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What could be the reason for persistent neck and back pain?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I recently got a shoulder and neck x-ray for persistent back and neck pain. The pain started a couple of years ago. No medicines were taken so far. My blood work and CT abdomen are fine.

Answered by Dr. Vivek Chail

Hi,

Welcome to icliniq.com.

I have read through your query in detail. Please find my observations below.

The cervical spine x-ray AP (anteroposterior) and lateral views show the following.

1) There is straightening of the neck spine.

2) The alignment of the cervical spine is normal.

3) Mild early degenerative changes are noted in the vertebral bodies of the cervical spine.

4) Intervertebral disc spaces are normal in appearance except a minimal suspicious decrease in disc height C 3-C 4 disc level anteriorly.

5) There is a small bridging osteophyte at C3 anterosuperiorly vs limbus vertebra (rare possibility). This is not a serious concern.

6) Pre-vertebral soft tissues are normal.

Impression: There is a possibility of neck muscle spasm and early degenerative changes in the neck spine.

Left shoulder x-ray AP view shows normal shoulder joint.

1) The bones are aligned normally and left shoulder joint space is maintained.

2) The scapula, lateral end of clavicle and head of humerus on the left side are normal.

I hope your query is answered.

The Probable causes

The possibility of neck muscle spasm exists with early degenerative changes in neck spine. Pinching of nerves due to disc problems (which might be seen only on MRI cervical spine) cannot be commented up on this x-ray. Further clinical neurological examination of neck spine might reveal any suspected causes for your symptoms. Orthopedic clinical examination of the left shoulder is also suggested to know any restriction of movements and whether any soft tissue structures like rotator cuff requires evaluation by an MRI shoulder.

Treatment plan

Recommended physiotherapy for few weeks and if there is no improvement or if there is worsening then the concerned area is to be evaluated by MRI scan. There is no need of doing MRI scan for both the regions. MRI scan of the cervical spine is more important in the view of muscle spasm and early degenerative changes.

Preventive measures

Please avoid sudden neck movements.

Answered byDr. Vivek Chail

Medically reviewed byDr. Vinodhini J.

Published At January 20, 2020
Reviewed AtJanuary 20, 2020

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vivek Chail
Dr. Vivek Chail

General Practitioner

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