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A Pain In The Neck Leads to More

Throughout the last several months I have written about chronic pain and autoimmune illnesses, etc.

I sit still and think back about the days where I would promise myself I would always be healthy. I ate healthily, I exercised, I had a positive mindset, I did everything I thought was going to keep me in good health. On my mother's side, between her health and all of her sisters, mother, aunt, even grandmother, their health was horrible. I did  NOT want to live that way. Yet here we are today. The mysterious pains and symptoms have been adamantly clear since at least since 1993ish. As time went onI focused more on my family and career. Once 2013 hit, it was all health issues down the hill from there.

Don't get me wrong, I am still hopeful, I believe God heals and I can receive a healing miracle. Honestly every time I think I know my body, I am correct, Then comes another diagnosis, round of doctors, tests, treatments. I just hide behind a smile.

Let's now move on to the latest discoveries, how exciting (do you hear and feel the sarcasm?)

A couple of months ago, my headaches and migraines began to intensify. Since 2012, I’ve received Botox injections for these migraines and for TMJ. It has always worked, like clockwork, every 91 days I go for treatment. I then take Topamax daily to control breakthrough headaches as well as a mood stabilizer.

Once the headaches began to migrate from the back of my neck into the back of my head, radiate down my shoulders, arms, into my hands and even my lower back, I knew this was different. I sought help from my rheumatologist. My rheumatologist diagnosed me with Impingement syndrome of the right and left shoulder, Occipital neuritis, and Sacroiliac dysfunction. During that visit, I was treated with lidocaine/ steroid shots in my neck, shoulders, the back of my head and lower back. I received minimal relief at all. My rheumatologist then ordered x-rays.

These x-rays showed:

  • Degenerative change at C5-C9 and C6-C7 with uncinate spurs
  • Lower lumbar facet joint space narrowing of the L5-S1 disc
  • Lucency proximal medial aspect fourth finger proximal phalanx, erosion

My rheumatologist suggested that I go to physical therapy. I thought about it, I decided against it. A friend of ours referred us to a great pain management doctor at UVA in Charlottesville, VA. I went to his office a couple of weeks ago. He thoroughly listened to my concerns and my pain. He scheduled me for a series of MRIs before proceeding any further. In the meantime, my rheumatologist called in two more muscle relaxers, which again did not alleviate the pain.

Last Wednesday, my new pain management doctor contacted me with the MRI results and explained that there were major findings as he suspected.

Findings:

  • C3-4: Bilateral uncovertebral hypertrophy
  • C4-5: Diffuse disc bulge and left greater than right uncovertebral joint hypertrophy.
  • Left foraminal stenosis
  •  C5-6: Diffuse disc bulge and uncovertebral hypertrophy. Bilateral lateral recess stenosis. Mild right and moderate left foraminal stenosis.
  • C6-7: Diffuse disc bulge and uncovertebral hypertrophy. Bilateral foraminal stenosis.

bulde v herniated

As you can see, this is a big deal, at least to me, not to include RA attacking two of the joints in my neck.

bone spurs

This is not my actual x-ray, it is just an example x-ray to show spurs

Foraminal stenosis is the narrowing or tightening of the openings between the bones in your spine. These small openings are called the foramen. Foraminal stenosis is a specific type of spinal stenosis. Nerves pass through the foramen from your spinal cord out to the rest of your body.

difference-between-lateral-central-and-foraminal-spinal-stenosis_1400x.progressive

My pain management doctor was confident that he could help me, He explained there was a procedure called “the epidural steroid injection”.

I researched the procedure, watched videos to prepare myself (I always do this). Upon arrival at the pain management office, Dr. Messinger informed me of the procedure and the medications being injected was FDA approved, the procedure was updated, he explained that there is a space in the neck actually called the epidural area, that it was not the same as an epidural being placed at the time of labor. This was a relief because I had both children naturally, my last pregnancy, I attempted an epidural, however, it would not go through and caused an air bubble in my spine (that’s another story).

We discussed the risks overall. He did explain that I would not be sedated in any way, he allowed me to take my anxiety medication before the procedure. He explained the time it would take and that he would walk me through every step.

He did just that! It was almost painless. I lay face down on the table, with my face through a round cushion, the neck area is cleaned, the proper coverings are applied, there is an x-ray machine under and above. A local anesthetic is injected, this I was barely felt, he warned that I would feel pressure as he inserted the needle into the epidural area, this was minimal pressure. He let me know exactly what to expect as he pushed through the medication. There again, minimal pressure. A band-aid was placed over the site and I was told not to immerse myself in water for at least 48-72 hours. He placed me on Zanaflex, this is a different type of muscle relaxer. Dr. Messinger explained it could take 2 weeks for the full effect and relief could last 6 months or longer. He warned about the flushing of the face for 24-48 hours, my glucose levels could rise (I am also a controlled type 2 diabetic). Then I was off. The procedure took less than 10 minutes.

