Cervical Spondylosis Explored

"Does C/S Radiculopathy cause chest pain??"

Yes it does.  That was the first symptom of my C/S many years ago.  It's a 'referred' pain in chest,  depending on which nerve in the neck is being threatened......quite often it will go hand in hand with a stiff, or stuck, neck.  Another common rerferred pain with C/S is a sharp pain right in middle of shoulder blade in back,.along with stiffish neck.  These pains usually dissipate, might take a few weeks,  and can reappear with different types of aggravation to nerve.  They are most commonly caused by lifting too heavy a weight, or trying to shift something heavy.  However,  it doesn't hurt to have them checked in case there might be another cause.

PS....

I should have added that any pains in chest, upper back, shoulder,arm or hand which are accompanied by a reduction in ROM (range of motion) in the neck area are likely to be referred issues from some issue with the neck,  not necessarily C/S, but most commonly C/S..

Hi Gerry,

Although I have C/S at level C4/C5/C6, I don't have much pain in the back of the neck, however I get pains in the back of the head (just above back of the neck). The pain is mostly in the upper back, left arm and left side of the chest.

I can re-produce the left side chest pain by pressing or leaning forward by sqeezing.

I am very much worried of the chest pain, the spine specialist says its all becuase of C/S. The cardiologist saying the pain is not related to my heart.

Do you suggest to go for anyother cardio test?? I have already undergone, Stress Ecghocardiography, Treadmill Stress Test, EKG etc in last 3 months.

Looks to me like you've already had the appropriate tests to rule out heart issues.  Your symptoms seem like typical C/S.  On the 'pains in the back of the head just above neck'...again typical of C/S. These are usually caused by muscular neck readjustments to protect a threatened nerve. As such they are an 'associated' symptom rather than a 'direct' symptom, and they can be eased by altering sleeping postures.  If the neck is well relaxed when sleeping,  these symptoms can disappear.  Try sleeping semi-up[right on a sofa for a few nights and see what happens.  It might hurt a bit more initially,  but once the body gets used to the readjustments,  it should ease off.  Try different positions and different postures.  If that doesn't work,  try something else.....the key to easing the symptoms  is in the sleeping routine.

" I guess if I ever do have a heart attack, I wont be able to discern the symptoms if they are subtle - it will just seem like another bad back or neck issue to me.  "

A blessing in disguise maybe,  if outcomes can't be avoided either way !   I've heard that heart attack issues usually come with a distinct pain down the left arm,  and a sense of breathlessness.  Chest pains probably more associated with angina,  signifying a vascular blood flow problem.  They've gotten quite good at determining risks of those sorts,  perhaps better than establishing a necl correlation.  THe trouble with the C/S chest pain is that sometimes it feels like it is increasing and spreading,  but that's probably got more to do with rib muscular tensions than anything else.  I'm sure the day will come when the first thing they look at will be the neck, and once that possible cause is eliminated, they can seek elsewhere.  ROM in the neck is easy to check, no machines required.

PS.....

I'm not familiar with the T1-T3 bone spur issues,  but I have had 'mimicked Thoracic Outlet Syndrome'  which is a known C/S referred issue.  I don't see why spurs at T1-T3 wouldn't  give rise to similar referred issues.  Apparently the bone structure at T1-T3 is much bulkier and less vulnerable than C1-C7,  so similar reactions in the thoracic spine are a lot less common....I presume.

Just wondering if you get the cold hands effect ?   Appently if it's actual TOS,  the hands turn a blueish colour and feel cold.  With 'mimicked' TOS,  the hands feel cold,  but don't change colour.  The difference is that 'mimicked' is caused by the neck,  whereas actual TOS is caused by nerves and veins being restricted as they pass through the thoracic outlet in the shoulder blade. 

