Numbness in hands and lower arms, pain in shoulders

by Brian
(Piedmont, Alabama)

I was injured in a fall in July 2010. I fell 14 feet down to a concrete floor, landing on my upper back/neck and right shoulder. I did strike an object at my lower back half way down the fall. Since that time, I have continued to suffer with numbness in my arms, pain in my right elbow, right and left shoulder. I had carpal tunnel surgery about 6 months after the fall, but that hand now hurts after very limited use.

My question is this: Could the fall have caused me to have facet joint arthropathy? I had a c-spine fusion over 12 years ago, but did not have any of these symptoms prior to this injury in 2010.

Now, the doctor is saying I have facet joint arthropathy and says it is most likely due to the spinal fusion 12 years ago. When I told him I was having no adverse symptoms before the fall and subsequent injury, he said the fall simply aggravated the existing problem.

The facet joint is greatly distorted with spurs and growth. I just had a myelogram 3 weeks ago, almost 4 years after the accident. Could the facet joint issue have developed in that amount of time? This is a work comp case and now I feel they are looking for a way to call my issue completely preexisting! I'm also having continued problems with the hand that had the carpal tunnel surgery. They have scheduled a FCE next week. I'm looking for answers that I can't get from my work comp team or physician.

I would appreciate your thoughts!

Hello Brian,
When there are large sums of money involved, it is indeed hard to know who to trust.

Clearly you did have pre-existent problems in your neck.

There are two questions to be answered:

1. If you were young and hadn't had all the previous issues, would you now be experiencing all these symptoms?

2. If you hadn't had the fall four years ago, would your neck and arms be largely fine? Not perfect, but not with all these pains.

The answer to the first is that you would probably be having some of them, but perhaps not all of them. A fall from 14 feet onto your neck and shoulder would inevitably cause some injury.

To the second, it's very speculative. You would probably be reasonable; after all it had been stable for 12 years. I would push that line, but the truth is that you could have started having problems even without the fall.

The advanced degenerative changes in that facet probably predate the fall; however the fall would have aggravated it.

However, what you really want is relief of pain, not another surgery paid by workman's compensation. Why not ask if you can consult an experienced chiropractor for an opinion, and perhaps three months of treatment?

WC is generally pro chiropractic because we save them a lot of money. They would probably be agreeable.

Think too about a home traction unit. One that you can apply, lying down, every day for twenty minutes.

I hope this contributes; let us know what transpires.

Dr B

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Jan 21, 2016
cervical angina
by: Brian

Thanks for your reply. I am now seeing a pain management doctor set up by work comp. I forgot to mention that I have been having chest pain, racing heart/palpitations, shortness of breath and some pain radiating down my left arm. I have had every conceivable heart test and 2 cardiologist agree that I have no heart issues. They also agree that it is likely caused by an injury/condition in the neck. The symptoms are usually brought on by exertion, climbing stairs, lifting (even light weight). Sometimes my heart will race and chest will feel tight and it wakes me up. I would like to know if a neck condition can cause this type of discomfort and if so, what are the possible remedies?

I am unsure, Brian. Frankly not sure that a cervical condition would cause these symptoms. I would want strong signs that this is indeed a neck condition, before agreeing with the cardiologists. Pain can do strange things though.

Let me know how it goes.

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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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