Cervical arthritis

Oh man, I am not happy about this, but you know, that is life. Due to my recent injury my doctor ordered an x-ray, and thankfully found no sign of fractures in my neck (yayyyy!) They did, however, find moderate arthritis (which he called degenerative disc disease, or is that something else?), which might well explain why my neck strain is taking so long to heal. They also want to do a bone density test as there were apparently signs of that problem in the x-ray as well.

They strongly want to do an MRI to make certain that there aren't other issues, they seem concerned that some of my pain is nerve...which means that I should get the MRI...well, the hospital will simply have to take payments.

I just can't get my mom out of my mind. She has terrible osteoarthritis in many parts of her body, but it is worse in her cervical spine...Hopefully I won't really take after her in this department :(

I have cervical spinal stenosis which is the narrowing of the spinal column that causes pressure on the spinal cord, or narrowing of the openings where spinal nerves leave the spinal column. Mine is caused by arthritis. It caused three things--pain in the neck and shoulders when riding long distances on my bike, numb fingers in my left hand, and a weak left arm. I pursued physical therapy to strengthen my upper body to help make up for the fact that I have a bad neck. The exercises have helped a lot and I can't ever back off of them or I have a problem.

I was told that I probably have 5 years of upright bike riding left. And I may have to ride more and more upright as time goes on. This is one reason I jumped on buying my Madone this year, when I was going to wait until spring. I don't want to lose winter riding in Texas this year.

My only advice is that if PT is recommended do it and do the exercises religiously. What a difference it has made for me. I've read that exercise is the best thing for arthritis and keeping it up is vital.

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Originally Posted by goldfinch

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My only advice is that if PT is recommended do it and do the exercises religiously. What a difference it has made for me. I've read that exercise is the best thing for arthritis and keeping it up is vital.

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Thankfully I've become accustomed to regular and rather intense strength training. I am going to have to let my trainer go soon though, at least for a time :( He is going to help me develop a couple of workouts to help me until I can, hopefully, hire him again. His experience and knowledge is amazing, and he is great with baby boomers, athletes or not.

Thankfully my riding position is already quite upright outside of the mountain bike, and it isn't too bad there. I understand the very best we can do with arthritis of any kind is to strengthen the supporting muscles and joints.

My MRI is Thursday, and I have to get a bone density exam as well. My doctor seems concerned that there might be some disc problem even though I don't seem to have the traditional arm issues...and while I really can't afford the co-pay for the MRI it seems prudent to make certain. They will simply have to take payments :o At least we will have the benefit of knowing exactly what is going on. I know there is SOME nerve impingement, but that has been there for years...

Catrin, I sure hope that the MRI doesn't reveal any serious issues related to Degenerative Disc Disease. I think it's important to note--perhaps with the hope of allaying some of your fears--that most people develop some degree of degeneration in their spine as they age. It doesn't necessarily lead to significant problems. This might provide some helpful information. Of course, I'm not trying to dismiss your fears; only trying to keep them in perspective for the time being. Easier said than done, I know. I remember how upset I was when I heard the word arthritis with respect to my hip. Hang in there. Keep us posted as to the MRI and BD scan.

Indy - thanks for the link. Interestingly enough most of what I've found on the internet is in reference to the lower back, not the neck - but of course, the spine is the spine. That is likely more common.

I am just talking myself out of a funk related to this - at least they said "moderate" osteoarthritis rather than "advanced". They have also called in an anti-inflammatory into my pharmacy so hopefully that will help the neck strain as well. At least the MRI will show if I have true whiplash (damaged ligament) or just a pretty strong neck strain involving muscles only.

MRI in the morning, I reluctantly agreed to it. As active and stubborn as I am, I figured we had better figure out if I've any nerve problems (my doctor is a bit concerned about this) in my neck. The cost of the MRI is better than finding out the hard way... At least there isn't a co-pay for the bone density test.

There is still swelling on the sides of my throat and some muscle spasms, but the neck strain is starting to feel a bit better. Then again, I started taking muscle relaxers 4 days ago...but I choose to believe my neck is calming down...but I won't stop the drugs just yet :rolleyes:

I still have the goal of mountain biking before the snow flies...hopefully we will have a LATE snow this year :o

Thinking of you Cat.