Your link to ATSDR is being moderated,  so I haven't seen that image yet....it's not on ATSDR home page.  The cold hand colouring is used to detemine whether the TOS symptoms are actual or 'mimicked'.  Actual TOS usually requires surgery on 'spare rib'  which is what the spurs on T spine are called, or a surgical clearing of any restriction in the thoracic outlet channel.  It can continue without treatment.  'Mimicked' TOS is different. It's caused by nerve compression in neck, which then recreates all the symptoms of actual TOS (except for the blueish hands), and treatments are directed at neck rather than thoracic area. 'Mimicked' TOS can come and go, and it varies in intensity.  Mine lasted about 3 months, then dissipated, but I still get occasional reminders.  It's symptoms are a sharp pain in one shoulder blade,  and a buzzing pain down same arm all the way to little finger,  numbness and pins and needles in hand, and cold hands with no discolouration (which is proof of the 'mimickling' referred effect ).  Certain postures, like driving, sitting on certain seats, and lying in bed increased the intensity...in fact,  I could only sleep on sofa with arm behind back.  BUt it eased off, on it's own, after 3 months.  I saw it as being similar to the Frozen Shoulder effect we can also get with C/S...i.e. self-resolving just requiring patience.

The whole issue of referred symptoms is really quite interesting,  because of the way it helps to define nerve behaviour.  I don't think the pain scientists (neuroscientists) have a good understandiong of referred nerve behaviour.  They tend to see it as nerve dysfunction because it goes against their theories for more direct injuries,  and that looks like a cop out to me because referred issues are common and standard acroiss a range of conditions, and are anything but a dysfunction.  It's meant to happen as part of the autonomic response to these conditions, and yet it is passed over as a malfunction requiring little explanation.  Quite often they end up treating the referred 'mimicked' symptom,  rather than the cause, which is usually a compressed or threatened nerve in the spine.  Instead of just seeing referred issues as nerve misbehaviour,  they really need to start looking at why the threatened nerve consistently creates these referred symptoms when vulnerable.  Such an investigation will obviously cause problems for their current accepted theories and practices,  so they simply don't want to go there if it means a certain unravelling of the opinions they already hold.  Reluctance at its worst !

Just wondering......Anyone got any interesting observations on the sleeping process, and how they think it might be affecting their morning C/S symptoms ?.

Everyone with C/S always describe their symptoms as being worst on waking in the morning.  What can possibly be the connection to the sleeping process ?  Any ideas floating around out there ?

I wouldn't say my symptomps are worse in the morning, maybe it's not C/S what I have? :P

Usually I feel better after laying down, not immediately, but after several hours into the night the pain it's mostly gone. Somethimes there is a bit of pain in the mornings while still laying down but about half the times there's little to no pain. I'm starting to feel pain almost immediately upon standing up. The pain tends to intensify for the next half hour or so, then it usually decreases to a 'baseline' level. Days are highly variable, pain can go up or down during the day with a peak in the afternoon, then it decreases in most of the evenings. Then there comes laying down which is sweet both because it tends to decrease the pain and is followed by sleep which it's the only thing which 100% eliminates the sensation.

 

Hi Michael

"I wouldn't say my symptomps are worse in the morning, maybe it's not C/S what I have? :P"

Perhaps I should amend my comment " Everyone with C/S always describe their symptoms as being worst on waking in the morning " to " Most people with C/S etc ". Certainly true in my case,  and most C/S posts I've read.  However,  it's not a means of determining whether someone has C/S or not.....it's just a common feature which keeps getting mentioned.  The rest of what you describe seems to fit the bill,  but because symptoms can be so varied with C/S, it's not a reliable method for saying yes or no.  MRI or Xray or neck ROM (range of movement) are probably the most reliable determining methods.

One thing you do point out is the 'desirability' of the mostly pain-free sleep state.....that's something I'm sure, we can all relate to.  The mystery of why pain doesn't register when we sleep is still in debate in medical circles....and considering it beats painkiller medications all to hell must be something of a 'thorn in the side' for those who get paid to investigate remedial solutions for chronic pain issues.  It would seem that sleep is our default comfort zone....that's how I feel about it now, and have done for years.  THere's been very little research into what actually happens when we sleep.....most research has focused on REM sleep states and dreaming etc,  but very little on pain relief effects.  I don't know why that aspect is so overlooked when there is obviously something very beneficioal occuring,  especially with conditions like C/S which don't offer much by way of relief during the awake hours.  Maybe if we made some noise about all this,  the researchers might get on the case and start exploring the sleep relief processes.

