Cervical Spine Issues: Symptoms, Rehabilitation, and Diagnosis

Q: Cervical Spine Issues: Symptoms, Rehabilitation, and Diagnosis

Hello： It is suspected that you may be experiencing symptoms of cervical nerve compression. <br>It is recommended to consult a neurosurgeon to discuss the possibility of arranging an MRI (Magnetic Resonance Imaging) examination. <br>If you experience severe weakness in your limbs

Cervical spine issues, cervical rehabilitation?

Hello Doctor: I would like to ask about my condition.
Around October last year, I experienced back pain and weakness associated with a cold.
After recovering from the cold, my symptoms improved, but then I started to feel a series of discomforts, including weakness in both hands and coldness on the outer sides (especially noticeable when lying flat).
Additionally, slight movements or lifting weights would cause soreness in my shoulders, and sometimes I would feel soreness even without movement (there is a cracking sound when I move, but I can raise my arms normally, so I initially thought it wasn't frozen shoulder).
My shoulders and neck are painful, especially the scalene muscles and the upper chest, which feel tight and painful, and sometimes the pain radiates to my armpits and the outer sides of my arms.
I also experience a hunching sensation in my upper back, and sometimes brushing my teeth causes tingling.
Pressing on my upper back is painful.
I had an X-ray taken during this period, which indicated cervical scoliosis and mild degeneration.
I later underwent rehabilitation, including cervical traction at 8 kg, which was increased to 9 kg on March 30 during my fourth session.
I am unsure if the discomfort in my neck is due to the traction or electrical therapy, but the pain worsens when I return home to sleep.
However, I can still fall asleep.
The next day at work, my neck feels completely dysfunctional and uncomfortable, and I feel the need for support.
Additionally, when standing, I experience numbness in my buttocks, along with my calves and the soles of my feet.

P.S.
I previously had pain in the left "Gao Huang" point, but since these symptoms started, I haven't experienced that pain again.

I have a few questions:
1.
Could my original symptoms be related to cervical spine issues or thoracic outlet syndrome?
2.
If I wait until next week, April 7, could my condition worsen?
3.
Regarding points 1 and 2, what examinations can I request during my consultation?

Wu, 30~39 year old female. Ask Date: 2022/04/02

Dr. Lai Zhaokang reply Neurosurgery

Hello: It is suspected that you may be experiencing symptoms of cervical nerve compression.
It is recommended to consult a neurosurgeon to discuss the possibility of arranging an MRI (Magnetic Resonance Imaging) examination.
If you experience severe weakness in your limbs, loss of bowel or bladder control, or unbearable pain, please seek emergency treatment immediately.
If your condition is manageable, it is advisable to seek treatment from a neurosurgeon as soon as possible.
Best wishes.
// Dr.
Lai Chao-Kang, Neurosurgery, Changhua Hospital

Reply Date: 2022/04/02

More Info

Understanding cervical spine issues can be complex, especially when symptoms are multifaceted and can overlap with other conditions. Based on your description, it seems you are experiencing a range of symptoms that could be related to cervical spine problems, thoracic outlet syndrome, or even a combination of both.

Symptoms and Their Implications
1. Weakness and Cold Sensation in Arms: The weakness and cold sensation in your arms, especially when lying flat, may suggest nerve involvement, possibly due to cervical radiculopathy or thoracic outlet syndrome. In cervical radiculopathy, nerve roots exiting the cervical spine can become compressed, leading to symptoms like weakness, numbness, or a cold sensation in the arms.

2. Shoulder and Neck Pain: The pain in your shoulders and neck, particularly when moving or lifting, could indicate muscle strain or cervical spine issues such as degenerative disc disease or spondylosis. The "clicking" sound you hear when moving your shoulders may also be related to joint or tendon issues.

3. Upper Back and Chest Discomfort: The tightness and pain in the upper back and chest, especially around the scalene muscles, could be indicative of thoracic outlet syndrome, where nerves or blood vessels are compressed as they exit the neck. This can lead to referred pain in the arms and hands.

4. Postural Issues: You mentioned a "hunched" posture, which can exacerbate cervical spine problems and lead to muscle fatigue and discomfort. Poor posture can contribute to the development of musculoskeletal pain and nerve compression.

Rehabilitation and Treatment Options
1. Physical Therapy: Continuing with physical therapy is crucial. It can help strengthen the muscles around your neck and shoulders, improve posture, and alleviate pain. Techniques such as cervical traction, electrical stimulation, and therapeutic exercises can be beneficial.

2. Pain Management: If you experience increased discomfort after therapy, it may be worth discussing pain management strategies with your healthcare provider. This could include medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), or muscle relaxants.

3. Ergonomic Adjustments: Make sure your workstation is ergonomically friendly. Adjust your chair, desk, and computer screen to maintain a neutral neck position. Avoid prolonged periods of looking down or holding your phone between your shoulder and ear.

4. Home Exercises: Gentle stretching and strengthening exercises for the neck and upper back can be performed at home. Focus on stretches that target the scalene and trapezius muscles, as well as strengthening exercises for the shoulder girdle.

Diagnostic Considerations
1. Imaging Studies: If your symptoms persist or worsen, further imaging studies such as an MRI of the cervical spine may be warranted to assess for any structural abnormalities, such as herniated discs or significant nerve compression.

2. Nerve Conduction Studies: If there is suspicion of thoracic outlet syndrome or peripheral nerve involvement, nerve conduction studies or electromyography (EMG) may be useful to evaluate nerve function.

3. Consultation with Specialists: Given the complexity of your symptoms, consider consulting with both a neurologist and an orthopedic or neurosurgeon specializing in spine issues. They can provide a comprehensive evaluation and recommend appropriate diagnostic tests.

Conclusion
In summary, your symptoms could be related to cervical spine issues, thoracic outlet syndrome, or a combination of both. It is essential to continue with physical therapy, maintain good posture, and consider further diagnostic evaluations if symptoms persist. Open communication with your healthcare providers about your symptoms and any changes you experience will be key to managing your condition effectively.

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