Shannon

I got the call today from my doctor's office on the results of the MRI for my cervical spine....

degenerated disks (C5, C6)
bulging disk
bony protrusion pressing on a nerve :eek: :eek: :eek:

The word "surgery" was suggested...but apparently there is an injection therapy that might work to shrink the protrusion (how would that work?) Obviously there is much to be considered, and I see my doctor next Wed morning.

They found other things as well, but my brain pretty much had shut down by that point. No wonder my neck has been bothering me in recent months, and here I thought it was stress :eek:

Oh, man. Hoping the least invasive options can give you relief.

Get a second (or third) opinion, Catrin.

Sending positive, healing vibes your way.

Crankin has given you good advice!

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Originally Posted by Crankin

Get a second (or third) opinion, Catrin.

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Most certainly, Crankin! There will be NO surgery until or unless more than one (or two) specialists convince me that it is necessary. These days there are so many alternative approaches and they will be exhausted.

I know my doctor is concerned about the possible consequences of that bone spur pressing on that nerve but outside of odd sensations in my arm when I walk and increasing numbness in my arm it isn't that noticeable. Some of that has been there for a long time...I don't know how dangerous nerve impingement in the neck can be, so I guess I need to educate myself.

Good luck in figuring out the best option for you. Take care!

I agree Catrin, explore all options before surgery. If it comes to that - Dogmama and I have both been there and can talk you through it.

Good luck!

This is my experience. Your mileage may vary.

I had the injections & they didn't help, but that's just me. In any case, it is a temporary fix. I was told that the nerve impingement needed to be resolved ASAP before it turned into a permanent problem. My PCP and a surgical nurse friend said, "Get it done. You'll have a better outcome if you don't present with a pile of crap."

Be sure to let us know what the doc says.

FWIW: I work for a personal injury attorney and over the years I have know many many people, including one of the attorneys in the office, who have had neck surgery for osteophytes and/or bulging discs. They almost all have had excellent outcomes and were glad they had the surgery. (I can only think of one person who said she didn't feel the surgery helped much.)

I am not saying this to try to convince you to have a surgery you don't want. Only you can make that decision, but rather, I just wanted to give you some anecdotal data to help you make an informed decision.

Surgery is scary, and shouldn't be taken lightly, but it also isn't the worst thing in the world, and can really help, if you are want it.

It is certainly good to hear of other experiences for sure. I have not actually seen my doctor as of yet, his nurse was the one who suggested that surgery would likely need to eventually happen. I want to know how bad the impingement actually is, and what are the odds of it getting worse.

Will things calm down and allow me to return to my normal activities, or is there real danger of causing myself permanent harm? These questions will need to be addressed in some way or another...and my budget doesn't really allow for a lot of extra medical stuff in the foreseeable future so I have to be prudent and as cost-effective as I can be. Like everyone else, I am sure, we have much higher co-pays and deductibles than we once did and then there is something called "co-insurance" that is different from the deductible. I don't pretend to understand the difference but it is time to figure that out :rolleyes:

Generally speaking, a deductible is what you have to pay--usually annually--before any insurance will kick in. After you've met your deductible, you may still be responsible for "co-insurance." That's usually stated in the form of a percentage, e.g., insurance covers 80%, while you cover 20%. Co-pays are similar, but are often stated in the form of an actual dollar figure and apply to routine procedures. For instance, you might pay $20 for every doctor's office visit.

If you've already met this year's deductible, I would squeeze in as much as you can (without rushing your decision-making) in terms of sorting out your cervical spine issues. I'm not going to encourage you to rush surgery, but if it is inevitable and multiple doctors agree, then you might try your best to get treated before the end of the year. Otherwise, you'll have to meet your deductible next year before any insurance kicks in.

Please know that I'll be thinking of you throughout this. Let me know if I can help in some way.

