Q. I have pain in my neck and upper arm, with numbness and tingling in both arms. Please help.

Answered by
Dr. Atul Prakash
and medically reviewed by iCliniq medical review team.
Published on Apr 07, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I have mucosal thickening with aerated secretions in the sphenoid sinuses with surrounding hyperostosis. The mucosal thickening in left maxillary sinus is greater than right maxillary sinus, with trace aerated secretions. Also, opacification of right mastoid air cells and right middle ear cavity is present. The right scutum is not eroded. There is a large, 2.1 cm hypoattenuating inferior left thyroid lobe mass. 

C2-3, small disc bulge with uncovertebral hypertrophy and mild bilateral facet arthrosis. Mild spinal canal narrowing with contact of the ventral cord surface. The neural foramina are patent. C3-4, bilateral uncovertebral hypertrophy, and mild bilateral facet arthrosis. Small disc bulge and mild ventral thecal sac effacement with possible cord contact, but no high-grade spinal canal narrowing. Moderate bilateral neural foraminal stenosis. C4-5, uncovertebral hypertrophy with disc bulge and calcified central disc protrusion. Mild bilateral facet arthrosis and mild ventral thecal sac effacement with ventral cord contact. Mild right, moderate left neural foraminal stenosis. C5-6, mild circumferential disc bulge, and uncovertebral hypertrophy. Mild bilateral facet arthrosis. Small central disc protrusion. The spinal canal is patent and mild bilateral neural foraminal stenosis. C6-7, disc height loss with mild circumferential disc bulge. Moderate bilateral facet arthrosis and the spinal canal is patent. Mild bilateral neural foraminal stenosis. C7-T1, disc height loss. Moderate to severe bilateral facet arthrosis and small central disc protrusion. Spinal canal and neural foramina are patent.

Impression, mild multilevel cervical spondylosis. Mild spinal canal narrowing with contact of the ventral cord surface is noted at C2-C3, C4-C5, and possibly at C3-C4. Moderate bilateral neural foraminal stenoses at C3-C4, secondary to degenerative disc and facet disease. Mild right and moderate left neural foraminal stenosis at C4-C5, and mild bilateral neural foraminal stenoses at C5-C6 and C6-C7. There are findings of right otomastoiditis. Inflammatory paranasal sinus disease with findings suggestive of acute and chronic sinusitis.

Dr. Atul Prakash

Fitness Expert Orthopedics And Traumatology Physiotherapy Spine Health
#

Hello,

Welcome to icliniq.com.

  • You have sent me the verbatim report of the MRI of the cervical spine and the mastoids.
  • This, however, is very little to help me as I do not know the exact symptoms you have.
  1. Do you have more problems with your mastoids or the neck?
  2. Do you have pain in the neck or does the pain radiate to the arm?
  3. Have you had treatment, what has been the response?
  4. What medications are you on?
  5. Is the condition progressive, how long have you had it?
  6. Do you have any weakness in the arms, or you just have tingling and sense of fumbling when performing fine work?
  • As far as the neck is concerned, I will be glad to help you with the answers to the queries, but ask an ENT surgeon about the mastoids.

Revert with more information to a spine health specialist online --> https://www.icliniq.com/ask-a-doctor-online/spine-health-specialist

Hi doctor,

Thank you for replying. Yes, I  have pain in my neck and upper back with numbness and tingling in both arms. This has been progressive for ten years now, at first I thought it was a bad migraine. I am taking Nurofen 340 mg, three times a day.

Dr. Atul Prakash

Fitness Expert Orthopedics And Traumatology Physiotherapy Spine Health
#

Hello,

Welcome back to icliniq.com.

  • Nurofen (combination of Ibuprofen and Codeine phosphate) is a rather nonspecific medication for neuralgic or radicular pain.
  • Did your doctor not discuss the role of Pregabalin or Gabapentin with you? This is a nerve stabilizing drug, which especially helps to combat the pain of neurological origin and helps prevent sensitization of chronic pain especially when started early. Please ask your doctor about this.
  • Secondly, have you seen a pain specialist who should start you on modalities like TENS (transcutaneous electrical nerve stimulation) and acupuncture, as they have some proven benefit (depending on which school of thought you listen to).
  • How does your hand symptoms affect your work or your lifestyle in general?
  • If after trying all the above options, you still feel that the improvement is not up to your requirement, then you should consider surgery. Decompression and fusion of the affected levels or steroid injection of the specific nerve roots.

Revert with more information to a spine health specialist online --> https://www.icliniq.com/ask-a-doctor-online/spine-health-specialist

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