Question
QUESTION: Hi Dr.Keith,
c4-5:There is a small focal right paracentral disk protrusion
indenting on the thecal sac no foraminal stenosis.

c5-6:There is a broad based right paracentral and foraminal
disk protrusion with disk osteophytic bulging noted resulting
in right foraminal stenosis and moderate narrowing of the left
foramina.
on the sagittal scan,there is some increased signal noted suggesting n annular tear,right foraminal aspect.

Impressions
c5-6:a broad based right paracentral and foraminal
disk protrusion with right foraminal stenosis ,disk osteophytic bulging ,and moderate left foraminal narrowing.annular tear of
the right foraminal aspect.
c4-5:a right paracentral focal small disk protrusion.no stenosis

x-ray:
flexion and extension views are unremarkable.no evidence of subluxation.
on the oblique view,there is mild narrowing of the neural foramina at c5-6 noted.

Impression;Mild foraminal narrowing of the right foramen foramen at c5-6.

Would like to say thank you to you Dr.Keith in advance of your
answer i just would like to know what i'm dealing with before
i go back to my Dr.I'm still having pain in my right side of my
neck and it radiates into my shoulder and upper arm,with tingling
and numbing in my shoulder down to my fingers.
been like this since february 16th 2012,on dr gave me cortizone shots in my bisep and trisep and told me there was nothing wrong with my neck and i was having numbness because i have carpel tunnel syndrome so where a brace,even though i have no pain in my fingers,hand,wrist,or elbow and the tine test he gave me did not send electrical shocks through my hand,arm or elbow.
then he said oh you might have cancer twice to me that a tumar
might be pressing on my nerves.
I'm in constant pain and all ive been gave is etodolac,flexeral,
which doesnt stop the pain,and makes my restless leg syndrome worse,gapapentin but couldnt take that cause it causes me severe chest pain i thought i was having a heart attack and i went into a panic attack which i inherited from my mom.
Ibruprofen 800mg and meloxicam wich i couldnt take because it made me sick to my stomach and made my chest hurt.
Have a good day Dr.Keith. Diane

ANSWER: Hello Diane,

I am sorry for the difficulty that you have been experiencing.  It is a shame that your doctors did not perform a good evaluation early on, which should have included the MRI.  Clearly, from the results, your arm pain/numbness/tingling is related to the neck issues.  In a nutshell, this is what the MRI says:

You have two discs in your neck that are damaged and are degenerating. As they do so, they place pressure on the delicate nerves that pass through that region.

That is the bad news. The good news is that often these can resolve without surgery... sometimes.

If you were in my office, we would be doing gentle long axis neck traction/decompression therapy. Adjustments would be very VERY light, possibly with only an Activator, or only involving soft tissues.  You would also be taught neck exercises.

If these methods were not helpful, you could then consider a consultation with a pain medicine specialist. Typically, they would want to do a steroidal epidural injection.  This might help, but the help is only temporary.  While you feel better, you should return to your chiropractor/physical therapist for more gentle therapy, traction, and exercise.

If the epidural is not helpful, and if physical therapy and traction fail, you might, as a last resort, consider surgery.  Remember that surgery doesn't fix anything. It simply cuts out damaged tissues. In other words, you will never have a normal neck again after surgery, even if it is successful in relieving your pain.

I know that you have  a lot of tough decisions. Good luck in deciding what to do.  Remember, always start with the simple solutions that are NOT invasive, and work your way towards more invasive treatments as the non-invasive ones fail.  

Keith Biggs, DC
http://www.eastmesachiropractor.com

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

QUESTION: so does osteophytic mean bone spurs?
does annular tear mean that my bulging disk has tore open
and the jelly disk is pushing out?
I'm in serious trouble if i can't go back to work my
fmla is up in june 5th then they will let me go from
my job wich is in housekeeping at a university there is
no light duty work in my position,even more now cause
the university is closed and we go scrub all the dorms.
Have a good day Dr.Keith.Diane

Answer
Dear Diane,

Osteophyte is a bone spur... and all of us get them.

Annular Tear is yes, a tear in a portion of the disc. It does not mean that the disc is torn completely open, and that the jelly is pushing out. That would be an extrusion of the disc.

Going back to work is not going to make you worse... even though it might make you feel uncomfortable/painful.  

Find somebody that can do decompression traction of the cervical spine. I use a table/system called the Triton DTS from Chatanooga Inc that works very well for many patients.

I know that you are in a lot of pain, but I also know that many others just like you have been able to respond to care and return to full function.  Yes, your spine will continue to degrade over time, but it does not mean that you will always be in pain.

So sorry that I am not available to see you and help you, but there are plenty of talented doctors near you.

Good Luck

Keith Biggs, DC
http://www.eastmesachiropractor.com