QuestionAbout 3 months back I started having severe pain in my right shoulder, stretching to the entire arm at times and also to the chest area on the right side. When normal pain killers didn't work, I went for MRI. Also I used to have pain in the chest area (again right chest) about 4 - 5 years back. I did an ECG at that time, and nothing incriminating was found.
When I did the MRI this time, mild generation in the cervical spine was found. The exact results that were found are:
AP canal diameters at midvereberal level (in mm) are as folows:
C3-C4:15
C4-C5:15
C5-C6:13
C6-C7:14
The other results that were noted were:
a) Spinal cord shows normal signal intensity with no features suggestive of myelomalacia/cord atrophy seen
b) Mild straightening of cervical lordosis seen
I went to a orthopedic with the result and he recommended
a) IFT to cervical spine
b) Int. cervical traction
The doctor also advised some neck excercises and wanted me to improve my psyscial activity.
I took the physiotherapy for about 2 weeks and have started walking for about 30 - 40 mins per day. However, due to the nature of my job (I manage delivery of software applications for various customers and the work involves project and people mangement; my work hours are longer and most of the time the work is stressful).
The pain has gone away totally after the physiotherapy for few weeks but is reccurring now. The nature of the pain remains same. It sarts from right shoulder and radiates to the right arm and to the chest area).
My question is:
a) What is the long term solution
b) I understand that excercise important. However, given that i am not able to spend time on excercises, is there any medication that will help reduce my pain
Appreciate the suggestion/help.
Answerneck pain, shoulder pain, chest pain, arm pain, radiating pain, spinal stenosis, loss of the normal curve, long term solution, medication risks,
Hello Ramesh,
Sorry to hear of your pain and problem.
First, I am not familiar with your abbreviations; IFT to cervical spine,,,, is that an injection? a therapy? an exercise? I am not familiar with 'IFT to cervical spine', Int. cervical traction,,,, I think that means intermittent cervical traction, or perhaps intermittent cervical nonsurgical decompression; but I am not sure of these acronyms or abbreviations.
Your findings are not terrible. The AP measurements are tending to get a little narrow, but not yet narrow enough to be called 'stenosis'- a narrowing of the spinal canal. You report no disc herniation or protrusion.
'Straightening of the cervical lordosis', in the Chiropractic arena is a big deal. The loss of the normal curve indicates a problem, can irritate nerves, can lead to hastened progression of degenerative joint disease (DJD also known as DDD- degenerative disc disease, also known as OA- osteoarthritic degeneration). Restoration of proper movement and proper alignment in your cervical spine is important to slow the progressive degeneration and allow the spine, joints, nerves and muscles to function more properly. I am sure your Doctor of Chiropractic (or other treating doctor(s) explained the NORMAL anatomy and its importance to proper function versus the abnormal anatomy (loss of curve) and the problems that currently causes and the problems hastened in the future.
Nerves from the neck (mid and lower neck) spread out and down. Nerves go down into the shoulder/ arm/ elbow/ forearm/ wrist/ hand/ fingers- you may feel symptoms anywhere along this route from the neck down. Nerves from the neck also spread out and down into the shoulder blade / midback area and also into the chest, heart, lungs.
I was once called into an intensive care unit to help differentiate between a cervical nerve involvement and a cardiac involvement. ECG (EKG), blood tests, chest Xrays were normal, the patient did indeed have chest pain due to an irritated cervical nerve, and not a pathology intrinsic to the heart. It is good you have differentially diagnosed your problem.
Chiropractic is definitely an appropriate choice in your condition.
What technique(s)/ treatment(s) is (are) you getting from your Doctor of Chiropractic? "Neck pain, shoulder pain, chest pain, arm pain, radiating pain, spinal stenosis, loss of the normal curve...", these are all common to chiropractic practice, and usually treated very safely, effectively and cost effectively.
I mention spinal stenosis because your diameters are normal, but tending towards the smaller side of normal. Stenosis can develop if your condition is left untreated or is treated improperly. Taking pills or shots to kill the pain mask the condition and actually allow the condition to worsen; that is why Chiropractic adjustment therapy is so important to your case- to allow proper motion and alignment and forestall further degeneration.
In my Staten Island Chiropractic office I have informational handouts that I utilize to help patients understand anatomy, physiology, their condition and treatment. Perhaps this will be of some help to you:
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Spinal Stenosis :
Spinal Stenosis is a highly VARIABLE condition.
Some people run marathons and lift weights with stenosis. Some people cannot get out of bed with stenosis. Stenosis is a narrowing of the spinal canal. There is not a lot of room in the spinal canal. Take a nickel coin and a dime coin, place the dime upon the nickel- if the nickel is the canal (the space that the spinal cord/ spinal nerves have to run through), the dime is the spinal cord/ spinal nerves. There is not a lot of space left in reserve,,, not a lot of space to 憄lay with? (note difference: spinal CANAL vs. spinal CORD ).
