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I have numbness in both of my arms and both hands. I have a feeling of electrical shock that I feel in my lower neck, when I move my head suddenly to the left or when I elevate my chin upwards. I feel it generating in my lower cervical vertebrae, but I also feel it radiating down the front up my leg above my knee and into the entire joint in my knee. I know from an MRI 3 years ago, that I have a bulging disc. My insurance company won't approve another MRI. I have been on Meloxicam and Methocarbomol for several years. I am going for PT 3 x week. Nothing is helping. What should I do?
Optional Information: Person's Gender: Female Person's Age: 60 Already Tried: See previous note.
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I would return to your doctor, show him the old MRI and say that you have all the signs of cervical cord compression as you now have sensations going into your lower extremities. Your doctor ( a neurologist) should examen you and check your reflexes in your lower extremity and then be able to tell you if the suspicion is correct.
3 years is a long time for an MRI in your age group. He should then fill out a letter of medical necessity giving his exam findings and reasons why you need this test repeated, with the possibility that you may need emergent surgery if this is cervical cord compression.
"letter of medical necessity" is the key here, as is the terminology "cord compression" that should get people moving as it is a litiginous topic.
Another suggestion would be to see a Pain management MD who does steroid epidural injections, take the old MRI with you and he might want to try an injection at your old root levels to see if he could change things, but commonly the problem is spondylolysis, or bony ridges off the disc itself, as a result of bone loss/demineralization in a post menopausal female.
it is difficult to treat spondylolysis with epidural steroids. you may need endoscopic cervical surgery.
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My old MRI said Multilevel cervical spine degenerative disc change, most severe at C4-C5 where there is posterior marginal osteophyte and right-sided predominate herniated disc protrusion,combining to cause slight mass effect on the ventral right aspect of the cord. Also bilateral foraminal stenosis, slightly worse on the right where there could be impingement of the exiting C5 nerve root in the foramen. I have noticed that I am sort of sliding my feet, and I have fallen recently. I can't get in to see a neurologist or neurosurgeon without an MRI, and evidence that I have had PT. Is an open MRI OK, or do I need the closed one? I am hate closed in places. Also do I need an MRI of then entire spine?
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The old MRI also said there was mild spondylosis with posterior marginal osteophytes and disc bulges at C5-C6, C6-C7, and C7-T1, all effacing the ventral thecal sac and partly attenuating the anterior subarachnoid space with no resulting canal stenosis.
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HI thank you for that reply. No you do not need a closed MRI. but if you get an open MRI, make sure it is 1.5 Tesla or greater
a 3.0 T (tesla) open scanner is best
Do I need an MRI of the entire spine?
and you should ask them to do the cervical scan in flexion and extension view (dynamic MRI) if they do that at the MRI center where you are going
no just the cervical, unless you have severe lower back pain as well do you feel the pain coming from your back out to your leg?
My lower back is sore but I don't feel pain from lower back out to leg
so you should reproduce your neck movement in the scanner that causes the sensation, understand?
yes
it occurs only with sudden movements
the concern is cord compression in your neck. If you have a pinched nerve in your back giving you pain then you can deal with that but it isn't as serious
I have felt it when getting up from the toilet, or when shaking my bangs off my forehead, when looking down
OK
that is classic for cord compression with the toilet thing, increases in pressure on your neck when you bear down
spondylolysis until proven otherwise
when looking down and to the side like when I am sending a fax
what is spondyloysis
get the scan and write me back oK?
I will send you a webpage on it hang on
OK. So far I can only see an APN, Can't get in to see my regular doctor
http://emedicine.medscape.com/article/306036-overview
take a look at that page, it pretty much tells your story
I am supposed to go to Finland in 1 week. Long plane ride. Will it hurt me. Is this an emergency?
Should I postpone the trip
I am supposed to be there for 2 weeks
are you still there?
hi
Should I not go on my trip?
You really are only at risk if you have a severe whiplash injury Plane rides are fine. Don't get constipated and try to bear down for a BM
go on the trip
you might want to purchase a soft cervical collar at a pharmacy
I have one. Should I be wearing it all the time?
to wear at night while in bed if you start to have severe cervical muscle spasm and need emergent relief
if it is not too tight, I tell pts to try and wear it while you sleep
I got it about 15 years ago after an auto accident. This all started from a whiplash 30 years ago
2 car accidents
your muscles relax. and then the collar works to stretch you out
typical story
do you take calcium supplementation
Caltrate D chewables
so you are doing what you should do. I would not change my life over this, but you need to keep an eye on it
my guess is that you don't have severe cord compression now
but you want to make it sound like that to the insurance company so they respect your wishes
and you need a new scan
I am a pediatric speech pathologist. It requires lifting children, sitting in small chairs all day in crouched position. I'm scared I can no longer do my job.
yes, that is understandible.
I've done this for 37 years
no heavy lifting is a good idea
yes, I'm sure you would hate to lose it
But I don't want further injury
right well you have to be as careful as you can with this in mind
but you don't want to ruin your life over it
I guess, my question is, if I continue to do this job, will it cause further injury, and result in complete loss of function in my arms and hands?
I am wondering if it's time to retire, and move on to something else.
I'll get the scan
That is unlikely, and it does not happen overnight either. this is bony degenerative change, so the nerve entrapment problems come on slowly. the cord compression can be quicker if you are in another whiplash for example
you have to protect your spinal cord
but you are not going to lose strength in your arms like you had ALS or something
do you have any other questions?
please remember to rate my answer as that is how I get compensation Dr Frank T.
Experience: General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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