Question
QUESTION: I am a 44 year old female. My job involves heavy computer use 8 hours a day. In June I started to get a stiff neck, which eventually got painful. The pain then radiated into my scapula, which went into spasm for one month and numbness in my right arm. I haven't been back to work since. My MRI results were-

Findings- The cervical and upper thoracic spinal cord are intrinsically normal. There is no cord compression. The visualized posterior fossa contents are normal.

Small disc herniation c4--5

Moderate broad based disc herniation to the right of midline and extending into the right lateral recess and neural foramen. No left lateral recess or left neural foraminal encroachment is seen.
c5-6 with ipsilateral lateral recess and neural foriminal stenosis.
Impression- Moderate broad-based disc herniation in the right lateral recess and neural foramen.

Also, I was found to have a shoulder cuff impingement in my right shoulder.

I am being treated with 300 mg of Neurontin daily, along with physical therapy. I still have lingering pain in my right scapula and cervical vertigo. My neurolgist says the disc herniation is "not that bad", and yet he is urging me to have surgery. I am also wondering how I can go back to work full time doing data entry when it is the main cause of my problem. My neurologist wants me to go back to work and if symptoms reappear, have the surgery. Do you think there is a chance I can beat this without surgery and without giving up my job?

ANSWER: Hi, Janice,

First thing:  surgery is not the answer.  Neither is Neurontin a "treatment" for the condition because it can do nothing to correct it.  From your description, it sounds like you have muscular contractions in your neck that cause disc compression, nerve impingement and vertigo (see "dizziness" at somatics.com/conditions.htm).  You can't correct muscular contractions with drugs or surgery; they're caused by brain conditioning.  You have to retrain your muscles and movements out of the contraction pattern.

Do you use a mouse a lot?  You're probably tensing up from the movements of your work pattern.  Your workstation configuration may contribute to the problem.

You may read my article on whiplash injuries for information on neck tension and an option for recovery, at somatics.com/page4.htm.

good wishes,
Lawrence Gold



---------- FOLLOW-UP ----------

QUESTION: Thanks so much for your answer. I do use a mouse 7+ hours a day at a desk with no support whatsoever. My physical therapist says if I want to go back to work they must provide me with an ergonomically correct work station. After 2 weeks of PT, my neck is starting to loosen up again. I am also reading a book on somatics. The Neurontin has terrible side effects, such as dizziness and drowsiness. I'm going to put in a call to my doctor to try to switch to something else to control the pain while I continue to work on recovering. Do you think I should continue with PT? A PT cervical specialist is working with me.

Answer
I can't really answer your question about continuing PT.  It depends upon the results.  Some PTs are sophisticated about teaching muscular control and movement.

But, of course, the problem isn't from your neck; your neck problem is from how you are applying yourself to your work (and possibly from a prior injury).  It won't do to work on the neck -- PT-wise -- if you don't also address your work pattern.

Please see my article, Addressing the Human Factor in Ergonomic Solutions, at somatics.com/page4.htm.

with regard,
Lawrence Gold