A Pain in the Neck

I found out the hard way that I have something called Cervical Spondylosis. When my doctor first told me the diagnosis of Cervical Spondylosis I said, “But I’m a boy”

They explained this is a condition affecting the neck bones, not whatever I might have been thinking.

Spondylosis is something akin to Arthritis, a sort of weakening or changing of the bones. Cervical Spondylosis affects the 6 bones of the cervical spine. The neck.

It turns out that a vast majority of people of a certain age has this condition. 85% of people over age 60 have some form of it. It is simple wear and tear and shrinking and dehydrating of the bones. For most people with the condition it will never be an issue unless there is, as my orthopedist explained it, an event. On February 13th,  I had an event.

I was having issues with my right shoulder prior to the event and x-rays showed spondylosis. Besides the narrowing of the vertebrae, bone spurs can develop, and the vertebrae can shift out of place.

30+ years  working in front of a computer can cause the displacement and that displacement set the bone spur into a nerve. It presented as shoulder pain and tingling down my right arm. Primarily when I was reaching for something. Yes, my chair and workstation have been set up for proper ergonomics. And I warned everyone who will listen about sitting up straight.

So, off to physical therapy. Those who know that I bred, raised, and trained horses in a past life know I am no stranger to physical therapy. That lifestyle is conducive to injuries. I still get cards from my old orthopedist’s office.

The physical therapy in Virginia would delay my trip back to New Mexico by a month, or so I thought. I planned to spend the 2023 holidays in Virginia and head back to New Mexico in January but it made sense to stay another month to address this.

My therapists at the Sentara Reid center in Woodbridge were all friendly and helpful. I asked the gentleman who was assessing me about the drive back ro New Mexico. He said driving would probably not be a problem, but the issue is even a minor car accident can do a lot of damage in my condition.

Two sessions a week worked wonders. Strengthening the small muscles that stabilize the cervical spine is key. The isometric exercises are subtle, but tough because few gym exercises engage those muscles.

Nearing the end of my sessions I felt like the trouble had been licked. Just getting the vertebrae back where they needed to be resolved the pain. I was planning my trip back West again. I missed my house and was sure it needed work by then.

February 13th I was driving to my second to last appointment. It was snowing a little. Nothing serious. Big, fat flakes melted on the road making it no worse than a cold rain. I saw the car coming out of the side street to turn left across traffic just as I was about to pass by at about 35 miles per hour. I moved left a little, certain it would see me but I was hit.

It was at once a lesson in defensive driving (think about blasting through terrorist roadblocks) and in physics. A larger car hitting a smaller car over the rear wheel will transfer a lot of energy. The roads were just the right dampness to send me spinning. The tires on the car were great, but the tread doesn’t help much going sideways.

The car still had momentum after going sideways a few feet, so it straightened out and went forward. Up and over a substantial curb first. That slammed the top of my head into the ceiling and deployed the airbag. Fat lot of good it did with me moving vertically. The seatbelt didn’t hold me down either.

At this point a concrete wall loomed straight ahead. A wall designed to prevent much larger vehicles from ending up in someone’s back yard. I had two thoughts: one, I have no idea how fast I’m going right now so I need to try to remain conscious. Try to go a little limp. I really overthink things. The second thought was this is how Dale Earnhardt died.

I hit the wall, hit the steering wheel, and saw the front end of the car disintegrate. I remember thinking, ok, I survived.

The car settled by the trees, facing the right direction. The glass didn’t break, and the electricity was still on. The car wasn’t running, I don’t think, but the radio was on and annoying. Banter of some sort you expect with a morning show between songs. I wondered if I could turn the radio off. My concern was using the phone. I wasn’t sure if the phone would work with the radio off. Bluetooth and such. As it was, the phone had some app or other open I didn’t recognize. I had to concentrate to remember how to get back to the phone screen.

I said a few times, “Hey Google, dial 911.” Google did not. My Android phone will pick up on background conversations without me saying anything, but call 911, no. At least not for me that day.

After I managed to talk to 911 I texted my coworker to say I’d be late getting back to work. She said ok, but maybe I should call my family next.