IndySteel, thank you. I've been trying to figure that out since our insurance changed. We do have a "maximum" for co-insurance. I do think I've met my deductible for this year...thanks to the dog bite :rolleyes:

I will mull all of this over before I see my doctor Wednesday. Of course I can't use any of my 2012 medical flexible spending allowance on things from December 2011, so that is also worth considering. I wish things didn't have to be so complicated. Of course, when I figured my flexible spending for next year I was thinking new glasses, not surgery...

When is your open season for your medical spending account If it hasn't passed, perhaps you can increase it. Our open season is currently running.

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Originally Posted by indysteel

When is your open season for your medical spending account If it hasn't passed, perhaps you can increase it. Our open season is currently running.

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Sadly it ended in early November...

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Originally Posted by Catrin

Sadly it ended in early November...

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Well, pewp. :(

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Originally Posted by Catrin

Like everyone else, I am sure, we have much higher co-pays and deductibles than we once did and then there is something called "co-insurance" that is different from the deductible. I don't pretend to understand the difference but it is time to figure that out :rolleyes:

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What you should also check is your maximum out of pocket. Most insurance limits the amount that you will have to pay in a year for all medical costs other than premiums, including the deductible and your "co-insurance." For example, my deductible is $5000. Insurance covers in network 80% and I pay 20%. But, my maximum out of pocket is $7500 so no matter what I am not out more than that amount. (There is a higher maximum out of pocket if I go out of network, but most everything is in network for me).

Thanks for all of the information, and thankfully my max. out of pocket is "only" $2,500... Of course it would help if I actually HAD that, but that is another matter.

I guess what I need to find out, sooner rather than later, the real odds of the nerve impingement causing real damage. Frankly I can deal with numbness/tingling in my right arm - I've dealt with that for years - indeed I've never given it a second thought (though it has worsened since the whiplash). I can deal with muscle spasms. My pain level isn't THAT bad that I can't adjust to it. It helps being a stubborn old bird. What matters is the odds of permanent nerve damage from the "bony protrusion".

I do appreciate all of the advice, and I will report what the doctor says Wednesday. His nurse was obviously uncomfortable telling me all of that over the phone and what she said may have been reflecting that as much as what she was reading to me.

Okay, I know this is stoopid, but my first thought was: how in the world can you get arthritis down there?? :rolleyes::p:eek:

Catrin, hope everything turns out well for you, I'm so sorry that you are having this trouble!

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Originally Posted by AppleTree

Okay, I know this is stoopid, but my first thought was: how in the world can you get arthritis down there?? :rolleyes::p:eek:

Catrin, hope everything turns out well for you, I'm so sorry that you are having this trouble!

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LOL, not stupid at all. That was my first thought as well :o :eek: :) I should have given this thread the title "Cervical Spine Arthritis"

This is a wonderful thread. My cervical disc issue has worsened, with heavy, weak arms being my most prominent symptom. It's not constant but I went to PT last week and am starting some exercises. I too am scared. I had an L5S1 directory 9 years ago and recovery was slow. No problems today but I certainly do not want to rush into surgery. The doctors here in AZ are horrible so getting a good opinion will be tough.

I am curious what exercises you were given. He only gave me a side to side neck stretch to do, that's all...

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Originally Posted by itself

This is a wonderful thread. My cervical disc issue has worsened, with heavy, weak arms being my most prominent symptom. It's not constant but I went to PT last week and am starting some exercises. I too am scared. I had an L5S1 directory 9 years ago and recovery was slow. No problems today but I certainly do not want to rush into surgery. The doctors here in AZ are horrible so getting a good opinion will be tough.

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Sorry to hear about your AZ doctors experience. I'm in Tucson & have an excellent orthpaedic spine surgeon - PM me if you want his name. He did my C4-c-6 about 8 years ago.

Now, the disks under the fusion are garbage and my last MRI said "advanced arthritis with stenosis" - that's why my arm is numb again. So, if you're prone to arthritis (I am - inherited - thanks Grandma!) it may just travel down. I'm doing acupuncture next week because I don't want to do injections or surgery. Have not done acupuncture yet so we'll see...

So fusion vs disc replacement? There seems to be those choices.

