I am an Orthopedic surgeon. I am simply amazed by the clinical exam videos you do. How visibly the weakness improved with cervical traction. Was a pleasure watching it. Please do more such video with strong academic impact. I am from India. I will tell you honestly I paid 200 thousand US Dollars for my Post graduation degree in Orthopedics and it did not teach me this. You did. A million thanks.
I have also seen other videos on tractioning and decompressing which alleviates some of the points on cervical spine issues. I have also noticed that this video has presented a more clearer and thorough explanation and evaluation of nerve root compression. This explains why I have also the same problem with the patient in this video. Thanks a lot.
Amazing video, concise, to the point, accurate, practical, easy to apply methods/processes and easy to remember with great visual support. Thank you and please continue to help us learn and retain.
Wow...you actually give real and clear treatment. I have the same symptoms and also in my back, waist and legs. It all happened when I was lifting machine shoulder press I felt something snap in my back and it felt like it reverberated to the top of my head I started getting numbness and tingling over three years ago everyday I hope the weakness and atrophy will stop but it hasn't. Anything you think that will help, I will dearly appreciate.
Thank you for this awesome video. My sister has c5-c6 enlargement she has dizziness most of the time especially proprioception. Any suggestion Doctor? GOD BELSS YOU🙏
After watching this video, I think I have the same symptoms as this patient. I have right bicep weakness and can barely lift / bicep curl a 10 lb weight more than 10 reps. I fell off my bike hard 3 weeks ago - impacted on my left side (hit an oil slick on the road) I was wearing a helmet but did feel my head hit the asphalt as well. I basically broke the fall with my left arm Maybe the energy transferred from the left side impact and radiated to the right side of my body and neck was affected. The weakness in the right arm started about 1 1/2 weeks after the fall.
I have had this shoulder pain in right shoulder first for over a year and now left shoulder for three months. It is sharp pain. I cannot lay on my back at all the pain in my shoulder is severe
Wow, very helpful video. I was in an accident 8 years ago and am now experiencing neck pain starting about 4 months ago. I don't know if the pain is due to the accident or just aging. From this video, it is C5 symptoms. Wish I could be evaluated by Paul.
Thank you. I am so surprised you answered! I do think it is time to get some professional help. It feels like I have a small knife stuck in my back on the right side with some burning pain. Your video shows the symptoms of each cervical vertebrae problem.
Hearing you talk and explain with such diligence and care is so soothing! A doctor who actually knows their stuff and cares! I have a question please; I am 40 years old and I have chronic cervical radiculopathy C6 C7 for 19 months. I had intense, unbearable pain for the first 7 months (was only offered painkillers). While the pain has subsided, it’s mostly axial neck pain now, what I have is what I can only describe as muscle fatigue. I’ve also had finger coordination problems for the past few months (it’s getting a little better). I was dropping keys, coins, hard to shuffle pages, peel fruit etc. My EMG is April showed chronic denervation C5, C6, C7, in ascending order of severity. The neurologists found my strength normal, but I know that my left side is weak, can’t put mulch strength for long. Would surgery benefit me at this point? I’m just worried about the neurological deficits, that denervation scares me. I just want my hands back fully functional. Thanks a lot, and keep up the good work!
I'm looking at an explanation of my MRI results back in Aug 2017.What you described is identical to what my condition is.Same c4-c5 through c6-7.My left bicep has become very weak and also dropping objects with my left hand.Pain runs from my left shoulder down to thumb and index finger.Im having disc fusions done in 2 weeks.I just had a nerve root steroid injection which helped for a month but symptoms are coming back.I will let you know how my surgery went.May have to remind me though.Hope you get relief.
@@jenkemjones68 Thanks for your response! I've actually had my surgery 3 weeks ago. I've had 2 artificial discs (Mobi-c) at C5-C6 and C6-C7. Overall, I'm very happy I've had it. Mobility has been maintained. I can't say that strength has come back entirely, but it may take some time to do so. I've had it for 2+ years after all. What I can do however is run, jump, and move my shoulder about with no pain. I'm confident that strength will come back once I'm able to work out properly. It just takes time. Just being able to stand up straight and sit without pain is a major improvement. Good luck with your operation! Keep a positive mindset at all times :)
What’s the biggest indicator or best way to know if there is a cervical spine problem or thoracic outlet syndrome considering there is disc degeneration, osteophytes, bone Spurs indicated on MRI?
Thanks Paul for the video, with the c5 diagnosis, with your expriance, is it also could be c6 nerve root, the areas he complained can also indicate c6 nerve, how do you differentiate? Also with neck traction, how effective is it, can it 'fix' the issue or just give temporarily relief?
Hello Doctor It was incredible evaluation I have left hand weakness with not able to lift up front side and side ways since 4 years Have numbness, tingling nerve compression in the neck Please suggest exercise or physiotherapy for pain relief
I would start by seeing your doctor and maybe try some physical therapy to see if you show improvement with cervical traction. If so, you may be a good candidate for a home unit.
Hi doctor I am neck pain and neck stiffness and pain in left arm shoulder for last 3 week and now my shoulder is not moving properly then i have don MRI for shoulder and neck doctor ask me then there is never compression in c3 and C4. what i have to do to avoid surgery.
