c6 and c7 nerve path not adding up.

by DANIEL WALKER
(ROSEVILLE CA)

C6 dermatome

C6 dermatome

C6 and c7 nerve path not adding up is a not uncommon conundrum.

So I had a minor ache in my back after working out in the gym and figured I just pulled a muscle. It has happened in the past and would usually just rest a few days and then go back to normal gym schedule.

This time however I went back to the gym, and after doing a chest/ tricep workout along with throwing a football far distances, I woke up with incredible pain in my upper back/ shoulder region. I figured I had either torn or strained a muscle in my back/shoulder area.

Then my index finger and thumb started to become numb and have been for a month now. I feel the pain radiating from my neck back area all the way down my tricep to my thumb and index finger.

I got an MRI and it said mild disc protrusion on c6 and moderate disc protrusion on c7 with possible c7 nerve root impingement. Have done some research these results don't add up for me. If I had the c7 nerve root impingement is should have a numb middle finger but that is not the case. And I do have numb index finger but can feel the pain radiating down through my tricep rather than my bicep. At physical therapy the PT says it is possible it is my radial nerve is the issue. Can a disc protrusion effect the radial nerve? Or can a strained or torn muscle cause radial nerve compression?

Hello Daniel,
Your concerns are genuine, and frankly confusing to clinicians too.

The radial nerve is unlikely to be affected since it is almost invariably due to severe trauma to the arm; dislocation of the shoulder, fracture, or being stabbed. Plus, it supplies the back of the arm, lower arm and hand. Is it the palmar surface of your first two fingers that are affected?

A disc lesion can certainly affect one of the nerve roots affecting the radial nerve, but again, back of the hand.

I don't believe a muscle injury can affect the radial nerve. Ask the neurologist for confirmation of that.

Also, the thumb and index finger is highly specific: C6 dermatome which would be affected by the C5-C6 disc.

It's the "mild" protrusion on C6 that is almost certainly affecting you, and not the "moderate" protrusion on C7.

To muddy the waters further, severe deep upper back pain is usually denervation of the rhomboid or levator scapular muscles, and they are C5.

One has to lay out the whole problem, which reflex is missing, which muscle has gone weak (most commonly the triceps incidentally which is why you probably have the pain at the back of the upper arm) But that is the C5 area probably, which perhaps correlates with the upper back pain. It's even possible that the C4-C5 level is the spoke on the wheel, despite not being obvious on the MRI. Which reflex has been affected? Biceps, triceps or brachioradialis? Ask.

And then palpation of the neck itself gives important clues as to which level has been affected.

For what it's worth, I often find that it's pull downs that provoke this injury.

Three key questions:
1. Does turning your head to the side of the painful arm, and then looking up cause pain in the neck and radiation to the arm?

2. Is the Upper limb tension test positive? Type it into the search function at chiropractic help, and have a friend do the test.

3. Is the numb tingly pain in your arm relieved or worsened by raising your arm above your head?

Dr B



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Feb 03, 2016
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me again
by: daniel walker

It's all in the right arm.

And I second take I do feel pressure and aching in the back with some head movements toward the bad arm as well.

I do have the MRI on my computer but I'm not sure how I would be able to share all the images with you over the internet.

Well in theory then Daniel you should be getting the tingling in the middle right finger, but scans and x-rays can be very misleading.

What I would be doing is looking for the fixated joint, and then trying to correlate it with your symptoms, the neurological examination and the scan.

If turning to the right does produce some symtoms then this is obviously coming from your lower neck, and possibly an upper back involvement.

Avoid look up to the sky, careful with backing the car, use the mirrors, and give that heavy upper body workout the miss for a bit.

It it doesn't settle down in a few weeks then look for a skilled and conscientious chiropractor.

For what it's worth, I find that too much manipulation of the degenerate cervical spine is not a good thing. Don't get sucked into a fifty treatment program. Half a dozen treatments over a month, would be good.

Dr B

Jan 30, 2016
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More in tingling in the C6 dermatome
by: daniel walker

The MRI exact wording is moderate sized broad based right paracentral/foraminal disc protrusion c6-7 with mild disc bulge results in mild canal narrowing, right lateral recess narrowing with mild flattening of the right ventral spinal cord. there is also moderate right foraminal narrowing with possible impingement of the exiting right c7 nerve root.

c5-6 mild broad based left paracentral disc osteophyte complex results in mild left lateral recess narrowing. No significant canal stenosis or foraminal narrowing.

1. I feel the pain tingling down my arm when I look away from the bad arm and stretch my neck up or down, almost like it is stretching the nerve and making my thumb and index finger tingle.

2. I didn't notice anything with the upper limb tension test

3. no significant difference with hand over head.

I almost always feel the tingling if I where to push up on my chin making my chin go up towards sky. and also if I do the stretch with a towel wrapped around me neck holding with my two hand and then looking up towards the sky.

Is the tingling a good or a bad sign? its almost like a nerve is hung up on something and when I stretch it slightly it is getting hung up and starts tingling.

Hello again, Daniel,
The tingling generally is not a good sign. Extension of the neck, looking up, narrows the foramina, so no surprises there.

Notice that the reports suggest right C6-C7 narrowing, but left C5-C6 narrowing. Which arm is it that tingles.

What is very encouraging is that turning towards the painful side doesn't exacerbate the pain, and the ULTT is negative. That's great news; my assessment for what it's worth, not having examined you, is that one of your movements at the gym put stress on the nerve root; it's slightly tethered but not frankly pinched by the osteophyte complex, and didn't take kindly to the movement.

What probably won't please you is that repeat of those movements is again likely to exacerbate your symptoms. Find some other way to have fun! That upper body stuff is damaging your health.

Let me know how you get on.

Dr B



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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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