Had an xray a couple of weeks ago for chronic neck pain. The pain started about 20 years ago when I began to be able to crack my neck at will by jerking my head to the side. It seemed to relieve a (minor) pain, as if there was a build-up of something that the crack released.
Within the past year the pain has increased to point where it’s almost constant and at times goes from a dull annoyance to really bad. Also, my neck rarely cracks anymore for me. On Sunday I did my first outdoor ride this year and, due to the aero position, I guess, the pain in my neck was really, really bad. Really bad. Bad to the point that I was wondering how I’m going to make it through the summer.
Today I got the results of my xray, and mild cervical disc disease was the diagnosis (c5-c6 vertebrae) and physical therapy the recommended course of treatment. I also read about it online and saw that arm weakness is also a possible effect, though I haven’t experienced that.
I’ll talk to the doctor about this, but I’m curious. Anyone have any experience with this? Is physical therapy effective? Are chances good for recovery, or will I have to learn to just deal with this? Is it likely to get a lot worse? Any suggestions for lessening the symptoms? I hate being injured.
I dont’ know yet. The nurse that called me with the results was pretty vague. “Arthritic” was also mentioned. I didn’t press her for information because I knew she couldn’t give it to me.
Try to find a good chiropractor. Might be a bit of work to find someone who works with athletes (all chiropractors will claim to work with athletes…) but worth the effort. They can give you stretching/exercises and use therapy similar to PT but also help you regain the mobility in the joints that won’t move for you anymore. Arms can be involved but if they aren’t already, that’s probably a good sign. Need to get all of the joints moving to spread the stress evenly instead of having some segments locked up and others trying to compensate to allow head movement. The joints that are compensating are being stressed more than they were designed to handle and you’ll get some degeneration in those joints, commonly called arthritis… Arthritis has a lot of meanings… and a lot of degrees.
Degenerative discs in the cervical spine are quite common. The most common areas are C5-7 and C6-7. Quite often these are even non symptomatic, meaning that many people will have them and not even realize it. In severe cases the nerves will get irritated and this can translate into pain in the arm or numbness in the fingers. More often than not it’s a transitory thing that may come and go. In some cases it can be quite persistant.
I’m a chiro and deal with this sort of thing continually, usually we have a pretty good success rate with these kind of problems. The PT’s approach may be a little different from the way a chiro handles it. Most likely the PT will do neck traction and give you exercises to strenghten certain muscle groups and increase flexibiliy. As a chiro I would do that and also do neck manipulation (adjustments). That’s why they call us “bone crackers”.
You’ve got a pretty good chance of recovery with the PT. However, you should be aware of this problem and practice regular neck exercises that he/she should give you. If you find that riding in an aggressive postion remains uncomfortable you should look at something less aggressive.
Did you get to see your x-rays. I’ve tend to believe that if your normal cervical curvature as reduced or reversed, it likely would make riding in the aggressive position less likely to be comfortable.
I have a mild DJD at C5-6. I can still ride my P2K in an aggressive position at age 53 but I do neck exercises and stretches every day. Once you get over this painful stage you should likely be OK if you take precautions and do the stretch exercises. If I don’t my neck pain always returns.
“Is cervical disc disease a generic term for a more specific condition”
It’s not a “disease” in the true sense of the word. DJD is really osteoarthritis of the spine. It is characterized as three stages depening upon the amount of disc wearing. Stage I would be mild, Stage II moderate, and Stage III severe with considerable disc wearing, osteophyte formation, etc. Stage III is when the disc is almost worn out and the vertebrae are almost fusing together.