I remembered thinking my cousin was closest to where I was and was probably not at work yet. My head was starting to clear some.

The poor girl who hit me was beside herself. Late for work and just didn’t see me was so sorry and scared that she had killed me. I kept asking if she was ok. Turns out her car needed a new bumper, but it was fine to drive. Again, if you ever need to blast through a terrorist roadblock, slow down, target the rear wheel of the lightest vehicle and just, well, FIDO. I won’t elaborate on that acronym. IYKYK.

The ambulance crew asked a couple of questions and left. My neck was sore, but I could move it and no extremity issues. The police, tow truck company, and everyone was nice and seemed thankful I was alive. They were having a busy morning. One of the only snows we’d get all Winter was causing a lot of problems.

I went to my doctor the next day and they worried about a concussion, especially me being on low dose aspirin like everyone of a certain age. Any sort of blood thinner can exacerbate internal bleeding, even aspirin. They ordered more neck x-rays, which I was due for anyway since my PT was nearly complete. They prescribed some muscle relaxants as well. I needed them but I’ve never been a fan. Flexeril is better than Methocarbamol, but they both make me loopy.

When I went for the neck x-rays it seemed like they were looking for improvement for the old issue more than evaluating the new one. There was improvement with the displaced vertebrae and the location of the bone spur, so PT really does work.

The main thing is nothing looked broken. After that sort of trauma, whiplash and other soft tissue injuries can mask a lot of things. The amount of generalized pain in the area would make it hard to pinpoint anything acute.

I set up new appointments with the Physical Therapists and would end up spending another two months there, twice a week. I’m sure they were disappointed doing the evaluation. I was due to be stamped, “good to go” but this being just a few days after the accident I was much worse than before.

The whiplash from my head snapping forward improved quickly over a couple of weeks. I’m glad because whiplash is painful. As I mentioned, the pain of the whiplash was masking the pain from my crushed neck bones. For better or worse, I could now feel where I was injured.

All in all the time in PT was valuable. We worked on a lot of stabilizing muscles all along the spinal column. I’ve said this before, the mid traps are among the least appreciated back/core muscles, but they protect and stabilize our spines. They’re not that easy to engage but there are isometric exercises to target them.

It surprised me to find out how simple, isometric exercises can strengthen the small neck muscles. Movements such as pushing your forehead into a hand or pushing your chin down in into your fist as well as pushing back and side to side, all with light resistance, can strengthen your neck immensely. The therapists were pleased with how strong I got, even though the pain wasn’t completely managed.

The therapists did a lot with traction and various massage techniques that helped the stiffness and muscle pain a lot. I remember after one good neck massage I was backing out of a parking space and noticed how much easier it was to turn around. For the muscles and alignment PT did wonders. The “narrowing of space” between the vertebrae (read, bone on bone)  is harder to deal with. For that I needed an orthopedic surgeon.

The Center for Advanced Orthopedics – NoVA Ortho and Spine is a big practice in Woodbridge. I met with a Physician’s Assistant first to review the X-rays I had and get a new set. The doctor only sees patients after an MRI.

The PA was very kind, friendly and informative. He showed me the difference between the healthy vertebrae and the damaged ones. It was noticeably different, with the healthy ones having a lot of space between them and the damaged ones having very little. Based on the scale the best description I can think of is you could fit a pencil between the healthy vertebrae. Between the damaged vertebrae you may be able to slip a credit card.  

The PA and later the doctor gave me very thorough neurological exams and both seemed surprised I didn’t have and sort off strength or coordination issues in the extremities.

I was given an order for an MRI and scheduled one at Sentara Advanced Imaging Centers. I’ve had MRIs before so I knew what to expect in the tube. The staff were very kind and fun to work with and the process was as quick and pleasant as that sort of thing can be.

Reviewing the MRI with the doctor a couple of weeks later educated me about the spondylosis condition. It was here I learned that most people have this condition and normal wear and tear can take a toll.

He said it takes an event to do this amount of noticeable damage. I’ve told others that, if this had worsened over 10 years it would be easier to accept then the 10 seconds it took.