The morning thing works for me like this (on a rough day) :   I wake up.  I feel blurred and numbish around head/neck.  After about half an hour that usually clarifies into more recognisable ache/pain.  After another hour, that might ease off somewhat to the point where I feel I can manage normal stuff better.  If it doesn't ease off naturally,  then it can linger all day,  with ups and downs.  If it does ease off in the morning, then that usually lasts all day.  Point being that the forecast for any day is usually determined by what we wake up with in the morning....and that can vary itself every day.  So,  if there was some way to affect what we wake up with,  that would also give some control over what lay ahead for the rest of the day.  In other words,  If I could find a way of sleeping which alters what I experience first thing in the morning,  that would have repercussions for how the remainder of the day might pan out.  That's my angle....to just focus on ways to improve the morning symptoms by altering sleeping arrangements, and then, in theory,  the rest of the day should take care of itself with less issues. 

Hello Gerry.

Sleep is turning off the consicence switch, that's why it works for pain (among others). So you're thinking on achieving the same but keeping the conscience on. Interesting, and certainly not something that's available today (even as an idea, as it's the first time I hear it).

About research and researchers... there's a lot of hype nowadays around this subject, especially cancer research. With the purpose of fundraising, a breaktrough is presented as imminent while in reality, at least by my estimate, humanity has about the same chances of curing cancer now as it had on getting to the Moon around the year 1500. And by my same estimate, compared to fixing issues of the spine, curing cancer is easy stuff.

As I see it, the rate of advances in microbiology or any other science is determined by:

 1) the number of working scientists

 2) the period of time these scientists activate

 

Funding/money can only increase #1. For #2, there's nothing one can do but be patient. Take the example of getting to the Moon at 1500, even if all the people in the world would have dedicated themselves to solving this problem, it is unlikely they would have succeeded on their goal within their lifetimes.

 

"Sleep is turning off the consicence switch, that's why it works for pain (among others). So you're thinking on achieving the same but keeping the conscience on. Interesting, and certainly not something that's available today (even as an idea, as it's the first time I hear it)."

Hi Michael

Not exactly what I was getting at,  but I know exactly what you mean.  I've played with that idea....How to achieve the same result when conscious (awake) as what happens when the pain switch is turned off when asleep (non-conscious), without the meds.  In theory, it should be possible,  but the means to achieving it would probably rely on entering some semi-conscious half-awake half-asleep suspended state,  perhaps a bit like the Hindu Guru's or the Persian Whirling Dervishes.  They often report a lack of pain sensations when they're in trance. I honestly don't know if that works,  and the life-long training would be off putting.

As I see it (here we go !) there are three known states of being.  There's 'consciouness' when we're awake and thinking, and we're familiar with it's workings. Then there's 'unconsciousness', which is a state where coinsciousness has been forcibly turned off ...for example, when in a coma, or when 'knocked out'.  And thirdly, there's the non-conscious, which is a state we are not consciously aware of,  but it regulates our autnomic systems (nervous system and immune system).  Non-consciousness purrs away in the background, behind the other two states, providing protection and responding as necessary to any impending or actual threats.  It's functions have absolute integrity,  and, desp[ite what some might say,  it can do no harm.  Autonomic reactions are always attempting to ensure our survival,  and they do one hell of a job, from beginning to end,  without the need for our conscious state to even be aware of what's going on.  It's only in the last century that we've even become aware of how perfect and how incredibly complex our autonomic reactions are (not can be !).

