Severe right neck pain

In this video of a cervical MRI review, Dr. Castanet will discuss the symptoms of this 70-year-old male. I last treated this gentleman 5 years ago, and he has been doing reasonably well since that time, until recently, last week, when he awoke with severe right-sided neck pain, without any known cause.

As you’ll see from this MRI scan, his neck doesn’t look too bad; he has a disc herniation at C5-6 and C7-T1, but these are not that bad. He may also have a tiny bit of spondylolisthesis at C7-T1 but, again, it’s modest. He has constant pain right now and his neck position, and range of motion are very limited by the pain. He does get some relief by raising his arm overhead, which is a common method of relieving pain in people with severe neck pain caused by a herniated disc.

Interestingly, sometimes patients have neck and shoulder pain, and it may be difficult to differentiate the source of the pain between neck pathology, e.g. a herniated disc, and shoulder pathology, e.g. a rotator cuff tear. In most cases, shoulder pathology will make raising the arm more painful. In the case of the neck, raising the arm will usually not make the pain worse, or may even provide relief. If raising the arm does relieve the pain, then you almost, definitely have neck pathology. I don’t allow myself to use absolutes in medicine because medicine is about probabilities. You don’t want to be wrong about a patient’s health, so always maintain some humility. I couch my statements in probability.

As for his 5-year-old MRI scan, I reviewed it because it was his anatomy. It may changed with this acute injury, but is he improves quickly, as I expect, there is no need for another MRI scan at this time.

Severe right neck pain

If I can help you with your neck or back pain, please call me at 404-558-4015.