I'm dealing with alot of pain in my shoulder and they are trying to figure out if it is shoulder or neck issues. No one has ever done a thorough evaluation like that for me. Ortho doc just said frozen shoulder, physical therapist is doing some exercises for me. Everyday is different. Who should I see for this to really get help
Kindly help Dr.Paul, Please have a look on these spine mri findings and suggest ------- Whole spine screening: Cervical spine: Loss of cervical lordosis. Anterior marginal osteophytes at C4, C5. Diffuse disc bulge at C4-C5, C5-C6 & C6-C7 causing anterior thecal sac indentation. Dorsal spine: T2 hyperintensity noted at D4, D9 - likely haemangiomas. Disc desiccatory changes at multiple levels. Schmorl's node at the inferior endplate of D11. Mild disc bulge at D1-D2 causing anterior thecal sac indentation. Ligamentum flavum hypertrophy at D10-D11 causing posterior thecal sac indentation. Lumbar spine: Modic changes noted at inferior end plate of L3. Schmorl's node seen at inferior end plate of L1, both end plate of L2, L4, superior end plate of L3. Loss of central T2 hyperintensity of IV discs s/o dessication is noted at all levels. Diffuse disc bulge causing anterior thecal sac indentation at L2-L3. Diffuse disc bulge causing bilateral mild neural foramina narrowing at L3-L4. Diffuse disc bulge causing bilateral moderate neural foramina narrowing at L4-L5. Diffuse disc bulge causing posterior annular tear, moderate spinal canal narrowing and bilateral mild neural foraminal narrowing at L5-S1 We really need your suggestion, my mother is experiencing unbearable pain(neck moments are restricted, Pain in both left and right hands)
3 weeks ago, I tried using my lacrosse ball to massage my tight upper back. I am dealing with some viral infection with a lot of inflammation and costochondritis type symptoms. But I might have gone too deep on the spine or on my right rhomboid area that by next morning, entire right side started spasming, and caused a radiating pain into my outer upper arm (lower arm not affected). Bending neck backwards to right side would cause the arm pain. Some other postures bring on arm pain as well. Got a trigger point injection, but still have an achy arm and scapula. Confused if I injured the nerve or muscle going too deep with the ball plus all the inflammation with the viral infection (possibly covid).
Hello, Please help me with a solution.. Problem - c4-c5, c5-c6 small disc bulge indenting anterior thecal sac, mild narrowing of left lateral recess and neural foramina and abutting left exiting nerve root..
This is a great video. I've never seen the individual nerve roots diagnosed line this. When you reference C5 and triceps, do you mean the disc between C4 and C5 or C5 and C6?
My back -cervical and lumbar is a mess. I now have a left shoulder subluxation and continuing leg weakness, very ẃeak adductors, abductors, and extreme numbness in feet. I cannot drive becuse of the numb feet. How can I find someone like yoū to do a thorough examination, and identify which areas are the problem? I also need help fiĝuring out the shoúlder issue - shoulder or cervical issue? Ortho and neûro cannot answer specific qûestions. Are you accepting patients and ẃherē are you located? I really need help. Thànk you.
Do you prefer traction over spinal decompression modalities (ie drx9000) for cervical decompression? I’ve had 2 treatments w drx 9000 and have seen little to no improvement to my pain at C5. Are there benefits w techniques of traction that might be gained over SD?
Hi Brian, I use the Saunders traction a lot. The idea is to take pressure off of the nerve root and give relief but if weakness in the arm continues then surgery may be indicated. I have had a lot of people purchase their own traction units and they stretch as needed and can do very well with it. I like to start with 3 times a day and if there is improvement, got to 1 time a day then a couple times a week and then as needed.
Hello Doctor. I have exactly the same issue. All the tests you did exactly matched the issue i have. I got an MRI and found the C5 nerve compression. Please tell what is the treatment and how to fix it.
Hey Paul , i am really impressed as a young PT. Is it necessary to hold this traction position all the time by retest?( i mean in the situation when you are alone without second person)
Hi Paul, thanks for your many excellent videos! I have noticed that your recommended treatment frequency with cervical traction in these cases is 3-4x/day. Is there a unit you send home with your clients to do this independently or what does their home traction exercise look like? Thanks.
Hi Scott, I start with manual traction and if they tolerate that well, I use the Saunders CTU in the clinic and if that goes well, they can purchase one for home.
Jus came across ur video.Awesome stuff My Dr did C-6 fusion on me 15 months ago because of my C-6 herniation and losing 100% strenght in my left bicept after sitting in a car in full police gear for 14 hours Halloween of 2018.got surgery Feb 1,2019.its now may 10,2019 n I can still barley curl 5 pounds for mabey 2 reps.ive done acupuncture,traction,massage,PT,REHAB,AND STILL CANT EVEN HOLD UP MY ARM RUNNING MORE THAN 2 MINUTES My surgeon said last week,"just rest it Terry"..but I HAVE for 15 months.it effects my every movement,as I can't even carry a pizza more than 30 seconds without my arm giving out n twitching like crazy.AM I DOOMED FOREVER?I CANT FLEX MY BICEPT STILL..N WHEN I DO,I ONLY FEEL IT IN MY NECK...MAD PAIN IN MY NECK.IM IN PAIN 24 HOURS A DAY IN MY NECK,BUT IT AMPLIFIES WHEN I TRY SUPINATE,TAKE A PILL,TRY TO WASH MY OPPOSITE ARMPIT,ECT...AM I JUS SCREWED HERE?WHAT DO U RECOMEND?IM A FORMER BODYBUILDER AND BOXER,NOW I CANT EVEN PUNCH A WATERBAG OR CURL A TINY WEIGHT...ITS VERY DEPRESSING,AS IM ONLY 43......PLEASE HELP ME WITH SUGGESTIONS.THANK U SIR
Sorry to hear about this Terry. I'm just going to throw this out there. C5 is the bigger controller of your biceps. It's possible you have another level that is affecting you. There are many things that could be going on such as Parsonage Turner Syndrome or a brachial plexus injury. Hard to tell without doing an evaluation.