If that summary is anywhere near correct,  then I'm inclined to see the pain event as being some kind of bridge between the non-conscious and the conscious,  perhaps a bit like dreams also seem to bridge the two systems.  As such,  pain seems to me to be a tool which is used by the non-conscious,  in order to influence specific conscious reactions,  or even to restrain possible conscious reactions which might be perceived as more threatening.  That's just my take on what pain might really be,  and in that overview I can see how it might be possible to affect the 'end result' conscious perception of pain that we know so well.

So, with C/S,  it looks like the painful protective symptoms are instigated whilst we sleep,  and if we can find ways to sleep which lessen those protective needs which the nervous system is reacting to when it does this,  then it stands to reason that there should be lesser symptoms on waking.  Most C/S symptoims seem to result from the nervous system attempting to protect  threatened nerve/nerves. THe actual threatened nerve doesn't usually relay painful symptoms,  it relays numbness....so the symptoms are all to do with the effects of over-taxing the surrounding tissues/muscles etc.  The only symptoms which are directly caused by the threatened nerve are numbness, pins and needles and loss of power in muscular reactions,  none of which are particularly painful in themselves.

Does any of that make any sense to you ?

To respond to your question about recreating a pain switch in the conscious state....that would be the ultimate solution,.  but I'm not sure that it would be possible.

PS....

( replying to myself now !!    Not a good move ! )

Just to say that I'm inclined towards thinking that merely thing about, and trying to rationalise,  the pain experience can have a positive Placebo effect.  It's only when we concede our rationalising abilities that we allow ourselves to get swamped with negative perceptions of pain.  I know that seems easy to say,  but maybe doesn't quite pan out that way in reality.....but I still like to think that it's a good thing to do to try and get a grip on experiences that have the potential to reduce our trust in our own rationalising abilities.  Doesn't matter if we figure it out wrong sometimes.....putting in the effort is what pays rewards.

Edit...

first sentence should read  'merely 'thinking' about.

>> As such,  pain seems to me to be a tool which is used by the non-conscious, in order to influence specific conscious reactions, or even to restrain possible conscious reactions which might be perceived as more threatening.

>> Does any of that make any sense to you?

I think it's plausible, the non-conscious (vegetative system) reacts automatically in ways it's shaped to. If there's a mechanical problem with the spine, then just drugs won't fix it. All one can do is hope the laxity is not as bad as to affect the spinal cord and carry on with the limitations imposed by the reflex reaction of the nervous system. Drugs can help here by dulling down the pain.

As for placebo, there's also nocebo. I tend to avoid talking/thinking about pain too much because I tend to become overfocused on it and seem to feel it amplified.

 

" Drugs can help here by dulling down the pain."

They certainly can do, perhaps in the same way that the relaxed sleep state allows some autonomic re-hab.  So, in a funny way, the meds might seem to switch off our busy consciousness and give the problem some space to attempt some fixing.

"As for placebo, there's also nocebo. I tend to avoid talking/thinking about pain too much because I tend to become overfocused on it and seem to feel it amplified."

That can happen too.  I wouldn't want to feel I'm giving anyone a worse headache with my ramblings !   Personally, I feel ok about separating the thinking from the experience.....been at it a while, so maybe I manage the distinctions without any crossover effects.   It's one of those things where, once the fear is conquered,  the doors just seem to keep opening.

Gerry, I remember from your previous postings you were making a distinction between trauma-induced and arthritis-based C/S. Also that you're experiencing the trauma one.

Don't remember to have read what sort of trauma. I think this can also be diversified in accidental one, like a fall or a car collision and micro-trauma which builds up in time, like working with your head and neck in weird positions. Wonder which one of these was the flavor which marked the onset of C/S in your case...