A condition due to narrowing of the spinal canal which can cause nerve pinching which can lead to persistent pain in the buttocks, limping, lack of feeling in the lower extremities, and decreased physical activity (to avoid the pain).
The Silent Epidemic
The most common indication for surgery in persons aged over 60 in the United States is Lumbar Spinal Stenosis (LSS). Currently, it is estimated that as many as 400,000 Americans, most over the age of 60, may already be suffering from the symptoms of lumbar spinal stenosis [The American Association of Neurological Surgeons (AANS) and The Congress of Neurological Surgeons (CNS)] and this number is expected to grow as members of the baby boom generation begin to reach their 60s over the next decade.
According to the U.S. Census Bureau, people over 60 will account for 18.7% of the domestic population in 2010 versus 16.6% in 1999. According to the United Nations' Population Division, Department of Economic and Social Affairs, the trend is global with the number of persons aged 60 years or older estimated to be nearly 600 million in 1999 and is projected to grow to almost 2 billion by 2050, at which time the population of older persons will be larger than the population of children (0-14 years) for the first time in human history. The majority of the world's older persons reside in Asia (53 per cent), while Europe has the next largest share (25%).
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Exercise: The Miracle Cure
It seems the more options you give people, the more they demand. Exercise, for example, is well known for its dramatic and wide-reaching physiological effects. Yet when you counsel a patient to exercise, they generally say something like, "Yeah, doc, I know all about exercise and diet, but what can I really do to help?" Often it appears that things with which you are very familiar are automatically either ignored or discounted (married people understand this concept well).
Among the many benefits of exercise that have been scientifically documented:
? exercising three days a week raises basal metabolic rate so that even on the days you don't exercise, you are burning 300 more calories each day;
? Finnish study found exercise relieves knee pain more than anti-inflammatory drugs or rest;9
? provides long-term relief of spinal stenosis symptoms
? lowers cholesterol levels;
? improves balance and coordination, even in the elderly;
? strengthens bones;
? fights insomnia;
? reduces the effects of mental stress;
? relieves depression;
? helps control type II diabetes;
? dissolves or prevents blot clots,11 possibly explaining exercise's protective effect against heart attacks;
? decreases breast cancer risk by up to 60 percent
? cuts the risk of gastrointestinal bleeding in the elderly in half
? postpones many effects of aging;
? increases resistance to infections.
Spinal Stenosis is a narrowing of the spinal canal. This can create irritation of the spinal cord or the spinal nerves. Stenosis can come about from many different causes. Just saying 搮stenosis厰 does not say much. Stenosis can be due to big bad things like a cancer or a tumor that irritates or puts pressure on the spinal cord. Stenosis can be due to a bulging or herniated disc. Tests should include MRI, Xray, perhaps CT scan to visualize the stenosis and the cause of the stenosis. Many times stenosis can be handled through noninvasive conservative care such as Chiropractic. Unfortunately, sometimes after conservative care has been tried unsuccessfully, more invasive treatments must be tried: medications (with attendant side effects), injections (with inherent risks), all the way up to invasive surgery.
One of the common causes of Spinal Stenosis is Degenerative Joint Disease (also known as Degenerative Disc Disease, Spondylitis, Spondylosis, or OsteoArthritis).
Degenerative Disk Disease
DDD = Degenerative Disc Disease; DJD = Degenerative Joint Disease; = similar/ same OsteoArthritis.
Degenerative Disc Disease (old term = DJD) is actually a quite common condition. However, the course of the condition is highly variable. Some patients with DJD literally cannot walk, yet other patients with similar X-ray/ MRI findings may be able to run marathons or lift heavy weights. Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow: Ice the area when painful- 10/ 15minutes on, 30/ 45 minutes off; avoid certain postures and movements; bend the knees when coughing or sneezing; bend the knees when lifting anything; do not extend legs straight out when sitting, laying down, lifting, or driving. Avoiding certain movements and postures will prevent aggravation of the condition. Practicing good postures and movement patterns will help the condition heal and be less painful. DDD, DJD, OsteoArthritis, - deteriorating discs (disk) is/ are often caused by, or often concurrent with the Vertebral Subluxation Complex. VSC is a misalignment which hastens deterioration of the joints involved, and can 憄inch?the space available for our nerves.
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of joints, and can cause osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
Subluxation is a serious condition identified by its five parts:
Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Inflammed Discs can easily bulge, herniate, tear, or degenerate. Other soft tissues may also suffer permanent damage.
Pathophysiology:
The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Subluxation may cause Arthritis, Disk Herniation, Disk Degeneration, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment.
ONLY a Chiropractic adjustment corrects the spinal vertebral subluxation complex.
ONLY a Doctor of Chiropractic evaluates for the spinal subluxation complex, as well as other pathology.
Correction of the vertebral subluxation complex slows spinal degeneration-- more proper alignment and movement slows deterioration.