Hi love this video, I have really severe what seems like permanent muscle atrophy on deltoids, which has gone on for years. I do find when I decompress the way you showed there’s a bit more strength. What exercises should I do every day to decompress my c5, c6?
Great video Paul. I had a ACDF on 9-13-19. Had a massive stenosis, possible early edema or subtle myelomalacia, and other stuff. I also have a moderate stenosis (spinal cord) at c-5, 6. severe right and moderate left neural foraminal narrowing. The surgeon said "we may go in later and do some things from the back." Does it sound like I will likely be having more c-spine surgery ? I'm 63, and this is likely from old injuries. Thank you. I love your videos.
Research does show that there is an increased chance of having issues above and/or below the level of fusion. A sight chance. Make sure you are keeping your posture in check. Good luck! Paul
Should the stretches and traction the patient tried at home not work is the next step surgery? I'm having similar issues, only I also have lost almost all feeling in my pointer finger and thump on my right hand at this point. At 35 I really dont want surgery if its avoidable
Diffuse disc bulge at c5-c6 level effacing narrowing both lateral recess with possible indentation to existing nerve roots, and Mild disc desiccation at c4-c5 and c5-c6 level Sir I am having pain in my biceps, triceps, shoulder. Sir what should I do to solve this problem
My myelogram and CT report say “foremen markedly narrowed by uncovertebral joint spurs and complete loss of disc height”. Does it seem like surgery is unavoidable? I’m a 49 year old dentist.
Hi Bethany, Yes that is likely the scenario. Disc material can be reabsorbed by the body over long time but spurs cannot. We see a lot of patients with anterior cervical disc fusions or disc replacement and they do very well. Opening up the foramen can make a world of difference. We see a lot of neck issues with dentists, hygienists, orthodontists etc... Best of luck!
Doc, I'm having terrible pain in upper shoulder and deltoid muscle. The pain becomes unbearable when I try to lie down (specially pain in the deltoid area) and it keeps increasing and I feel like it will burst and that's why I can not sleep. Do u know what is it
Hi, Paul, I'm 54 and was diagnosed with cervical radiculopathy 15 years ago, but until fairly recently have been able to live relatively pain-free and with a fairly free range of motion and good strength. I was told my main problem was most likely referred pain from impingement of the C4 and C5 mostly. However, about two or three weeks ago I was doing a moderate workout where I combine fully-body stretching exercises with relatively light seven lb. hand weights. Ever since that day I have been in excruciating, debilitating pain going down the left side of my neck into my upper arm, shoulder and clavicle, but mostly in my shoulder blade area. My left shoulder blade is the locus of almost all the pain. I also can't really lift my head very high or backwards very far, lie completely flat without discomfort, or raise my left arm above the shoulder without pain. I am really getting scared and worried because it now seems so painful and crippling (like a stooped hunchback who can't look up easily), but more concerning is that it seems to be mimicking a heart attack or stroke, with almost constant chest pains at the left side of my chest under my armpit, and with stabbing pains from my shoulder, upper arm, left chest, but mostly coming from behind my left shoulder blade. Could I have a bulging, ruptured or herniated disc? After all my research of symptoms and pathology, it seems that it may be what is described as a "winged scapula" in which maybe my scapula is not lying flat or has been dislocated. It also said that can be caused by either trauma such as blunt force or non-trauma things such as viral factors or infections. But mainly it was corroborated to me by saying it could be caused by or an adjunct to cervical radiculopathy. I'm sure you know all this, and I apologize, but I'm just tryng to be as specific as possible to tell you how I present. I just can't believe such an old-person workout I was doing could exacerbate my condition so accutely and severely. Thank you so much for taking the time to read my problem, and any diagnoses or advice would be so appreciated. Take care. Thomas Humphrey
@Thomashumphrey7395 I just read your post and I have the exact same pains and symptoms you are describing but for me it's the right arm shoulder etc.. for me started out with right hand index finger tip section went numb tingling loss of precise feeling for touch or pressure.. than a week later overnight woke up to only able to keep my arm in 1 position to tolerate the pain and it was my forearm resting on the top of my head.. chiropractor showed me pictures of this scenario for slipped disc sign with a name for it just can't recall it.. I have the c4 messed up after the diagnosis and after the first adjustment I was able to have my arm down finally again 30something hrs after.. how are you doing now? 4years after your post..
