Question
Hello, I am a 51 year old female. I have lived with neck pain it seems like forever. I recently had an MRI due to total numbness on by 2nd toe on my left foot.I also have some numbness on top of left forearm and pointer finger,my right forearm has pain and I feel as though I am losing strength,constant pain and fatigue in my shoulders. I feel as though I can touch a nerve on the back of my neck. Headaches are pretty normal for me as well. The report reads as follows...C3-C4 uncovertebral hypertrophy is identified on the left. There is also mild left facet hypertrophy. This results in mild narrowing of the left neural for amen.C-4-C-5 diffuse disc protrusion impresses upon the thecal sac, minimally effacing cerebrospinal fluid anterior to the spinal cord.C5-C6 The intervertebral disc is somewhat narrowed.Anterior osteophyte formation is present. Difuuse disc bulging and hypertrophic osteophytic ridging effaces cerebrospinal fluid anterior to the spinal cord.C6-C7 The intervertebral disc is somewhat narrowed. Diffuse disc bulge is associated with hypertrophic osteophytic ridging. This minimally impresses upon the the cal sac without spinal stenosis.C7-T1 Focal extruded disc herniation extends inferiorly, posterior to the T1 vertebral body. This effaces the cerebrospinal fluid anterior to the spinal ccord. Thank you so much for your time. I just want women sort of idea as to what to expect. Again thank-you, Michele

Answer
Hi Michele,

Sorry to hear about your problem. I'm not sure if the entire report is listed, so I will try to concentrate on what is there. This really needs to be correlated with orthopedic and neurological findings. It is possible for pressure on the spinal cord in the neck to cause symptoms in the legs or feet. There is some indications you have pressure on the cord, however, there are usually additional symptoms with this, therefore it is difficult to correlate this with the total numbness on the second toe of your left foot.

The C3-C4 uncovertebral hypertrophy is related to the back part of the joint which has developed a reactive bone formation due to degeneration. This can cause pain on the left side of the neck from the base of the skull into the top of the left shoulder. Mild narrowing of the left neural foramen in this area, and although mild, it can cause pain in the back of the neck and top of the shoulder with numbness into the upper arm.

The C-4-C-5 diffuse disc protrusion can cause pain, numbness and weakness into the upper arm and into the forearm. Diffuse disc bulging at C6-C7 can cause pain, weakness and numbness into the first 2 fingers. C7-T1 Focal extruded disc herniation can cause pain, weakness and numbness into the forearm.

The pressure on the cord can result in myelopathy. The first sign is usually difficulty in walking or stability and can be followed with upper extremity numbness and loss of fine motor control in the hands. There can be bladder or bowel problems. In degenerative myelopathy, 91% will have numb arms or hands, 85% will have numb legs or feet, 82% will have clumsy hands and 78% will have neck pain. Bending your head forward may cause an electric shock sensation in the arms or legs.

It is difficult to say if the symptoms are due to non-cord nerve irritation, which the scans show, cord irritation (myelopathy), which the scans show or a combination of both factors, which is most likely.

I wish there was an easy solution. There can be some reasons for such early degenerative conditions; accidents/injury, genetic factors, modic changes - which the report does not indicate, or a combination.

I am of similar age and suffer from these advanced signs of degeneration and it is very frustrating. But there are causes as previously noted. When you buy a tire for your car that is rated at 50,000 miles and it wears out at 25,000 miles, something is not right. Unfortunately, replacing a tire is much easier than dealing with these types of spinal conditions. As noted above, the findings need to be correlated with a complete neurological and orthopedic examination. I cannot tell you what to expect from just a piece of the puzzle, however, usually conservative measures are tried for a period of time (physical therapy, chiropractic, medication, injections, ect.) and, if there are no significant results, a surgical consult is the next step.

In any event, I wish you all the best and a speedy resolution to your condition.

Regards,

Dr. Steve