Question
Heidi-
Just recently my rheumat. sent me for an MRI for a torn rotator cuff.  I couldn't do it--lasted 4 min.  So he sent me for aqua therapy.  3 yrs. ago, his partner (now retired) told me that I had 3 bone spurs on C4 & C5 and that the pain in my shoulder was referred pain.  I told this new doc. this and asked if he could xray my neck and compare the two.  Finally he did.  Results came back 'reveals presence of anterior osteophytic spurs particularly on C2 and C3.  There appears to be increasing neural foraminal encroachment particularly affecting C3-4, C4-5 on the left side and C3-4, C4-5, C5-6 on the right with apparent progression from previous study.  Impression: 1 Cervical spondylosis. 2. Neural foraminal encroachment multilevel with progression from previous study.'  Now he wants me to go to a pain clinic.  I think I should give the PT (aqua) a chance.  I don't want IV's which is what they do at the pain clinic.(I tried this once)  I am on 160 m. of oxycontin a day for this and other problems.
My concern is that I don't know how dangerous this is and should I be seeing someone else, i.e. a neurosurgeon?  It makes me nervous--I used to be quite active but am not now, partly due to neuropathy in legs and feet and lack of balance.
Can you explain what the xrays mean and what I should do?  Thanks in advance
Nanc

Answer
Dear Nancy, thank you for your question. Sorry about the late answer, but I didn't get a notification until today.
You are right, the pain management will not change the problem, only your symptoms (mask them a little).
Foraminal stenosis means that the opening formed by 2 vertebrae is getting smaaler. Spinal nerves, coming from the spinal cord, exit the spine through these openings. When they are too small, pressure is put on the exiting nerves and you end up with pain-in the neck, upper back or even the arm. Pain meds cannot change the fact that the opening is getting smaller. I teach my stenosis patients how to use home cervical traction. This temporarily increases the disc space and relieves some of the pressure on the nerves. Eventually you may have to have surgery to increase the space and decompress the nerves. In the meantime, stay active and mobile. Aquatic exercises are great, since the pressure is minimized in the water.
I hope this helps, let me know.
Heidi