Question
I am a 35 yr old female breast cancer survivor (1yr out).

Recently, I woke up one morning with pain in my neck that radiated to my left shoulder area, down the lateral aspect of my arm to my hand.

Also, when I rotated my head to the right, I would get the radiating pain.  The pain in the neck is gone now (I can turn my neck), but I continue to have a numb/throbbing sensation, specifically at my elbow area.  

It feels better when I move around, but if I am just sitting or driving, thee pain/numbness returns, again in the elbow.

I saw a dr and the took xrays of my cervical spine, the finds were:

"There is reversal of normal cervical lordosis centered at C5-C6.  There is C5-C6 and C6-C7 degenerative changes with marginal osteophytes.  The prevertebral soft tissue are normal.  Vertebral body heights are maintained....Impression-Reversed lordosis with lower cervical degenerative changes.  The reversal of lordosis is either positional or possible spasm induced".

The dr gave me some muscle relaxers and pain pills.  They help but it have been over a month and I although the other issue are nearly gone, the issue with my elbow continues.

My questions are:

-Is it possible that one night, I slept weird to cause this "spasm" or issues?

-Is there any other tests (mri...etc) I should be asking for at this point?

-Because of my breast cancer history, should I be pushing anything else?

-If it is just a neck issue, what type of treatment should I look to get?

Any help will be greatly appreciated

Thank You In Advance...

Answer
Dear JON,

The findings you have on x-ray point to the fact that this problem has been long standing.  Reversal of the lordosis(normal curve) of the neck is a serious issue (even though many doctors see it as trivial).  This places increased abnormal stress on the central nervous system and the exiting nerve roots of the spine.  Moreover, the abnormal biomechanical relationship of the neck in relation to the gravitational pull of the earth, increases stress on pressure on the discs and joints of the neck which create the degenerative changes seen on the x-ray.

The fact that your symptoms have just started to occur could have been set off by improper sleeping position, but that is not the true cause...more like the straw that broke the camels back scenario.  Concerning spasm of the neck muscles, I am sure that you have these issues as well, and they can be a continuing cause of pain in the local area, but the reason they are in spasm related directly to the reversed curve position, the spasm does not cause the curve reversal!!

The pain patterns you are experiencing are in direct relation to the nerves that exit the spine from the neck called the brachial plexus, and this plexus gives rise to the peripheral nerves that extend down the arm.  Specifically, your pain location is part of the C5, C6 and C7 nerve nerve roots which correspond with branches of the radial, axillary and median nerves.  Irritation of the nerve roots will result in pain down the arm but not necessarily with reduced muscular function.

So, I would suggest that you seek out the care of a good chiropractic physician to examine the function of the arms and neck with orthopedic and neurological tests.  Please realize that x-rays are only one part of the diagnostic pyramid, and does not stand alone for anything.  The chiropractor may elect to do an MRI of the neck as well if any compression is suspected, which can be caused by the bony degeneration or disc degeneration/bulging, but this should be ordered only after a thorough examination of the neck and upper extremities.

lastly there are specific ways to rehab the curve in the neck to reduce the loss of lordosis and create a more normal presentation.  Two disciplines of chiropractic that have been proven to have success in gaining the curve back are Pettibon and Chiropractic Biophysics techniques, and I would suggest that you research them on the web and look for certified doctors in your area.  A chiropractic neurologist would also be a great choice to improve the neurological symptoms you are having and address the problems from a nervous system perspective instated of a structural perspective.  However, a combined approach would be the best.  You can learn more about chiropractic/functional neurology at the Carrick Institute which is easily accessed on line as well.

Hope this helps.

Respectfully,
Dr. Shawn Leatherman
www.suncoasthealthcare.net