Question
I was in a rear end auto accident a few months ago.  Since then I have been having pain and tingling/numbing/pin &needles from my left shoulder blade down to my hand.  Also have chest tightness/difficulty breathing.

I have done an EMG and it came back normal. My MRI came back with the following.
Small broad based protrusion that causes mild left foraminal narrowing at c6-c7.

I think that this is my problem area.
1. Is this what is call a disc herniation?
2. Why does the EMG shows up normal when I am in pain in those area?
3. The rest of my cervical and thoracic spine MRI shows everything to be healthy.  There is no mention of bone spurs or degeneration anywhere on the report.  Does this prove that the protrusion is from the accident?
4. I have not seen any specialist yet since the MRI.  Is there any recommended treatment for my symtoms?

Thanks in advance.

Answer
Dear Liam,

Hwerer are the answers to your questions:

1. Is this what is call a disc herniation?  Yes and no...a disc protrusion is often less than an herniation.  A bulge/protrusion is usually termed is it is 3mm in size, but a herniation needs to be 5mm for that classification.  You can read more about disc in jury on my website.

2. Why does the EMG shows up normal when I am in pain in those area?  For an EMG to be abnormal there has to be nerve root encroachment that is affecting the motor portion of the nerve root so that the muscles do not fire correctly, or muscle spasm.  Pain can be created by inflammation alone without spasm or nerve root encroachment, and is often referred from the original site of injury.  This is called sclerotogenous pain and is a common finding from auto crash trauma.  Disc pain can refer to the head, neck, shoulders, and face.

3. The rest of my cervical and thoracic spine MRI shows everything to be healthy.  There is no mention of bone spurs or degeneration anywhere on the report.  Does this prove that the protrusion is from the accident?  No, but it does highly suggest it.  Car crashes create what is termed an acceleration injury due to the transfer of forces through the spine.  They often create ligamentous tearing, disc damage and bulging, and cartilage damage.  this has been firmly confirmed in the scientific research.

4. I have not seen any specialist yet since the MRI.  Is there any recommended treatment for my symptoms?  Yes, chiropractic care is the best form of treatment for acceleration injuries, and the best research in the area has been performed with chiropractors in key roles, and the best information available on these injuries was authored by two chiropractors "Whiplash:  The acceleration/deceleration syndrome" by Croft and Foreman.  

I would suggest that you research this more by visiting the Spine Research Institute of San Diego's website:  www.srisd.com.  You can learn more about crashes and find physicians who are trained and certified by the center.  If you need more information or help, I would be more than happy to send you a bunch...just request it.

Good Luck Liam.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net