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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 17527
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have chronic neck pain. MRI shows straightening of the

Customer Question

I have chronic neck pain. MRI shows straightening of the cervical spine, arthritis and 2 bulging discs. I have no nerve pain or neurological symptoms (numbness tingling etc). Myleogram also showed no pinched nerves. I do not want to live my life on pain medicine and muscle relaxers. Will a surgeon consider cervical fusion in the absence of a pinched nerve? I have already tired 2 rounds of injections - both facet and epidural and got zero pain relief from either.
Submitted: 6 months ago.
Category: Neurology
Expert:  Dr. D. Love replied 6 months ago.
Hello from JustAnswer. The surgeon would usually be hesitant to perform surgery solely because of a bulging disc, unless there is evidence that the bulging disc is the cause of the pain. To clarify what I mean by this, it is important to understand that MRI findings do not always correlate with symptoms. There are many people with bulging discs that have no pain and are only discovered because an MRI is done for another reason, and there are also many people with chronic neck or back pain with no significant findings on the MRI. There are also many patients that undergo surgical correction of an identified anatomic defect that continues to have the same pain after surgery. If there is clear correlation between the symptoms that are present and the anatomic findings, such as pressure on a nerve associated with pain along the course of that nerve, then those people are more likely to have a positive response to surgery. But when there is not a clear correlation, there are going to be more people that will not respond positively to surgery. In a situation such as yours, the surgeon will usually initially prefer non-surgical interventions, so will only consider surgery if other interventions fail. It is also common to try interventions to clarify whether the pain you are experiencing is from the bulging discs that are seen on the MRI. For example, if the injection of numbing medicine into the area eases the pain transiently, then that would support that the bulging discs are contributing to the pain. Of course, the numbing medicine will wear off, so is not a long-term solution to the problem, but it can help guide decision making about whether surgery may be helpful. The injections that you note were done may have also included numbing medicines. When these injections are used for treatment, it is actually a steroid medicine that is used to try to treat the underlying condition, but they may have also added some numbing medicines to see if there is some transient relief from the numbing medicine. It would be reasonable for you to make an appointment with a Spine Surgeon to review your case, and the surgeon can consider trying to find evidence to support that the bulging discs are contributing to your pain. The surgeon would be more likely to consider surgery if such evidence can be found and there is an inadequate response to non-surgical interventions. If I can provide any additional information, please let me know.
Expert:  Dr. D. Love replied 6 months ago.
Please let me know if I can provide any further assistance. If you would like my assistance with any future questions, I can be reached through my profile at www.justanswer.com/medical/expert-DrDLove/