I have pretty noticeable symptoms. Trying to get into doctor. No luck till middle of January. Now I'm very concerned about permanent damage. Wht can I try at home till visit? Ty
I have exactly that problem. Mine started 10 yrs ago. Is it still possible to fix? If so, can i avoid surgery? As long as i workout with machines i can lift heavy. If i use freeweights for upper body, reinjures easily.
i have the same thing on my right side, when the chiro does sustained traction it irritates it, mainly the neck and just behind the neck shoulder area, chiro said if it hurts like that it could be muscle related also in that the muscles are tight around there i also got xrays done and have lost some curve in my neck and a disc buldge around c5 c6 also and been using a wedge thing thats supposed to help get the curve back so my question is would muscle tightness have a role to play in the problem of the nerve irritation?
Hi, Doctor, thanks for this video, I have the similar problem but with severe pain in my left arm, bicep, elbow and left shoulder as well. Last two weeks I am surviving with pain killers and still with pain. I did an MRI that shows some bulging and compression, could you suggest what kind of home exercise I can do to avoid surgery please. Regards, Altaf
@@OrthoEvalPal Outstanding, that gives me hope. I’m currently going through PT post ACDF (C4-5-6 ) my deltoid weakness/palsy started Prior to my operation. I was diagnosed with C5 palsy PRIOR to my surgery. I have small improvements but I’m still significantly weak. Do you have any experience or videos about this? I’m 32 military and law enforcement and was in very good shape up until 4 months ago when this happened.(no injury)
@@gt1123 strength is the last to come back. I've seen hundreds of these and many say they are 1yr+ improving. Best of luck to you. This is inspiring me to do a video of the progression with my next patient who has this.
I am 47 years old in good condition and have e c5-c6 pinch nerve, pain on my right shoulder, have done the MRI and have been diagnosed with pinch nerve. Now since coronavirus is around I am afraid to follow up on doctors office. Any suggestion?
Hi, I place most of my patients on home cervical traction to give the nerve root a rest and decrease radiating pain. This is how I do it and this is what I use. www.healthproductsforyou.com/search?searchterms=saunders%20cervical%20traction%20device ruclips.net/video/xBtMnPCKN5A/видео.html Best of luck!
@@OrthoEvalPal It's been like this for 2 years. I went to the ER on/ 4/2/20 bc I also had other pain but they took a scan and an xray and then just said it was due to my bulging discs. They gave me an injection and rx for pain meds even though I told them I had quit my norco meds 2 years ago after 18 years. I fear Im too late to do anything about it bc that was their go to for 18 years since my car accident Thank you so much for your timely response.
Dear doctor, i have c4 c5 or c5 c6 root, because 6 years ago i had cracked my neck on the right, i did it almost everyday until now, after i crack something grow bigger inside my right neck and it become very hurt, i cant turn my head left because i can crack my right neck and the little thing can be bigger and very hurt, i just can rẽcover by wake up after sleep, i know it can be c5 root because i have same trouble at my shoulder like the guy on the video my tendom right neck is smaller than my left day by day , i cant use computer often now because it can hurt even i not crack anymore. May u aswer me can i find my trouble by using MRI?i ask it because i live in a poor country, doctor in my country think i am insane because i am only 22 year olds now, i have pain in 6 years and they told me iam crazy and kick me out. Hope u aswer me, i am thinking i will have to live with this pain forever.
I am an Orthopedic surgeon. I am simply amazed by the clinical exam videos you do. How visibly the weakness improved with cervical traction. Was a pleasure watching it. Please do more such video with strong academic impact. I am from India. I will tell you honestly I paid 200 thousand US Dollars for my Post graduation degree in Orthopedics and it did not teach me this. You did. A million thanks.
You are welcome! I have lots more to come. Please share with colleagues.
Pro tip : you can watch series at Flixzone. Been using them for watching a lot of movies recently.
@Casey Carmelo Yup, been watching on flixzone for since november myself =)
I have also seen other videos on tractioning and decompressing which alleviates some of the points on cervical spine issues. I have also noticed that this video has presented a more clearer and thorough explanation and evaluation of nerve root compression. This explains why I have also the same problem with the patient in this video. Thanks a lot.
As a current DPT student, this was incredible to witness. Thank you!
As a fellow PT, I'd like to commend you on those great videos! Excellent work, thanks.
Thank you very much Raymond! Very nice of you to say. I plan to continue as long as I can. Best regards, Paul
I enjoy watching your videos and learning. No one has ever taught in the clinic like you do🙏
Thank you so much Nightingale! More to come!😃
Fantastic job👏
Excellent video! Very clear and precise. Thanks
amazing work
Thank you Usman!
very cool maneuver !
this is really awesome . traction and back to normal strength. i love it. Thanks for video
Excellent video!
Thank you much! More to come. Spread the word!
Amazing video, concise, to the point, accurate, practical, easy to apply methods/processes and easy to remember with great visual support. Thank you and please continue to help us learn and retain.
Glad it was helpful Carline! Will do!
Wow...you actually give real and clear treatment. I have the same symptoms and also in my back, waist and legs. It all happened when I was lifting machine shoulder press I felt something snap in my back and it felt like it reverberated to the top of my head I started getting numbness and tingling over three years ago everyday I hope the weakness and atrophy will stop but it hasn't. Anything you think that will help, I will dearly appreciate.
Amazing video.. excellent work .. thanks
Excellent video.. thanks for the advice.
Glad it was helpful! More to come GD!
fabulous job.you are at the top of your game! 👍
Thank you Shadyblue! More to come!
Amazing..Doc is genius.. diagnosed within a minute..
Thanks Shree! More to come!