Certainly; safe, effective, cost effective, noninvasive, conservative Chiropractic care should be utilized, if even for a few weeks- before proceeding to risky medication or risky, invasive surgery. Visit your local family Doctor of Chiropractic for an evaluation and treatment which may be necessary.
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
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Medications have their risks. Here is another informative handout I utilize in my Staten Island Chiropractic office:
PAIN
Pain is a 憆ed light on the dashboard?
Pain is your body telling you that something is wrong.
That RED LIGHT on the dashboard of your car- -- do you ignore it until the car breaks down, or do you get it checked and correct the problem? Pain, pain in your body- -- do you ignore it until your body breaks down, or do you get it checked and correct the problem? Pain, do you cover up the pain by taking a painkiller? Take a painkiller, mask the pain, and allow a problem to progress in your body?
NOTICE ON PAIN RELIEVERS:
Label changes ORDERED by FDA; the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news 206- 207; 12-9-06) ;
The American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement 2-26-07).
Pain can often be the result of the Vertebral Subluxation Complex.
Vertebral Subluxation ( 慥SC?, 憇ubluxation? )
Vertebral Subluxation is actually a quite common condition. Doctors of Chiropractic look for pathological conditions which may require referral to other specialties, and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system (the master control system- ALL health disciplines learn this).
Only a Doctor of Chiropractic will evaluate and treat for VSC.
The course of VSC is highly variable. Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights. Some patients immediately develop symptoms related to the VSC, some patients take years to develop symptoms. Some people suffer for only a few days with pain and symptoms, some people suffer for months. Some people recover in days, some take months or years, depending upon severity of the condition.
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
Subluxation is a serious condition identified by its five parts:
Spinal Kinesiopathology: This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
Neuropathophysiology: Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
Myopathology: Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
Histopathology: A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
Pathophysiology: The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment.
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Short term use of medications ( a few days ) can releive pai and not cause complications, long term use can cause problems; of course only a licensed medical doctor can comment upon medication appropriateness.
"Long term solution"- I have yet another explanatory handout I use in my practice:
""""" What ? ! , I have to brush my teeth!?,,, after EVERY meal ! ? ,,, For the REST of my life ! ? ! ... I don抰 want to. period. I won抰. To heck with it ! If I get a hole (cavity), THEN I抣l take care of it. Maybe I won抰 get any cavities anyway?.
It took the American Dental Association YEARS to educate people that they should brush frequently to avoid dental disease. It has taken YEARS to educate patients that visits to the Dentist for hygiene, cleanings, flossing, coatings, etc. are necessary to PREVENT dental problems. Some people still do not floss after every meal, some do not even brush often enough (yyyuuukkkk), so some people still have severe dental problems despite all the knowledge about PREVENTION and dental health maintenance that is out there. Can you believe it ?? !!
Some people have the same problem with PREVENTATIVE Spinal Health
that used to exist with preventative dental health. Some people come to the Doctor of Chiropractic and say, ?..do not adjust me, just give me therapy...? some people say,
?..What ? ! , I have to practice SPINAL HYGIENE !?!, (practice proper postures, proper movement patterns, and see the Chiropractor periodically !?!), Naahh, ... I don抰
want to. period. I won抰. To heck with it! When I get PAIN, then I抣l take care of it.
( pain is often the LAST symptom to appear- whether a cavity or a heart attack ! )
Vertebral Subluxation Complex (a.k.a. 憇ubluxation?
The vertebral subluxation complex can be the underlying cause of many healthcare problems. A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.
This (Subluxation) is a serious condition identified by its five parts:
Spinal Kinesiopathology, Neuropathophysiology, Myopathology, Histopathology, Pathophysiology.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals (medicine), stretching, yoga, massage, vitamins or physical therapy alone. Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with the chiropractic adjustment. For good health- Treat the Cause, not just the Symptoms.
Chiropractic corrects the Vertebral Subluxation Complex.
You cannot be 慼ealthy?if you have a Subluxation. You MAY feel it, with a pain, stiffness, or a 慿ink?in your neck/ back. You may NOT even feel it-
just as people often do not feel the cavity growing in their tooth,,,, until it hits the nerve; or you may not feel it at all, like people do not feel high blood pressure or diabetes until AFTER damage has been done!! PREVENTION- Visit the Doctor of Chiropractic REGULARLY,,, just like your dentist! (practice spinal hygiene as you do dental hygiene -PREVENTION!-
Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a Hospital in New York State (DHSI); As Seen in PREVENTION Magazine """""""""""
I hope this information helps answer your questions.
Your temporary treatment regimen allowed you temporary relief. I recommend you think long term regimen for long term relief. Stay with your Doctor of Chiropractic (commonly called the 'spine specialist') for your spine and 'pinched nerve' problem.
I hope this helps.
I wish you good luck and Good Health Naturally. If further information is necessary, please do not hesitate to re-contact me here at AllExperts.com
( http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm )
Thank you,
your Staten Island Chiropractor friend signing off,
Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
