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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35035
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Arun, I am having extreme neck pain and shoulder and arm

Resolved Question:

Hi Dr Arun, I am having extreme neck pain and shoulder and arm pain. I recently had a MRI for my neck as I have had c5-6 disc herniation for over 7 years, I have exhausted all types of treatment. The MRI showed that I now have c6-7 herniation as well with significant changes and narrowing I have numbnesds in my right hand, and <strength in left arm. I have been referred to a Neurosurgeon but will not get in till Summer probably July. Since Tuesday the neck pain has increased and feels like a nerve is pinched. The pain is in the lower part of my neck on the left and the shoulder. I have a high pain threshold but I would rate this pain about 8-9. I was very confused this morning, could not figure out what day it was and got even more confused when I looked at the calendar. I also could not remember the pin # on my bank card today, which I use several times a day. I also was confused driving today, had a hard time concentrating and was probably driving a little eratic, and was confused as to the route I was on, and I know the route. I called our Health Info line and they told me to immediatly go to Emergency, however I am reluctant to go as they normally tell you to go to emergency or call 911. I dont know if this is related (I also have a bulging disc in my back but haven't had a repeat MRI in a few years) I have had severe diarrhea today and have gone about 10 times and I only ate once today. The diarrhea is very watery and it is floating, the last one about 15 min ago looked kind of strange so I pulled up some on toilet paper, it was very small and was hard like a peanut, it almost looked and felt like little stones, there were quite a few. I haven't eaten anything that was hard like peanuts. Also I had a small amount of blood on the toilet paper. I thank you in advance for your expertise, again.
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello and welcome Laurie,

Your confusion about the day and route warrant an examination by a physician. This can be just the anxiety, but need an evaluation as there is a condition called as transient ischemic attack which should be ruled out. This is unlikely to be related to the disc bulge in neck. For your cervical disc disease and arm/shoulder pain you can do following;

) Neck care in the activities of daily living.

a) No working on computer for more than half an hour in a single stretch. Same for TV.
b) Monitors and televisions exactly in front (180 degrees).
c) Contour pillow: Should fill the hollow when lying on back or straight. Available over the counter.

2) Cervical Collar or Brace

3) Cervical traction

4) Anti-inflammatory analgesics like Ibuprofen

5) Some physicians do give oral steroids in severe radiculopathy cases, in which pain / numbness / tingling is quite significant.

6) Physical therapy: gradually increasing exercises from passive stretching to active against resistance regime.

7) Electrotherapy in the form of TENS, interferential and laser and ultrasound.

8) Hot fomentation

9) Local analgesic patch / ointment / spray

10) Epidural steroid given by pain management physician.

11) Acupuncture.

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 6 years ago.
I have tried everything you stated with exception of steroid injection. I have a tens at home and didnt help at all. I have been taking muscle relaxers baclofen and not even the least bit of relief, same as advil. Also, does the diarrhea have anything to do with this? Thanks so much for your quick response
Expert:  Dr. Arun Phophalia replied 6 years ago.

You are very welcome, Laurie.

Diarrhea can cause electrolyte imbalance and dehydration, but usually these symptoms due to electrolyte imbalance only occurs when it is severe. So may not be likely related in your case as you do not have other severe symptoms of electrolyte abnormalities.

Since you have tried all conservative measures for neck pain and associated pinched nerve (cervical radiculopathy); the only option is surgery now.

It is privilege assisting you.

Dr. Arun

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