I had a herniated disc in February and March of this year, and I had a conservative surgery where the herniated parts of the disc were removed, but the rest of the disc was left in place. Prior to that, I was under the care of a chiropractor (she's the one who sent me who ordered the MRI and sent me to the neurosurgeon) who tried spinal decompression to alleviate the problem. Since I knew we were dealing with something nasty, I got a second opinion from an orthopedic surgeon, who agreed with what the chiropractor was doing (no manual adjustments, but the spinal decompression was fine). The spinal decompression alleviated the pain significantly, but my disc was too messed up to be corrected without surgery - the MRI showed a 9 mm disc protrusion and the neurosurgeon said he took out multiple fragments. The pain was gone, but my arm was still weak and I still had persistent numbness in my index finger.

My husband was having issues with some arm weakness, and this chiropractor was able to correct the problem with the spinal decompression. It might be something you can look into as a last resort prior to surgery.

The advice that I was given in several places was to avoid hardware (plates and screws) if at all possible, if a fusion is recommended.

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Originally Posted by Catrin

I got the call today from my doctor's office on the results of the MRI for my cervical spine....

degenerated disks (C5, C6)
bulging disk
bony protrusion pressing on a nerve :eek: :eek: :eek:

The word "surgery" was suggested...but apparently there is an injection therapy that might work to shrink the protrusion (how would that work?) Obviously there is much to be considered, and I see my doctor next Wed morning.

They found other things as well, but my brain pretty much had shut down by that point. No wonder my neck has been bothering me in recent months, and here I thought it was stress :eek:

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Get the book "Treat your own neck" by Robin McKenzie. http://www.youtube.com/watch?v=Fgl3Qud_GV0 and find a McKenzie therapist in your area. http://www.mckenziemdt.org/ The injection therapy does nothing for the bone. You can't shrink bone with an injection. The injection may shrink the nerve.

They either have to remove the bone or ... you can correct your posture which may keep the nerve and bone lined up properly. :)

Source of knowledge: If I was a horse they'd shoot me (disclosure; no horses were hurt in this post). I have a compression fractured spine, torn ACL (both knees), torn meniscus (both knees) and arthritis from the ears down from an impact sport. You're doing the right thing which is get your bike fit to you and keep moving.

We've pretty much all got arthritis after 20 or so especially if you're an athlete. However since you're truly having pain see if you can find a certified McKenzie therapist in your area first before exploring further choices.

Thanks for the book recommendation Trek and I will check it out! That post was about a year ago, and it turned out that my pain and discomfort was much more from the whiplash injury than the disk/arthritis problems. The injections really helped a lot with my symptoms, and then I went to a great physical therapist who helped me a lot. There was so much going on with my neck that my doctor (osteopath) wasn't sure if the pain was from the disc problems or the whiplash. Turned out to be the whiplash, hands down

A year later we've learned that my whiplash injury still isn't quite healed - it was a severe injury. I've learned how to deal with it however, and I am always working to strengthen that area and to do things that are neck friendly. Thankfully I didn't need more than that first set of injections - the dr who gave them warned me if I didn't get the right therapist that he would be seeing me again...

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Originally Posted by Catrin

Thanks for the book recommendation Trek and I will check it out! That post was about a year ago, and it turned out that my pain and discomfort was much more from the whiplash injury than the disk/arthritis problems. The injections really helped a lot with my symptoms, and then I went to a great physical therapist who helped me a lot. There was so much going on with my neck that my doctor (osteopath) wasn't sure if the pain was from the disc problems or the whiplash. Turned out to be the whiplash, hands down

A year later we've learned that my whiplash injury still isn't quite healed - it was a severe injury. I've learned how to deal with it however, and I am always working to strengthen that area and to do things that are neck friendly. Thankfully I didn't need more than that first set of injections - the dr who gave them warned me if I didn't get the right therapist that he would be seeing me again...

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Catrin - I have the book, did nothing for me. It's yours if you want it.

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Originally Posted by snapdragen

Catrin - I have the book, did nothing for me. It's yours if you want it.

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I will send you a PM, I can always pass it along once I've read it. Thanks!