Thank you for this awesome video. My sister has c5-c6 enlargement she has dizziness most of the time especially proprioception. Any suggestion Doctor? GOD BELSS YOU🙏
Great
very appreciable...can you plz evaulate like this in lumbar nerve root evaluation..? with treatments approach
After watching this video, I think I have the same symptoms as this patient. I have right bicep weakness and can barely lift / bicep curl a 10 lb weight more than 10 reps. I fell off my bike hard 3 weeks ago - impacted on my left side (hit an oil slick on the road) I was wearing a helmet but did feel my head hit the asphalt as well. I basically broke the fall with my left arm Maybe the energy transferred from the left side impact and radiated to the right side of my body and neck was affected. The weakness in the right arm started about 1 1/2 weeks after the fall.
I have had this shoulder pain in right shoulder first for over a year and now left shoulder for three months. It is sharp pain. I cannot lay on my back at all the pain in my shoulder is severe
Wow, very helpful video. I was in an accident 8 years ago and am now experiencing neck pain starting about 4 months ago. I don't know if the pain is due to the accident or just aging. From this video, it is C5 symptoms. Wish I could be evaluated by Paul.
You probably want to start with some PT and or neurology
Thank you. I am so surprised you answered! I do think it is time to get some professional help. It feels like I have a small knife stuck in my back on the right side with some burning pain. Your video shows the symptoms of each cervical vertebrae problem.
Sure wish u was here in Texas Ive been to 2 chiopractor this year and was nothing like this no help at all.. Ive been dealing c4 c5 nerve pinch at c5
Hearing you talk and explain with such diligence and care is so soothing! A doctor who actually knows their stuff and cares!
I have a question please; I am 40 years old and I have chronic cervical radiculopathy C6 C7 for 19 months. I had intense, unbearable pain for the first 7 months (was only offered painkillers). While the pain has subsided, it’s mostly axial neck pain now, what I have is what I can only describe as muscle fatigue. I’ve also had finger coordination problems for the past few months (it’s getting a little better). I was dropping keys, coins, hard to shuffle pages, peel fruit etc. My EMG is April showed chronic denervation C5, C6, C7, in ascending order of severity. The neurologists found my strength normal, but I know that my left side is weak, can’t put mulch strength for long.
Would surgery benefit me at this point? I’m just worried about the neurological deficits, that denervation scares me. I just want my hands back fully functional.
Thanks a lot, and keep up the good work!
I'm looking at an explanation of my MRI results back in Aug 2017.What you described is identical to what my condition is.Same c4-c5 through c6-7.My left bicep has become very weak and also dropping objects with my left hand.Pain runs from my left shoulder down to thumb and index finger.Im having disc fusions done in 2 weeks.I just had a nerve root steroid injection which helped for a month but symptoms are coming back.I will let you know how my surgery went.May have to remind me though.Hope you get relief.
@@jenkemjones68 Thanks for your response! I've actually had my surgery 3 weeks ago. I've had 2 artificial discs (Mobi-c) at C5-C6 and C6-C7. Overall, I'm very happy I've had it. Mobility has been maintained. I can't say that strength has come back entirely, but it may take some time to do so. I've had it for 2+ years after all. What I can do however is run, jump, and move my shoulder about with no pain. I'm confident that strength will come back once I'm able to work out properly. It just takes time. Just being able to stand up straight and sit without pain is a major improvement. Good luck with your operation! Keep a positive mindset at all times :)
What’s the biggest indicator or best way to know if there is a cervical spine problem or thoracic outlet syndrome considering there is disc degeneration, osteophytes, bone Spurs indicated on MRI?
Thank you for your videos. I was curious if traction and conservative non surgical treatment helped this patient or did he need surgery?
Thanks Paul for the video, with the c5 diagnosis, with your expriance, is it also could be c6 nerve root, the areas he complained can also indicate c6 nerve, how do you differentiate? Also with neck traction, how effective is it, can it 'fix' the issue or just give temporarily relief?
Hello gm, which c3 can c5 c6 c7 c8 is for area of the forearm? Thanks
Hello Doctor
It was incredible evaluation
I have left hand weakness with not able to lift up front side and side ways since 4 years
Have numbness, tingling nerve compression in the neck
Please suggest exercise or physiotherapy for pain relief
I would start by seeing your doctor and maybe try some physical therapy to see if you show improvement with cervical traction. If so, you may be a good candidate for a home unit.
Hi doctor I am neck pain and neck stiffness and pain in left arm shoulder for last 3 week and now my shoulder is not moving properly then i have don MRI for shoulder and neck doctor ask me then there is never compression in c3 and C4. what i have to do to avoid surgery.
I'm dealing with alot of pain in my shoulder and they are trying to figure out if it is shoulder or neck issues. No one has ever done a thorough evaluation like that for me. Ortho doc just said frozen shoulder, physical therapist is doing some exercises for me. Everyday is different. Who should I see for this to really get help
Kindly help Dr.Paul, Please have a look on these spine mri findings and suggest ------- Whole spine screening:
Cervical spine:
Loss of cervical lordosis.
Anterior marginal osteophytes at C4, C5.
Diffuse disc bulge at C4-C5, C5-C6 & C6-C7 causing anterior thecal sac indentation.
Dorsal spine:
T2 hyperintensity noted at D4, D9 - likely haemangiomas.
Disc desiccatory changes at multiple levels.
