MRI Blues

Got pain?

For the last two months or so, I have been experiencing increasingly excruciating pain and numbness on my left arm, shoulder and back. Especially this month, there were daily occasions when I couldn’t even do any work with the computer. A few moments with my left hand on the keyboards and a piercing pain strikes my upper left extremities. For countless nights, I couldn’t sleep at all as it would be very painful after a minute or so just laying on my back in bed. I had to always move. The least pain I would feel sleeping face down which in a way relieved the “pressure” on my left shoulder and back.

I finally saw an orthopedic doctor at Capitol Medical Center (CMC) last May 17 with my wife accompanying me. It was a short consultation. The doctor’s diagnosis – cervical spondylosis.

Spondylosis is a medical condition signifying degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. In extreme cases, it may cause pressure on nerve roots with ensuing sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.

According to Wikipedia:

“When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.”

The doctor told me to have an MRI test which he believes is better than taking a regular X-ray test.

An MRI test. I’ve heard about it and have seen it on movies. But this is one test I haven’t taken.

By definition MRI refers to a magnetic resonance imaging (MRI) scan, a noninvasive method to create detailed pictures of the various parts of the body.

Unlike x-rays and computed tomographic (CT) scans, which use radiation, MRI uses powerful magnets and radio waves. I read somewhere that he magnetic field produced by an MRI is about 10 thousand times greater than the earth's. That’s a powerful set of magnets!

The magnetic field causes hydrogen atoms in the body to align in a certain way (identical to how the needle on a compass moves when you hold it near a magnet). When radio waves are sent toward the lined-up hydrogen atoms, they bounce back, and a computer records the signal. Different kinds of tissues emit back different signals.

There are two general types of MRI machines, the open and closed versions. A closed machine is smaller, has a narrow tube and is said to produce better images than the open type. An open MRI machine on the other hand, is open on three sides, making it more comfortable for the patient. However, the images are limited and are not as good since the magnets do not circle the whole body.

Open MRI machine

Not surprisingly, undergoing an MRI test entails a lot more money than having a regular X-ray test. Capitol Medical Center’s fee of 8,000 pesos for the MRI test I needed seemed to have already worked wonders in my body. I kept on telling my wife that my back has miraculously healed upon hearing the test fee!

Of course the pain didn’t go away. Sooner or later, I knew I had to get it to understand what was happening. It was a good thing that the hospital had a substantial discount for government employees due to their arrangement with GSIS. On the day I had my MRI test (May 27), I only paid 4,570 pesos. If there are medical findings, I could reimburse that amount with my office’s medical welfare fund.

The hospital had the open type MRI machine which I suppose lessened my chances of experiencing claustrophobia. But my MRI test wasn’t the longest 35 minutes of life because of fear of tight spaces. It was primarily because of the pain. I couldn’t move my body even if there was actually considerable space to move because that would ruin the image and we will have to do everything all over again.

A minute or so into the procedure, I was already experiencing piercing pain on my left back and shoulder coupled with widespread numbness over my left arm simply by lying down on my back. I tried to focus my mind on finishing the test, to bear the pain and to finish the test. I prayed a lot. At some point I thought I had already asked the intercession of all the saints in heaven and yet the test continued. It was the LONGEST 35 minutes of my life! I just thank God I was able to finish the test.

I got the results earlier today from Capitol Medical Center. Among the findings were:

· Alignment of my spine was normal

· The heights of the vertebral bodies and the intervertebral disks were well maintained

· The cervicomedullary junction and the spinal cord are normal

· There is no intraspinal or paraspinal mass lesion

I’m no medical doctor but all that pretty much sounds positive. However, there were other “impressions”:

Assymetric disk bulge, C5-C6, causing right-sided foraminal stenosis

Assymetric disk bulge, C6-C7, causing left-sided foraminal stenosis.

It is said that so-called cervical (neck) injuries usually result in full or partial tetraplegia (Quadriplegia). According to the Wikipedia article on spinal cord injury, one’s bodily functions retained, depending on the specific location and severity of trauma:

• Injuries at the C-1/C-2 levels will often result in loss of breathing, necessitating mechanical ventilators or phrenic nerve pacing.
• C3 vertebrae and above: Typically results in loss of diaphragm function, necessitating the use of a ventilator for breathing.
• C4 : Results in significant loss of function at the biceps and shoulders.
• C5 : Results in potential loss of function at the shoulders and biceps, and complete loss of function at the wrists and hands.
• C6 : Results in limited wrist control, and complete loss of hand function.
• C7 and T1 : Results in lack of dexterity in the hands and fingers, but allows for limited use of arms.

It is not only severe trauma that could cause spondylosis. Even simple reasons such as bad posture and other sources of what is termed as “repetitive strain injury” such as driving, traveling and working in front of computers without ergonomic care could also result in spondylosis. In my case, that seems to be the likely suspect.

I don’t know when I will visit the doctor again to show my MRI results. But I expect at the very least, a series of physical therapy sessions coming my way in the near future. One thing is for sure. I’m extra careful with my spine nowadays. I’m extra cautious that I don’t lose my footing on slippery tracks. No back breaking tasks for me unless truly necessary.

As far as the bad posture in front of the computer…now that’s something I still have to work out on.