EMG in Neck and Arm Problems - Part III

Cervical Myelopathy Top

Question

It has been a while since I have left a message. They think that I have cervical myelopathy. Six months later, and 4 doc's. The most recent doc I visited talked with me for 10 mins. Watched me walk and said this is what he thinks I have. 98% sure! Anyone out there ever heard of it??? Am taking Baclofen 10mgs at night for the first 15 days then twice a day after that. Any comments?

Answer

Cervical myelopathy is due to pressure on the spinal cord at the level of the neck. Baclofen should help to ease the spasticity. All the best.

Brachial plexus injury  Top

Question

If damage occurred to a nerve during shoulder surgery, will nerve conduction studies show the damage to that nerve? Symptoms include decreased range of motion, atrophy of muscles in arm and severe pain. Also have history of some carpal tunnel syndrome. Will the test shoe which injury is causing the problems listed above? Also, is the needle test really necessary if you have already had the other part of the test and it showed nerve damage?

Answer

Yes, nerve conduction studies are very helpful in your case. It should help to tell where is the lesion and is it one or more than one nerve involved. Also, I would think that needle examination in important in your case.

Best treatment for C3/4 disc protrusion Top

Question

With C 3/4 disc protrusions and radiculopathies what's the best course of treatment?

Answer

You're asking a very general question which is impossible to answer without a great deal more info on the subject, age, lab findings, symptoms etc.. There may be a variety of approaches which are suitable for some cases but not for others.

EMG/neurological tests in multiple level disc and upper and lower limb complains Top

Question

I suffer from extreme low back pain and neck pain and weakness in my arms pains in my shoulders...and more. I had surgery on my back 10 years ago. I had an MRI and it shows multiple levels of bulging. I have numbness in hands and feet, sciatica, etc...My question is why do I have to go to a neurosurgeon or get EMG test?? I am going tomorrow for the neurology tests. However I already met with a neck surgeon who said he would be happy to operate on my neck...He didn’t need Nero tests???? It seems to me I should see a orthopedic surgeon not a neurosurgeon...I heard that neck surgery may stabilize a back...Is that true??? The multiple levels of bulging are in my neck...

Answer

Various doctors rely on different tests to establish a diagnosis and it may well be that in cases like yours, there are too many doctors involved in the care who might not know what the others are thinking. It is always best to narrow down the number of doctors you're dealing with to avoid such situations.

Just Wondering about cervical myelopathy Top

Question

Has anyone ever heard of cervical myelopathy? Prognosis? Treatment? etc. After all I have been through I am very skeptical. Any feedback would be great!

Answer

Cervical myelopathy means that you have a tight spinal canal in the neck area. The spinal cord is inside that canal of course and it comes under pressure because of the lack of space. This is what is referred to as a myelopathy (myelo refers to the spinal cord and pathy is used to indicate disease). Diagnosis is made by CT or MRI and or myelogram. The symptoms may involve root symptoms and also some weakness and increased reflexes in the legs if the canal is too tight. Treatment, when the disease is advanced, involves surgery to relieve pressure on the spinal cord.

Comment

Thank you! You have told me more than anyone else I have asked. When searching the internet for cervical myelopathy, there isn't much. I have started Baclofen 10 mgs twice daily, been taking for about 2 1/2 weeks, have noticed some increased weakness, but less cramping, a little more pain. No talk of surgery. Today I go for my first PT, hopefully something helps, and this has been the most frustrating 8 months of my life. Without your web site I would still be out in the dark!

Answer

Would like to hear of your symptoms and history. I have been thru a very frustrating time also. I have weakness in my legs and ankles and increased reflexes. I also have tripped and fallen several times and suffered one broken bone already. I have a small spur in the cervical area (arthritic) PT has helped somewhat but certainly has not eliminated the problem. I do not have a lot of pain, just leg muscle cramping and stiffness and what I mentioned above. Baclofen has not been working for me. Doctors do not seem to be too anxious for surgical intervention. Would like to hear from you.

Myelogram results for cervical disc Top

Question

I just got my myelogram back reads: Extradural defects located at the C 5/6 level of disc. What does this mean?

Answer

The result of the myelogram would indicate that there is a sort of pinched nerve at that level (C5/6), which is the upper cervical level. This result should be taken into consideration in your further management after your doctor has looked at the myelogram films.

Having neck and UL pain. What specialty might be of help?!        Top

Question

Hello. I have been fighting headaches, neck, shoulder, arm, and back pain for about five years, and I'm wondering if someone can help me decide where to go next. I have been doctoring in a small town--have seen doctor, chiropractor, physical therapist, and anesthesiologist. So far physical therapy has helped the most. Right before Christmas, the last two fingers on my right hand went numb. I couldn't start my car, had trouble opening doors, holding anything with a handle. The pain was worst right between (and under the right) my shoulder blades, but I'm also having pain across the top of my right shoulder and behind my right arm pit.

In the past, I've had extreme tension-type headaches, stiff neck, cold and hot sensations down my right arm (usually feeling like water pouring down, heaviness in my upper arm, stiffness and pain under my shoulder blade, and a quivering across my upper back. My arm seems weak, but I can do things if I concentrate.

The symptoms started while I was pregnant with my second child, but I can't think of any injury that could have started them.

I saw an orthopedic surgeon in a larger city last week and had an MRI that showed a bulging disc (C6-C7), but he feels that the disc isn't significant enough to cause all this trouble. Wednesday I am having local anesthetic injected into the nerve root there as a "diagnostic procedure."

My question is this--am I seeing the right kind of doctor? I am completely frustrated by the pain and the amount of time I've wasted so far. Can anyone give me any idea of what I might be dealing with?

Answer

I gathered that you have 2 problems that could explain your symptoms. The first one is the neck, this has been investigated by MRI and was not significant, and you are undergoing some further evaluation for that. But the second problem is the symptoms in the hands, that could be the cause of good deal of your symptoms, I believe a pressure or entrapment of nerve at wrist (carpal tunnel syndrome) should be excluded by doing (EMG). Seeing a neurologist would help you evaluate all your symptoms, including the headaches.

Answer 2

I saw your post and also the reply by another doctor telling you to go see another doctor of course. I deal with clients everyday with your types of symptoms and it could very well be a situation involving your nerves somewhere between your head and your fingers. Since you have tried just about every type of doctor, I would suggest that you find a massage therapist to work with and start working with the muscles in your neck, upper back, rhomboids, pectoralis major and minor and all the way down your arm. Of course, don't neglect the rest of your body either. Tight muscles can impinge nerves and cut off circulation to any part of your body. Releasing the tension in these muscles and getting the blood flow circulating properly again can do wonders. I know I had a serious injury, which involved symptoms that you are describing and studied to become a massage therapist while healing from my injuries. I believe massage therapy sped up my healing process and gave me lasting relief. And I still have doctors running around trying to figure it all out with all their tests. Massage therapists get right to the source and take care of it. Let me know if it helped or if you have any more questions.

Answer 3

OR, you could burn incense and chant.....for God's sake see a competent neurologist.