Cervical Degeneration
In this video Dr. Castanet will show you the cervical MRI scan of a patient with right scapular pain complaint. He has significant degeneration of C4-5, C5-6, and C6-7. You will see some cervical stenosis and his spinal cord is being touched by a few of the degenerative changes in his cervical vertebrae, but there is no significant cord compression, no cord signal change, and no cord degeneration.
As usual, the degenerative changes include changes to the vertebrae, the ligaments, the discs, and the joints. Keep in mind that the pain generators in the spine, are the joint, disc, and nerve. In this patient’s case, he did not have radiating arm pain, so we know that he doesn’t have a pinched nerve. What he does have is referred pain from his neck that is felt in his scapular, i.e. shoulder blade area. This kind of pain is typically coming from a disc/osteophyte complex. Disc/osteophyte complexes are degenerative lesions (lesions are defined as ANYTHING that is a problem, anywhere in your body. And it could be an anatomical or functional problem) that are a combination of a degenerated disc and joint. These degenerative problems are often painless, until you do something which aggravates them. For example, you might sleep in a bad position, or paint a ceiling, or lift a weight, that irritates the tissue, incites an inflammatory episode, and causes pain and limited range of motion.
Since the nature of all of these degenerative lesions is compressive, it is easy to understand why decompressing these problems, with specialized treatment engineered to do this, is the most effective way to treat these problems. That is exactly what I will do for this gentleman, and he is almost certain to improve quickly. In fact, he came to me for his pain, because I have treated his low back pain previously, effectively, so he knows this method of treatment is the most effective.
If I can help you with your neck or shoulder pain, please call me at 404-558-4015.
