Cervical Instability and FMS, an interesting correlation?

[cookiebaker]

Well, thank you @JayCS for sending me down this rabbit hole, not sure if it is a good thing or a bad thing at this point, but VERY timely..

After reading Jay's post here discussing sleep and various experts opinions on what works, what doesn't, I started reading through the 4 related blog posts about sleep on health rising, starting at the beginning of the series.. also reading some of the comments after each post.. which led me to a comment about Positional Cervical Cord Compression (PC3) witch in turn, led me down another path reading about PC3... and I came across this little chart in an article called "Using Dynamic MRI to Diagnose Neck Pain: The Importance of Positional Cervical Cord Compression (PC3)" by Andrew J. Holman, MD - Dec 2012 (found on the Practical Pain Management website)...

Hmmmmm... Very, Interesting.... I have known neck (cervical spine) problems that have been getting worse over the last year.. and a multitude of the listed symptoms above.. all of which can be attributed to other things, very true, but i find it interesting that there is a definite correlation here with cervical spine problems, FMS and sleep problems...
Of note - in the paragraph prior to that table, it is stated that one clinician found that 54% of her FM patients also had PC3 - that is an astonishing number.

This is very timely because I have an appointment tomorrow (Sept 15) with my Physical Med doc to follow up on lumbar nerve ablation and to potentially discuss other things... (SI joint flare, neck issue getting worse, etc)

I think this is something that I really want to follow up on with him. I have had multiple view x-rays of my neck, which do show multiple degenerative issues (called "mild" on the report) but have not had an MRI of the region (have had MRI for lumbar) - the big question will be can i get the multiple views on MRI that actually show the positional aspect of PC3? Even if i can get just 2 of the 3 suggested, it could be quite illuminating.
I will update this posting as I learn more from personal experience.

 

[JayCS]

not sure if it is a good thing or a bad thing at this point, but VERY timely..

Hehe, oh these rabbit holes.... Trying to keep it short and not spoil my good self-discipline so far...

Two general points to remember: association is not causation.
And even if it is causation it might be the other way round or a hen-or-egg-scenario.

More specifically my therapists and I myself have very much focused on my neck, but apart from being another local pain and (important) stiffness less it hasn't done anything at all for fatigue etc.

This is the long story I wasn't gonna to write....
"During" my diagnosis 2.5y ago I was pointed to a German "environmental doc" Dr. Bodo Kuklinski. "Your Neck - the 'Weakest Link'." is the German translation of a book of his.
He is an MD, and was a head physician, but has become what you'd call a functional doc (and likes to slag off his colleagues etc. and is very "full of himself", bit of a bulldog, see youtube).
His other basic assumptions are mitochondria damage (ATP) and nitric oxide toxicity - via the neck issues.
I got my neck thoroughly treated both with an osteopath and my acupressurist, who both said the neck is vitally important for the rest, and always started with the neck when doing body manual therapy. During this I realized that regular neck stretching of my own greatly improved flexibility and pain there, but nowhere else.
I was sent his complete supp protocol and worked thru it several times for a few months each, without the least success. At least he does teach/know a lot of basics which I still use today, it wasn't that expensive and he doesn't sell products. (He slags docs, researchers and insurance off for calling them "supps", saying it's actually a causal therapy. He bases everything on "studies", but the way he does it is not trustworthy to me - no maybes, all 'truth'.

 

[cookiebaker]

association is not causation.

I am well aware of this, believe me..
but if I can get even a little relief from the neck pain, the sleep issues (another rough night) and some of the other symptoms.. even just a measly 5-10% would be something

Maybe I am grasping at straws here, maybe there is nothing to this.. but the Pain Management article sure does pique my curiosity.. and I have found more recent research papers that are closely related to that one that say basically the same thing.. that there is an improvement in symptomology when PC3 is diagnosed & treated, both surgically and non-surgically. (which method is determined by the severity of the compression)

During my "awake" periods last night (and i do get up out of bed so I dont disturb my partner) I was doing some of my neck stretches and then tried to rest a little with a rolled up hand towel behind my neck (leaning back in my office chair) Interestingly, the edema is way down this morning.. (yes, have made multiple trips to the bathroom, lol) where it had been pretty severe in the left leg for the past couple of days...

Who knows, maybe i will be a "test case" for my local clinic/hospital, lol. They like to tout themselves as a research and teaching facility.. well, lets do some research and teaching!

 

[JayCS]

a little relief from the neck pain, the sleep issues (another rough night) and some of the other symptoms..

Definitely, so important! 4-5 small local pains tonight all indirect consequences of the tooth treatment (less exercising and sleeping with head higher was bad for back and more), but no neck hurt! Even if it were just another local pain, it's harder to distract from than others.
If it does sometimes hurt at night, I now only have to stretch once left/right, don't have to get up. Always have a pillow under the side of my face so my necks's fairly straight, despite lying half face down and the rest of me usually twist stretched in recovery position.

Who knows, maybe i will be a "test case" for my local clinic/hospital, lol. They like to tout themselves as a research and teaching facility.. well, lets do some research and teaching!

Hehe, I like that!
(First I read that you were going to test your clinic, how it reacts.
Like I sometimes do/did new docs before big things come along I want to entrust someone with.)

 

[cookiebaker]

well, MRI is scheduled.. sadly, because of the insurance thing, it will be a simple standard, neutral view - doc said if he could, he would order all 3 views, but insurance wont cover them, so... we are going to start there and see what comes of it. Sadly, the functional MRI views are not widely accepted yet.. that is not to say that he cant send me back for another view later
I made the comment to him about being a willing research case, he chuckled.. if only he could..