Ultimately he said there’s nothing they can do for me. Since the doctor is an Orthopedic Surgeon I understand it to mean there’s nothing mechanical that can be repaired with surgery. He said this is life now. I will hurt, some days more than others. The good news is that daily use, gym workouts for instance, will not further damage the area. It may hurt, but it takes a traumatic event to do more damage.

He referred me to Ortho-Lazer in Woodbridge and said a lot of his patients noted it reduced their pain and may aid in healing. Insurance doesn’t cover it, but it seemed worth a shot. The doctor also said I should expect to need PT and other treatments like this periodically throughout my life. I may go long periods feeling fine, but the occasional tune-up will be required.

Ortho-Lazer currently has a location in Woodbridge in Potomac Town Center near Wegmans.  Getting there can be tricky with all the construction in the area, but that’s anywhere on the 95 corridor.

The pricing plan is reasonable and to be effective you should plan on 12 sessions in total, having two to three session a week. FSA will pay for the sessions and I suspect a good HSA will as well.

The concept is the red light will stimulate the area and help in healing. In fact, they say to not use ice on the area since that will reduce the inflammation that the red blood cells cause in healing. Or something like that.

It’s similar to hair restoration, I believe. The laser treatments after a transplant attract more blood cells to the scalp which feed the transplanted follicles. Sort of like a grow light works on a… potted plant.

Ortho-Lazer is trying to build a following since it’s relatively new for this sort of treatment. There are signs asking for reviews that read, “The #1 question we get is, does it work?”

The pain I felt going in to this was primarily on the left side with some radiating pain down the scapula. Not unbearable, but achy. The pain from 1-10 was 3-4 most of the time.

The treatment itself takes 15 minutes though the first session is longer while they gather information from you.

The machine looks a bit like something from a dentist’s office with an arm to allow the lasers to be positioned any which way. I sat in a chair with my collar rolled down for access.

They worked on both sides of my neck, focused on the damaged vertebrae. They used a handheld laser a few times to add more treatment to the left side. They say it can take four to six sessions before noticing a difference and they’re right. After four sessions I noticed some improvement.

I was that far in to the sessions when I decided to get back to gym class. I met the crew at E60 in Alexandria one Saturday. I planned to take it easy, but I went a little too heavy with the shoulder work. The rest of the day my neck hurt, and the pain radiated down the front and back more than it had. I took it easy the rest of the day and took a muscle relaxant before bed. The neck was back to normal by Sunday morning.

I told them about this at my next Ortho-Lazer treatment and they focused a lot on where I had said I felt pain. This was shirt-off session. This proves to me they listen to you and want to treat the patient as best they can.

Over the following weeks I noticed my neck hurt less most days and it didn’t start to really ache until much later in the week. Even then it wasn’t as bad as it had been. Long days and weeks at work take their toll but the pain level during treatment was about two rather than four.

It has been a few weeks since my last treatment and the long days at work are taking their toll again. By the end of the week, it’s pretty achy but by Monday it improves. It’s like the doctor said, it’s going to hurt.

Meds help but I don’t like medicating unless I have to. The muscle relaxants are for emergencies, and I’ll only take Ibuprofen to get through particularly bad days. I can deal with a little pain, but I’d rather keep my kidneys and liver healthy.

I take some time most days with a heating pad on my neck. All the doctors recommend frequent breaks and heat. The physical therapists recommend using heat before my stretching and necks-ercises in the morning.

As for Ortho-Lazer, they offer a number of maintenance packages. I bought a bank of them using my FSA. They are good for two years and I can go in for one-off maintenance sessions as needed.

The bottom line of all of this is, take care of your body.

• Take workstation ergonomics seriously.

• You will likely end up with some form of spondylosis at some point.

• Do work the small stabilizing muscles around your spine using isometric exercises.

• Consider alternative treatments when all traditional treatments have been exhausted.

• Ortho-Lazer is effective and worth it if you have an FSA or you can afford to pay out of pocket.
  

Besides that, heed my physical therapist’s advice and do not get into car accidents. Even a minor one can do lasting damage.