Schmorl's node at the inferior endplate of D11.
Mild disc bulge at D1-D2 causing anterior thecal sac indentation.
Ligamentum flavum hypertrophy at D10-D11 causing posterior thecal sac indentation.
Lumbar spine:
Modic changes noted at inferior end plate of L3.
Schmorl's node seen at inferior end plate of L1, both end plate of L2, L4, superior end plate of L3.
Loss of central T2 hyperintensity of IV discs s/o dessication is noted at all levels.
Diffuse disc bulge causing anterior thecal sac indentation at L2-L3.
Diffuse disc bulge causing bilateral mild neural foramina narrowing at L3-L4.
Diffuse disc bulge causing bilateral moderate neural foramina narrowing at L4-L5.
Diffuse disc bulge causing posterior annular tear, moderate spinal canal narrowing and bilateral mild neural foraminal narrowing at L5-S1
We really need your suggestion, my mother is experiencing unbearable pain(neck moments are restricted, Pain in both left and right hands)
3 weeks ago, I tried using my lacrosse ball to massage my tight upper back. I am dealing with some viral infection with a lot of inflammation and costochondritis type symptoms. But I might have gone too deep on the spine or on my right rhomboid area that by next morning, entire right side started spasming, and caused a radiating pain into my outer upper arm (lower arm not affected). Bending neck backwards to right side would cause the arm pain. Some other postures bring on arm pain as well. Got a trigger point injection, but still have an achy arm and scapula. Confused if I injured the nerve or muscle going too deep with the ball plus all the inflammation with the viral infection (possibly covid).
I can move arm and everything just fine like in the video. But I can feel the pain and crunchiness in the rhomboid area.
can i do the traction myself?
Hello,
Please help me with a solution..
Problem - c4-c5, c5-c6 small disc bulge indenting anterior thecal sac, mild narrowing of left lateral recess and neural foramina and abutting left exiting nerve root..
This is a great video. I've never seen the individual nerve roots diagnosed line this. When you reference C5 and triceps, do you mean the disc between C4 and C5 or C5 and C6?
Hi Ken, C5 nerve root is between C4 and C5. C6 nerve root is between C5 and C6.
My back -cervical and lumbar is a mess. I now have a left shoulder subluxation and continuing leg weakness, very ẃeak adductors, abductors, and extreme numbness in feet. I cannot drive becuse of the numb feet.
How can I find someone like yoū to do a thorough examination, and identify which areas are the problem? I also need help fiĝuring out the shoúlder issue - shoulder or cervical issue?
Ortho and neûro cannot answer specific qûestions. Are you accepting patients and ẃherē are you located? I really need help. Thànk you.
Hello doctor I have problem c3 c4 c5 please solve
Do you prefer traction over spinal decompression modalities (ie drx9000) for cervical decompression? I’ve had 2 treatments w drx 9000 and have seen little to no improvement to my pain at C5. Are there benefits w techniques of traction that might be gained over SD?
Hi Brian, I use the Saunders traction a lot. The idea is to take pressure off of the nerve root and give relief but if weakness in the arm continues then surgery may be indicated. I have had a lot of people purchase their own traction units and they stretch as needed and can do very well with it. I like to start with 3 times a day and if there is improvement, got to 1 time a day then a couple times a week and then as needed.
Hello Doctor. I have exactly the same issue. All the tests you did exactly matched the issue i have. I got an MRI and found the C5 nerve compression. Please tell what is the treatment and how to fix it.
I try traction with a lot of my patients. shrsl.com/3t55c
Hey Paul , i am really impressed as a young PT.
Is it necessary to hold this traction position all the time by retest?( i mean in the situation when you are alone without second person)
Hi Ka, Only hold it for a few seconds. That's all it takes. Paul
Hi Paul, thanks for your many excellent videos! I have noticed that your recommended treatment frequency with cervical traction in these cases is 3-4x/day. Is there a unit you send home with your clients to do this independently or what does their home traction exercise look like? Thanks.
Hi Scott, I start with manual traction and if they tolerate that well, I use the Saunders CTU in the clinic and if that goes well, they can purchase one for home.
@@OrthoEvalPal Thanks so much for your quick reply, Paul. Have a great day!
Jus came across ur video.Awesome stuff
My Dr did C-6 fusion on me 15 months ago because of my C-6 herniation and losing 100% strenght in my left bicept after sitting in a car in full police gear for 14 hours Halloween of 2018.got surgery Feb 1,2019.its now may 10,2019 n I can still barley curl 5 pounds for mabey 2 reps.ive done acupuncture,traction,massage,PT,REHAB,AND STILL CANT EVEN HOLD UP MY ARM RUNNING MORE THAN 2 MINUTES
My surgeon said last week,"just rest it Terry"..but I HAVE for 15 months.it effects my every movement,as I can't even carry a pizza more than 30 seconds without my arm giving out n twitching like crazy.AM I DOOMED FOREVER?I CANT FLEX MY BICEPT STILL..N WHEN I DO,I ONLY FEEL IT IN MY NECK...MAD PAIN IN MY NECK.IM IN PAIN 24 HOURS A DAY IN MY NECK,BUT IT AMPLIFIES WHEN I TRY SUPINATE,TAKE A PILL,TRY TO WASH MY OPPOSITE ARMPIT,ECT...AM I JUS SCREWED HERE?WHAT DO U RECOMEND?IM A FORMER BODYBUILDER AND BOXER,NOW I CANT EVEN PUNCH A WATERBAG OR CURL A TINY WEIGHT...ITS VERY DEPRESSING,AS IM ONLY 43......PLEASE HELP ME WITH SUGGESTIONS.THANK U SIR
Sorry to hear about this Terry. I'm just going to throw this out there. C5 is the bigger controller of your biceps. It's possible you have another level that is affecting you. There are many things that could be going on such as Parsonage Turner Syndrome or a brachial plexus injury. Hard to tell without doing an evaluation.