Really,  I had to guess the origin of my C/S.  First diagnosed aqed 30...pain in chest/stiff neck etc.  Working it back from there I could only remember two incidents which might have been responsible.  One was a car crash aged about 10,  where I was thrown against front seat. The other was a motorcycle acciodent aged 20,  where I slid along the ground. Otherwise, no obvious cause...i.e no arthritis etc.  With injury based C/S, I think the fault occurs ,  then it gradually affects the other vertebrae by wear and tear.  So, the symptoms are slow to evolve with wear and tear,  unlike with an arthritic condition like OA, where the degeneration is much quicker,  and usually only occurs later in life.  I've had plenty of time to observe the dynamics of each symptom as it happened.  MOst treatments seem to be directed at the 'later in life' arthritic cases,  where medication/surgery are the usual response,  at the expense of good advice for C/S cases which are injury based and longer lasting.  The way I see it is that, at age 30 I had neck problems that would be normal for a 70 yr old,  and that requires managing, not medication.

So brutal shocks applied to the spine are not a good idea :P

Bottom line is that spine degeneration it's not curable in the classic way: take some pills, do some sports and you're like new. There's no silver bullet for C/S.

Brutal shocks to the cervical spine are an absolute no-no.  I might make an exception for some surgical interventions which do sometimes work temporarily,  but have an unknown predictability long term.  The research seems to suggest a less than 50% success rate, even for that....so that's always going to be a tough decision until they improve the techniques.

"Bottom line is that spine degeneration it's not curable in the classic way: take some pills, do some sports and you're like new. There's no silver bullet for C/S."

THat's mostly right, except don't expect 'and you're like new',  and perhaps steer clear of any sports which involve jerky neck movements (most physical sports).  Activities such as swimming, or walking, or exercising other body parts besides the neck, probably hold the least risk for C/S.  By managing C/S,  and I wouldn't exclude medications in that,  but only when necessary,  I mean managing the symptoms.....getting to understand their causes and adjusting lifestyle accordingly.  Like you say 'There's no magic bullet',  the degeneration won't rebuild itself,  so that's maybe as good as it gets.  Small improvements and symptom accommodation become big improvements when compared to the alternatives.  I think it's probably one of the last things we're inclined to look at because it seems so much easier to just rely on professional help whether that be meds, surgery, or physio.  I'm sorry to say that the feedback from those services isn't exactly encouraging.

Spine surgery is essentially an amputation. They should call it this way, it would temper the enthusiasm and high hopes of those who rush for this 'solution'.

Yes.  Most surgery is essentially a threat to life.  It's no different to having a wound inflicted,  except for the fact that it has been carefully planned and risk assessed so that the immune system can repair the surgical damage.  Without the immune system response,  most surgery would be too risky.  It's the immune system which does the real healing,  the surgery just removes the offending part.  People tend to see the surgery itself as the corrective action,  whereas it's really the following immune response which should take the credit...without the response,  the surgery wouldn't even be possible.  So really we should be congratulating ourselves on our self-healing abilities ,  rather than thinking that surgical interventions are some kind of holy grail.

Same is true of any medical problem we experience, with the possible exeption of auto-immune diseases because , in those cases,  the immune system itself is seen as a threat.  Again,  that is usually the wrong way to see auto-immune issues....in fact,  the immune system is still trying to do its best to cancel out a perceived threat,  even though the perception of threat has been somehow misread by the immune system.  It's complicated,  but essentially the immune system never falters even though it has been incorrectly triggered into an over-reaction.  THe fault lies in the triggering mechanism,  not in the immune system itself.  Similarly with the nervous system,  where sometimes its responses are seen to be peculiar,  as with referred and radiated issues which we're familiar with.  These responses are meant to happen the way they do because they are the lesser threatening responses.  For instance,  if a trapped nerve in neck were to behave the same way a trapped nerve in lumbar region does,  we would find all our neck functionalities (breathing/swallowing/bloodflow etc) seriously compromised ,  and that simply can't be allowed to happen.,...so we get referredf issues instead.  It's a trade off that we're not always aware of.

PS...........again.......

Just to rub some salt into the wound......There are no medications, no surgical interventions, and no Physio exercises which actually heal anything.  All they do is encourage the nervous system and immune system (autonomic systems) into a more vigorous response to assist healing.