Cervical radiculitis

Patient

Q: I recently went to my Ortho doc with pain in my right shoulder and elbow, and tingling in my wrist, hand and fingers. This seemed to be a progression from my first visit to him back in October 2009, when he had an MRI done. The results are below. He said the pain and tingling were Cervical Radiculitis, gave me a Medrol dose kit, a tens unit and home traction, I preferred that to PT. Based on the results below, should I expect more progression? How often should I agree to a new MRI?

Doctor

A:   The pain in your right shoulder  and elbow, tingling in your wrist as you described it is due to a cervical nerve compression : cervical radiculitis, but it would be important to rule out inflammation of the peripheral nerves at the level of the arm and hand. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory drugs (as “motrin”, “advil”),TENS, also a re-education of habits and posture to improve quality of life. You should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. Patients whose condition fails to improve with a comprehensive rehabilitation program and selective injections (medrol dose kit) should be presented with a surgical evaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation. The timeframe between MRIs is variable for each particular case.

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