Hi love this video, I have really severe what seems like permanent muscle atrophy on deltoids, which has gone on for years. I do find when I decompress the way you showed there’s a bit more strength. What exercises should I do every day to decompress my c5, c6?
@MrRaven888888 I am facing similar situation , are you having atrophy on both deltoid muscles?? What's the solution for this ?
@@abhijeetsingh2361 yes I have it in both deltoids
Great video Paul. I had a ACDF on 9-13-19. Had a massive stenosis, possible early edema or subtle myelomalacia, and other stuff. I also have a moderate stenosis (spinal cord) at c-5, 6. severe right and moderate left neural foraminal narrowing. The surgeon said "we may go in later and do some things from the back." Does it sound like I will likely be having more c-spine surgery ? I'm 63, and this is likely from old injuries. Thank you. I love your videos.
Research does show that there is an increased chance of having issues above and/or below the level of fusion. A sight chance. Make sure you are keeping your posture in check. Good luck! Paul
@@OrthoEvalPal Thank you Paul.
Should the stretches and traction the patient tried at home not work is the next step surgery? I'm having similar issues, only I also have lost almost all feeling in my pointer finger and thump on my right hand at this point. At 35 I really dont want surgery if its avoidable
Surgery is sometimes indicated especially if there is weakness associated. You need a good evaluataion first before going down that road.
Diffuse disc bulge at c5-c6 level effacing narrowing both lateral recess with possible indentation to existing nerve roots, and
Mild disc desiccation at c4-c5 and c5-c6 level
Sir I am having pain in my biceps, triceps, shoulder.
Sir what should I do to solve this problem
Hi Pulkit, have you tried cervical traction? check this video: ruclips.net/video/xBtMnPCKN5A/видео.html
My myelogram and CT report say “foremen markedly narrowed by uncovertebral joint spurs and complete loss of disc height”. Does it seem like surgery is unavoidable? I’m a 49 year old dentist.
Hi Bethany,
Yes that is likely the scenario. Disc material can be reabsorbed by the body over long time but spurs cannot. We see a lot of patients with anterior cervical disc fusions or disc replacement and they do very well. Opening up the foramen can make a world of difference. We see a lot of neck issues with dentists, hygienists, orthodontists etc... Best of luck!
Doc, I'm having terrible pain in upper shoulder and deltoid muscle. The pain becomes unbearable when I try to lie down (specially pain in the deltoid area) and it keeps increasing and I feel like it will burst and that's why I can not sleep. Do u know what is it
Very Hard to say without doing a full evaluation. Many things causes shoulder pain. Should have it evaluated.
What city, state are you located ? I have the exact same problem as this guy. I’m from Los Angeles California, is there any way I can work with you ?
Hi Ernesto, I am across the country in Maine!
Hi, Paul, I'm 54 and was diagnosed with cervical radiculopathy 15 years ago, but until fairly recently have been able to live relatively pain-free and with a fairly free range of motion and good strength. I was told my main problem was most likely referred pain from impingement of the C4 and C5 mostly. However, about two or three weeks ago I was doing a moderate workout where I combine fully-body stretching exercises with relatively light seven lb. hand weights. Ever since that day I have been in excruciating, debilitating pain going down the left side of my neck into my upper arm, shoulder and clavicle, but mostly in my shoulder blade area. My left shoulder blade is the locus of almost all the pain. I also can't really lift my head very high or backwards very far, lie completely flat without discomfort, or raise my left arm above the shoulder without pain. I am really getting scared and worried because it now seems so painful and crippling (like a stooped hunchback who can't look up easily), but more concerning is that it seems to be mimicking a heart attack or stroke, with almost constant chest pains at the left side of my chest under my armpit, and with stabbing pains from my shoulder, upper arm, left chest, but mostly coming from behind my left shoulder blade. Could I have a bulging, ruptured or herniated disc? After all my research of symptoms and pathology, it seems that it may be what is described as a "winged scapula" in which maybe my scapula is not lying flat or has been dislocated. It also said that can be caused by either trauma such as blunt force or non-trauma things such as viral factors or infections. But mainly it was corroborated to me by saying it could be caused by or an adjunct to cervical radiculopathy. I'm sure you know all this, and I apologize, but I'm just tryng to be as specific as possible to tell you how I present. I just can't believe such an old-person workout I was doing could exacerbate my condition so accutely and severely. Thank you so much for taking the time to read my problem, and any diagnoses or advice would be so appreciated. Take care. Thomas Humphrey
@Thomashumphrey7395 I just read your post and I have the exact same pains and symptoms you are describing but for me it's the right arm shoulder etc.. for me started out with right hand index finger tip section went numb tingling loss of precise feeling for touch or pressure.. than a week later overnight woke up to only able to keep my arm in 1 position to tolerate the pain and it was my forearm resting on the top of my head.. chiropractor showed me pictures of this scenario for slipped disc sign with a name for it just can't recall it.. I have the c4 messed up after the diagnosis and after the first adjustment I was able to have my arm down finally again 30something hrs after.. how are you doing now? 4years after your post..
