones.
Additionally, there is a noticeable protrusion in my coccyx area, and I feel significant pressure on the shoulder blades towards the spine.
I previously had a standard X-ray, and the physician said there were no issues, so I suspect it might be a nerve problem.

It has been a year and a half since the incident, and I would like to ask the physician what this issue might be, as it has made it very difficult for me to concentrate on studying for an extended period due to the discomfort.
Thank you very much for your response!

Xiao N, 10~19 year old female. Ask Date: 2020/12/19

Dr. Zhang Junwei reply Neurosurgery

You have described so much, but without a physical examination, it is truly impossible to provide an answer.
I recommend that you schedule an appointment with a neurosurgery clinic for an evaluation.
If you still have doubts, consider seeking opinions from several different physicians.

Reply Date: 2020/12/19

More Info

Understanding nerve issues in the cervical spine after trauma, particularly following incidents like physical altercations or accidents, is crucial for effective diagnosis and treatment. Your symptoms suggest a complex interplay of musculoskeletal and neurological factors that may have arisen from the trauma you experienced.

Firstly, the cervical spine is a delicate structure composed of vertebrae, intervertebral discs, and a network of nerves that exit the spinal cord. Trauma to this area can lead to various issues, including muscle strain, ligament sprain, disc herniation, or even nerve root compression. The symptoms you describe—such as abnormal pressure sensations, a feeling of "cervical collapse," and audible popping sounds during neck movement—could indicate several underlying conditions.

1. Cervical Strain or Sprain: The immediate response to trauma often involves soft tissue injuries, such as strains or sprains of the neck muscles and ligaments. These injuries can lead to pain, stiffness, and a sensation of instability in the neck. The "clicking" or "popping" sounds you hear may be related to the movement of tendons or ligaments over bony structures or could be indicative of joint dysfunction.

2. Cervical Disc Issues: Given your history of trauma, it is possible that you may have developed a herniated disc or degenerative changes in the cervical spine. A herniated disc can compress nearby nerves, leading to symptoms such as pain, numbness, or weakness in the arms. The sensation of your right hand and head feeling "pulled" could be a sign of nerve irritation or compression.

3. Cervical Radiculopathy: This condition occurs when a nerve root in the cervical spine is compressed or irritated. Symptoms may include pain radiating down the arm, numbness, or weakness. The fact that you experience pressure and discomfort in your shoulders and arms could suggest that one or more cervical nerve roots are affected.

4. Post-Traumatic Stress: Sometimes, the psychological impact of trauma can manifest as physical symptoms. Anxiety and stress can lead to muscle tension, which may exacerbate feelings of discomfort and pressure in the neck and shoulders.

5. Structural Changes: The mention of a noticeable difference in shoulder height and a "hunched" posture could indicate muscle imbalances or structural changes resulting from the trauma. This can lead to further complications, including chronic pain and reduced range of motion.

Given that you have already undergone X-rays that did not reveal any significant issues, further imaging studies such as an MRI may be warranted. An MRI can provide a more detailed view of the soft tissues, including discs, nerves, and muscles, and can help identify any underlying pathologies that may not be visible on X-rays.

In terms of treatment, a multidisciplinary approach is often beneficial. This may include:
- Physical Therapy: A physical therapist can develop a tailored exercise program to strengthen the neck and shoulder muscles, improve posture, and enhance flexibility. Manual therapy techniques may also help alleviate pain and improve mobility.

- Pain Management: Depending on the severity of your symptoms, your healthcare provider may recommend medications such as NSAIDs for pain relief or muscle relaxants to reduce muscle tension.

- Neurological Evaluation: If symptoms persist or worsen, a referral to a neurologist may be necessary to assess for any nerve-related issues.

- Lifestyle Modifications: Incorporating ergonomic adjustments in your study environment, practicing good posture, and engaging in stress-reducing activities can also contribute to symptom relief.

In conclusion, while your symptoms are concerning, they are not uncommon following trauma to the cervical spine. A thorough evaluation by a healthcare professional, possibly including imaging studies, is essential to determine the exact nature of your condition and to develop an appropriate treatment plan. It’s important to address these issues promptly to prevent chronic pain and functional limitations.

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