The Physical Med doc (or physiatrist, if you prefer) that I have been seeing is pretty darn good.. he actually listens to concerns, and is more than willing to go over x-rays, mr images, etc with you, show you (point things out) what they see and what it means.. go over the reports with you to make sure you understand what they say.. answer any questions you have (to the best of his ability, at least.. he is not perfect and he is the first to admit it), I really like this one.. and i dont say that about many docs in this clinic... they could do with a lot more like him.

but yeah, he agrees that the neck seems to be more problematic right now than the SI joint, which is sore, but i can live with that for now.. if it gets worse, then all i have to do is call and we can set up an appt with pain management.

oh, speaking of pain management.. he will be making the referral (again) to them to see about getting me started on the LDN - he wanted to do this way back last December, but due to my financial situation, i just could not do it, but now, with the disability kicking in, i should be able to.

so, new stuff on the horizon... we shall see how things go with all of this..

MRI scheduled for Oct 5

 

[cookiebaker]

I realized that regular neck stretching of my own greatly improved flexibility and pain there, but nowhere else.

yeah, i have tried doing stretches, and neck strengthening exercises (as prescribed by a PT) but i have to be careful with this because i have made things worse by stretching too much, or in a slightly wrong orientation.

to follow on with my post earlier about stretching and using a rolled up hand towel.. the foot/lower leg edema is much much better this afternoon since this mornings "exercises"

Thinking i will continue this line of self care over the weekend - see if the edema stays down, and/or if i can get any better sleep, then stop again and see if it comes back, or what happens..

 

[cookiebaker]

whelp.. neck issues have not improved much at all..
in fact, have been plagued with "ice pick" headaches on & off all day today..
have tried the rolled up hand towel, and while it feels good initially, it just does not last..
same with ice packs.. feels good to start with, but once the chill wears off, no real change..
Sleep has not been very good either.

going to be a long 2+ weeks to the MRI..
just took two OTC extra strength Tylenol to hopefully take the edge off and let me sleep tonight.

 

[JayCS]

but i have to be careful with this because i have made things worse by stretching too much, or in a slightly wrong orientation.

neck issues have not improved much at all..

Sorry about that. Hopefully there's nothing too much at the root of it.
A PT neck class taught me many diagonal neck stretches (normal and then using diagonal arm movements and then adding weights). My acupressurist says not to, just head high, head middle, head low. I do also press my head against my hand like she showed me. But my main one was just head middle side stretches. Is that any help?
Do you with "orientation" mean that there is too much resistance at a certain point or do you only find out after if it was a wrong move or not?

 

[cookiebaker]

Do you with "orientation" mean that there is too much resistance at a certain point or do you only find out after if it was a wrong move or not?

it is usually a little afterwards.. while i am doing the stretches it might be ok, but after stopping and simply sitting at rest, it will start to tighten up worse than it was before.
sometimes it can be a "more resistance" situation.. as in pain increase before getting to a previously non-painful stretch position.

primary stretch is tilting head to one side (ear to shoulder), and "dropping" the shoulder on the stretch side to get just a little more stretch, and if that was not enough, then use the opposite hand and very gently pull the head over a little more
example: tilt head to left shoulder, drop right shoulder, and if needed use left hand to pull top of head more to left/down..
i have also found that by turning my head (looking up or down), while tilted to the side like above, i can change the stretch just a bit

not sure what i did, but the right shoulder has been quite painful the last couple of days now, too.. so doing the shoulder "drop" on that side is out of the question. if I try to do that, it "pops" and feels like it is out of position... not really dislocated, but close.

 

[JayCS]

tilting head to one side (ear to shoulder)

Yep, that'd be other examples for the ones my acupressurist discouraged me from....
Other ideas: I've had a lot of success combining these stretches with massaging with my massage "pistol". Praps heat now it's hurting, but you'll be doing that already.
I don't like ice packs at all by the way, only very short if inflamed. Short like the short showers....

 

[cookiebaker]

go figure.. one professional says try this, another says no, dont do that..

cant win for losing. oh well.. I do what i feel helps me, without over doing it..

i am not sure what your massage pistol is, tho... has me curious

 

[JayCS]

go figure.. one professional says try this, another says no, dont do that..
cant win for losing. oh well.. I do what i feel helps me, without over doing it..

That's what I thought too, but I trusted the acupressurist more and did well with just that.
I was just mentioning this alternatively cos you said it's been harming....?

i am not sure what your massage pistol is, tho... has me curious

Hehe, sunkacola's already said you have other guns/pistols where you are, and "none" of us do...
This is closest we get to having a "gun" in the house. My acupressurist used it on me, but I wasn't sure it was working that well, then my wife pushed me to buy it, and now I use it for 2 or 3 minutes for all local pains, lower back unrest, during some stretches as said, and more recently even to dislodge food or capsule blocks from my esophagus stricture....

 

[cookiebaker]

ok, pretty close to what I had imagined..
Might have to look into that (after my disability income starts - next month )

 

[djhsix]

Posting to keep this thread alive. My next step is a cervical MRI too after a clean EMG and NCS.

 

[cookiebaker]

Posting to keep this thread alive. My next step is a cervical MRI too after a clean EMG and NCS.

i hope you can get some answers from your MRI..

I havent really posted much in this thread lately because the initial test injections in the neck did not go well. MRI says arthritis and related stenosis (foraminal and facet) causing problems, and I am currently waiting to see my physical med doc next week to discuss where we go next.