I have pretty noticeable symptoms. Trying to get into doctor. No luck till middle of January. Now I'm very concerned about permanent damage. Wht can I try at home till visit? Ty
Hi Teresa, I am a big advocate of cervical traction. amzn.to/3IyWIOG
Hello sir how are you how clear c4 c5 nervous block
not sure what the question is??
I have exactly that problem. Mine started 10 yrs ago. Is it still possible to fix? If so, can i avoid surgery? As long as i workout with machines i can lift heavy. If i use freeweights for upper body, reinjures easily.
Hi Chris, you should get some guidance for this because some activities will make this worse. Best regards, Paul
@@OrthoEvalPal any recommendations in the orlando area? Every chiropractor ive visited has failed to identify what u shared in this video.
@@chrischung2365 wish I knew someone down there. Good luck!
I have m r i scan
i have the same thing on my right side, when the chiro does sustained traction it irritates it, mainly the neck and just behind the neck shoulder area, chiro said if it hurts like that it could be muscle related also in that the muscles are tight around there i also got xrays done and have lost some curve in my neck and a disc buldge around c5 c6 also and been using a wedge thing thats supposed to help get the curve back so my question is would muscle tightness have a role to play in the problem of the nerve irritation?
Hi Joe, you could have muscle tightness as a result of nerve irritation but very hard to tell without evaluating you.
Hi, Doctor, thanks for this video, I have the similar problem but with severe pain in my left arm, bicep, elbow and left shoulder as well. Last two weeks I am surviving with pain killers and still with pain. I did an MRI that shows some bulging and compression, could you suggest what kind of home exercise I can do to avoid surgery please. Regards, Altaf
Hi Altaf, I am a big advocate of using traction. ruclips.net/video/bKaV1QehHmA/видео.html
Best of luck!
Do u ever get diziness and ear pain?
Is there a post op or post treatment follow up with this patient? If so is there a video of it? What’s the update on him?
He did great! I know him well and all of these symptoms subsided
@@OrthoEvalPal Outstanding, that gives me hope. I’m currently going through PT post ACDF (C4-5-6 ) my deltoid weakness/palsy started Prior to my operation. I was diagnosed with C5 palsy PRIOR to my surgery. I have small improvements but I’m still significantly weak. Do you have any experience or videos about this? I’m 32 military and law enforcement and was in very good shape up until 4 months ago when this happened.(no injury)
@@gt1123 strength is the last to come back. I've seen hundreds of these and many say they are 1yr+ improving. Best of luck to you. This is inspiring me to do a video of the progression with my next patient who has this.
Thank you for what you do. I’ll be on the look out for more videos!
I am 47 years old in good condition and have e c5-c6 pinch nerve, pain on my right shoulder, have done the MRI and have been diagnosed with pinch nerve. Now since coronavirus is around I am afraid to follow up on doctors office. Any suggestion?
Hi, I place most of my patients on home cervical traction to give the nerve root a rest and decrease radiating pain. This is how I do it and this is what I use.
www.healthproductsforyou.com/search?searchterms=saunders%20cervical%20traction%20device
ruclips.net/video/xBtMnPCKN5A/видео.html
Best of luck!
Hi.. i have same thing. So painful have you found any cure yet?
Could this cause your arm to swell up and be an inch or so bigger than other arm? Thank you for your video. :)
Not likely Susan. that sounds like a vascular issue.
@@OrthoEvalPal It's been like this for 2 years. I went to the ER on/ 4/2/20 bc I also had other pain but they took a scan and an xray and then just said it was due to my bulging discs. They gave me an injection and rx for pain meds even though I told them I had quit my norco meds 2 years ago after 18 years. I fear Im too late to do anything about it bc that was their go to for 18 years since my car accident Thank you so much for your timely response.
Dear doctor, i have c4 c5 or c5 c6 root, because 6 years ago i had cracked my neck on the right, i did it almost everyday until now, after i crack something grow bigger inside my right neck and it become very hurt, i cant turn my head left because i can crack my right neck and the little thing can be bigger and very hurt, i just can rẽcover by wake up after sleep, i know it can be c5 root because i have same trouble at my shoulder like the guy on the video my tendom right neck is smaller than my left day by day , i cant use computer often now because it can hurt even i not crack anymore. May u aswer me can i find my trouble by using MRI?i ask it because i live in a poor country, doctor in my country think i am insane because i am only 22 year olds now, i have pain in 6 years and they told me iam crazy and kick me out. Hope u aswer me, i am thinking i will have to live with this pain forever.
It is difficult to know without seeing you. The MRI could be helpful if there is a growth and if there are similar symptoms as in the video.
Omg i in the exact same situation, where are u located??
Maine
@@OrthoEvalPal thank you,
What happened with this particular patient?
Anterior cervical disc fusion and did excellent!
@@OrthoEvalPal surgery needed pls?
Sir plzzz tell me treatment time I am in very big problem plzzzz contact with me
Sorry I don't do consults on the internet.
Dr isn't responding to questions😮