Throughout the day, there was minimal discomfort. The main discomfort was I had felt for months was being alleviated. During the night, I did feel a little achy and I took the muscle relaxers as prescribed. This morning I woke up with an elevated glucose reading.

All in all, so far, I am very delighted with the results and the decision that was made.

I will continue to drive over the hour it takes to see Dr. Messinger. I am pleased with his bedside manner, his professionalism, and his overall care for patients.

If I may offer any advice at all, please do yourself a favor, know your pain. If you have a doctor dismissing you, find another. If you have medications not working, speak up, they obviously are not treating your condition. If it doesn’t feel right, it most likely is not. Be your own advocate. You DO NOT have to settle.

Additional information below

What Are The Causes of Uncovertebral Hypertrophy?

 (https://bestdoctor.com/blog/uncovertebral-hypertrophy-causes-symptoms-and-treatment/)

Uncovertebral hypertrophy can be caused by many factors. Rheumatoid arthritis can cause the lining of joints to be swollen and inflamed. Or, the joints cartilage can wear away, which is mentioned as facet joint osteoarthritis. Once the cartilage disappears, the body recompenses by extra bone growth on the joints defined as bone spurs. These bone spurs can make it appear as if the joints are larger and thicker in a few areas. Therefore, either by extra bone growth or inflammation, facet joint “enlargement,” or “hypertrophy,” can happen.

What Are The Symptoms Of Uncovertebral Hypertrophy?

The pain of facet joint hypertrophy does not appear from the inflammation itself, nonetheless slightly from the inflammation effect has on surrounding spinal nerves. The vertebrae are enclosed by openings defined as foramina, via that our spinal nerves pass on their way to and from the sensory organs and muscles.

The swelling of uncovertebral hypertrophy can press on these nerve passageways, compelling the nerves to become restricted. This is why symptoms can frequently be “mentioned,” which defines they seem in places that are far from the damage site. For example, even though you may have uncovertebral hypertrophy in your lower back, the pain and numbness can spread all the way via the leg and buttocks.

What Is Right Uncovertebral Hypertrophy?

Right uncovertebral hypertrophy is a kind of a spinal disorder. Like sclerosis, it comprises the narrowing of spine parts. This can cause meddling with the spinal cord, leading to pain. You should see a physician/chiropractor immediately if you experience it.

What Is The Treatment Of Uncovertebral Hypertrophy?

Traditional treatments, such as physical therapy and pain medication, can achieve many cases of compression of nerve compression because of bone spurs. You can consult the best doctor to find the best kind of nonsurgical treatment for uncovertebral hypertrophy depending on your medical history and condition. If chronic pain continues after several months of traditional treatment, a doctor may recommend surgery as an option.

Cervical Facet Hypertrophy

(https://www.panoramaortho.com/wp-content/uploads/2015/03/Dr._Knight-Cervical_Facet_Hypertrophy.pdf)
  •  Degeneration and enlargement of facet joint.
  •  Each vertebra has two facet joints, one on each side. They are like the
    “knuckles” of the spine. They are small joints that have cartilage lining like other joints in your body. These wear down over time, with obesity, and with trauma (ex: MVA).
  • Sometimes you have facet disease without any other cause just due to your genetics.
  • Facet joints glide and allow movement to provide flexibility, stability, and
    support to the spine.
  • Enlargement of facet joints can cause pressure on the surrounding spinal nerves and can cause radiating nerve type pains.

Symptoms of Facet Disease

  • Stiffness, discomfort when tilting neck backward, joint swelling, decreased mobility,
    tenderness near inflamed facet joints, muscle spasms and/or weakness.
    May cause neck pain that wraps around the neck and/or radiates to the top of shoulders.
  • Symptoms usually present themselves more with reading, sitting at the computer,
    driving, and/or jobs where you have to look up or down for prolonged periods.
  •  Usually, Facet Disease of the cervical spine will present with neck pain only.
  • However, if the facets are enlarged enough, they can compress the surrounding nerve roots and cause radiating nerve pain.
  •  Therefore, figuring out facet disease can involve a process of elimination. An injection can help to do this. If your pain goes away with a facet injection, then we know this is where your pain is coming from. Sometimes you can have both facet disease and nerve compression. So, sometimes you need an injection to the facets as well as to the nerves.

 

I plan to keep everyone updated on my journey, stay tuned.

As always thank you for reading, following, and please comment or ask questions. You can comment on this blog directly or via colorfulchaosthejourney.com

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