Can a disc herniation cause chronic neck pain?

Question

Hello doctor,

I am suffering from neck pain for over three weeks now. I got an MRI (Magnetic Resonance Imaging) done two days back but must wait for my results for a couple of weeks. I have the images of the MRI and would like to know is there is any disc herniation or anything else wrong with my cervical spine? Would you be able to have a look at it and let me know if everything is fine? I am in a great deal of pain and just want to know what is wrong with my neck?

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

I received your neck MRI (Magnetic Resonance Imaging) images and saw them now. (attachment removed to protect patient identity). There is a loss of cervical lordosis (straightening of your cervical spine).

There is squaring of the vertebral bodies. Signal changes in the bodies suggestive of marrow edema are more at levels C6, C5, C6, and C7. The discs are hyperintense on both T1 and T2, suggestive of calcification.

Early syndesmophyte formation at C4-C5 levels. The height of the disc spaces is maintained. There is no disc herniation. There is no cord or root compression. Well, this was the scientific description of the set of images you have sent me. The message for you is stated below.

The good news is that there is no disc herniation or bulge and pressure on the cord. But there are changes suggestive of inflammatory changes in the spine at multiple levels, and that is the reason for your pain in the neck. Regarding inflammation, my first impression would be an autoimmune disorder called ankylosing spondylitis.

We need to do several lab tests to catch the diagnosis, the most important being the HLA B27 assay; the others would include the ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), RA factor (rheumatoid factor), and anti-CCP (anti-cyclic citrullinated peptide) antibodies. The results of these tests would find the cause of the inflammation.

Regarding treatment, the primary (or first-line) treatment of all inflammatory disorders is common NSAIDS like Ibuprofen thrice daily after food. Along with this, you should take Pantoprazole 40 mg one tablet 20 minutes before your breakfast. (If Ibuprofen causes uncontrollable heartburn, you can go for other options in the NSAID group).

Going through the tests is required to establish the cause of inflammation. In case the NSAIDs do not work, further treatment depends on the cause. Also, the ESR and CRP levels help in monitoring the response to the treatment with NSAIDs.

I hope this helps.

Thank you.