syrinx

[lciszek@sympatico.ca]

Hi, Since November 2007 I was experiencing pain at the back of my head, bottom, close to the neck, to the right side, which radiated to to neck and shoulder area, caused muscle spasms and pain radiating into head area. I actually feel like right side back of the head is a little bit swollen or larger. Since the onset of the pain in November 2007, I've been to two different physiotherapists, a psychologist for biofeedback to help with the pain, massage therapists, and currently seeing a Chiropractor and massage therapist. It was actually the biofeedback specialist that recommended the MRI because she could see the pain I am experiencing on her computer program, she felt there was definitely something going on.

So in September 2008 I asked my family dr if I could get an MRI and the results of that test showed a small 'syrinx' between C5 and T1 with no evidence of abnormal enhancement, as well as mild degenerative disease in the spine from the cervical area to the lumbar. My family dr prescribed Meloxacam 7.5 mgs. which reduces the pain is reduced but as soon as I stop taking the medication, it gets bad again within a matter of days. I just want to know if this is normal with osteoarthritis and if the 'syrinx' indeed has nothing to do with any of my pain.

I went to see a Neurologist today, January 5th, 2009, but was told that the 'syrinx' has no bearing on any of my pain symptoms and that I wouldn't have even known about it, had I not had an 'MRI' done and that I no longer need a Neurologist and I can just see my family physician for arthritis precription. The Neuro said probably I was born with it??

Any advice,thoughts, or suggestions would be greatly appreciated.

Thanking you ever so kindly,

Linda Ciszek

[MG (Admin)]

Please will you send us the exact wording of the full MRI results and more importantly the precise findings of the neurologist when he examined you (it should refer to your muscle power, reflexes, sensation etc etc).

thanks

[lciszek@sympatico.ca]

Here is what my MRI reports says:

Findings:

Mild degenerative changes in the cervical spine from C4 to C7 area noted.

In the thoracis spine there are small posterior disc protrusions at T8-T9 and T9-T10 effacing the thecal sac. There is no direct impingement of the spinal cord.

In the lumbar spine, there is a posterior disc protrusion causing mild spinal stenosis at L1-L4.

There is also posterior disc protrusion association with degenerative changes of the facet joints at L4-L5 causing mild central spinal stenosis.

At L5 and S1 there is a posterior disc protrusion associate with degenerative change of the facet joints. There is minimal effacement of the thecal sac.

The neural foramina at all levels appeared unremarkable.

A small syrinx is again seen from C5 to the T1 level. There is no evidence of abnormal enhancement.

Incidental note is made to the patient having uterine fibroids with a retroflexed uterus.

IMPRESSION:

1. There is a small syrinx in the cervical spinal cord.
2. Mild degenerative disc disease identified in the cervical and thoracic regions as well as degenerative disc disease in the lumbar spine as described above.

***end**

thanks,

Linda

[MG (Admin)]

And how about the neurological examination?

[lciszek@sympatico.ca]

The neurologist did her exam and said everything was normal/fine (muscle power/sensation etc) and that I have mild degenerative disease, the 'syrinx' is not causing any of my pain because it is small and I otherwise wouldn't have known about it had I not had an MRI done and that I was probably born with it, and she said I was doing everything I could already and to continue with the pain pills, meloxicam, and that she will send her report to my family physician and if I need further pain pills I could see my family physician. I was concerned about exercising, and she says there's nothing to worry about.

I asked her if even though my complaint of pain was generally my head and neck, especially to the right, if she was sure the syrinx had nothing to do with it, and she said yes. I just found that hard to believe.

Linda

[MG (Admin)]

I think on balance it is clear that the syrinx cannot explain all of your symptoms. This is because the nerves that involve feeling of the upper neck and head do not actually go anywhere near the area of the syrinx.
This does not mean that you do not have a problem (you are suffering so that means you do have a problem) just that the syrinx cannot be blamed for all of your symptoms.

If the neurological exam is normal then I would certainly not consider any surgery etc on the syrinx but I would probably just arrange follow-ups in the neurology clinic every few months.
In terms of the pain, have you been seen in a pain clinic?

[lciszek@sympatico.ca]

No I haven't. What exactly is a pain specialist?

[MG (Admin)]

Usually an anesthesiologist who specializes in dealing with pain (may work in a "pain clinic" .

[lciszek@sympatico.ca]

I see my family physician next Tuesday, I'll bring it up with her and see if she will refer me to one. Thanks very much for reviewing my post.

Linda

[MG (Admin)]

All the best.