Question
My husband has been having severe right arm pain x 1 month. He has seen his PCP and had an MRI of the cervical spine, results as follows: At C6-7 level, there is disc desiccation. There is protrusion with osteophyte. This does lateralize to the right. There is cord flattening and mild central stenosis. Foraminal narrowing is moderately narrowed at this level related to osteophyte and disc protruding into the foramen. Left foramen is mildly to moderately narrowed. Impression:C6-7 disc space narrowing with bulge and osteophytic ridge with cord flattening and resultant mild degree of central stenosis as well as right greater than left moderate foraminal narrowing. He saw a Neurosurgeon today who reviewed the films from the MRI after a physical exam which entailed bilateral reflex check, which showed NO reflex response on the right at all points, left was normal. Right arm severe pain from shoulder into thumb and index finger with minimal sensation in thumb. Numbness and tingling in forearm, felling of hand edema, definite decreased dexterity, dropping objects frequently, unable to pick objects up using right hand. Neurosurgeon states NO pinched nerve,no surgery needed however, he stated the signs and symptoms are classic for a pinched nerve but not seen on MRI films. He is sending my husband to a neurologist. Is this a clear finding of NO pinched nerve? Any recommendations? Should we persue a second opinion? Very confused!  

Answer
Summer,

Get a second opinion.

I saw someone in this condition.  Her neck muscles were extremely tight.  No reflexes, nor use of, the right arm.

We did some sessions to teach her to relax her contracted neck muscles.  Function returned.  She now has full functioning, no pain.

Contracted neck muscles pull vertebrae together, causing flattening of the disc and a bulge into the foramenal space (where nerves exit the spinal column).  The consequences can be severe, but correctable, sometimes without surgery, as I have related.

If your husband is thus contracted, surgery is not the complete answer.  He must learn to relax the tight neck muscles.

Whomever you see must base the opinion on MRI films and on palpation of the musculature.  Without that, it's whistling in the dark.

with regard,
Lawrence Gold