Based on what you write, I will forward the following professional advice. As we age, all of our joints suffer a fair amount of wear and tear. The discs separating the bony vertebrae are really nothing more than specialized joints. Because of the vector of the stresses placed on the spine, certain discs tend to wear out more quickly than others. In the neck C5-6 is most commonly affected. In the lumbar spine, L4-5 and L5-S1 are most commonly affected. As the disc wears out, it loses some of its cushioning properties. On an x-ray this appears as loss of height of the disc space, and often results in bone spur formation at that level. Most times this is asymptomatic. Occassionally, the degeneration can be severe enough to result in instability of the spine or to allow for disc fragments to become dislodged. In either case, pressure can result on one of the cervical nerve roots, causing radiating arm pain, numbness, and in bad cases arm weakness. In short, some degree of C5-6 arthritis, spondylosis, or degneration (all synonymous), occurs in all of us as we get older. It is nothing to worry about, unless you start getting arm pain, numbness, or weakness, in which case you need an MRI to look for nerve compression. This isn’t to say you’re neck pain isn’t a real “pain in the neck”, just that the pain isn’t likely to signify anything more sinister going on, in the absence of other symptoms. While physical therapy may be helpful, I would recommend changing your bike set up to accomodate some age induced loss of neck flexibility. (If it hurts when you do that, don’t do that.) If things don’t get better by adjusting your position, then consider the MRI. As a member of the medical specialty with the highest malpractice premiums, I must add that a note from cyberspace does not substitute for an evaluation (in person) with a trained physician. Although rare, other diagnoses do exist that can cause neck pain that may in fact be serious or life threatening. I have only presented you with the most likely interpretation of your problem. Because I don’t believe in anonymous medical advice, I am. Kevin A. Walter, M.D. Assistant Professor of Neurosurgery and Pathology University of Pittsburgh School of Medicine
Just to add to what Doc Walter says, I forgot to note that neck pain can come from several sources. The posterior facet joints are a good example and these pain syndromes often responds quite well to manual therapies such as traction and/or manipulation.
<<I can still ride my P2K in an aggressive position at age 53 but I do neck exercises and stretches every day. Once you get over this painful stage you should likely be OK if you take precautions and do the stretch exercises. If I don’t my neck pain always returns. >>
I have lumbar version - L4 & L5, have just missed 3 months of activity with horrible sciatica. After 2 nerve root injections and a lot of Phys therapy I am finally riding about an hour and swimming a little. I spend an hour + a day doing my back workout, hope to drop that to half hour in another month or so. All I can say to the original poster is DO YOUR EXERCISES and avoid a chronic return of the symptoms, if indeed disk degeneration is the problem.
Also refreshing to hear that cerveloguy can ride again, even in an agressive position. I’m 51, been competing for 25 + years and would probably jump off a cliff if I could not ride my bike or go for a nice long trail run in the desert… Starting to look for a new bike with a moderate position.
Finally, I think that riding my road bike with shorty bars contributed to my back problems, I would definitely look at your position and make sure you are managing that part of the issue.
Thanks CerveloGuy, Crono and others for the information and advice. It’s much appreciated. You’ve helped to calm my fears a bit that this is not the beginning of an inevitable slide into couch potato land. I start PT tomorrow, and I’m glad to hear that this may be somewhat within my control to help heal. Thanks again!
“I can say to the original poster is DO YOUR EXERCISES and avoid a chronic return of the symptoms,”
This can’t be stressed enough. I tell my patients that exercises aren’t a cure. If you do them when you’re hurting they often make you feel worse. Do them as prevention when you’re feeling good. Unfortunately, 90% of the population won’t since it involves taking some responsibility for your own health.
“Starting to look for a new bike with a moderate position.”
Welcome to BabyBoomer land. The good news is that there are now some very nice high performance road bikes out there with taller head tubes, etc. that are designed for us. The Specialized Roubaix, Giant OCR carbon, Trek Pilot, Klein Reve, etc. come to mind. I can still ride aggressive on my road and tri bikes but figure by the time I turn 60 it be time for a change. Once I give up tri, I’ll never run again but intend to ride as long as my body isn’t so frail that I can’t turn a crank. Of course we won’t be riding in an aggressive position by then.
