Just got back from the VA.  Got my MRI results.  They are pretty much what I expected, and simply clarify and validate the x-ray findings.  The MRI of my left shoulder showed the bone spur in my shoulder joint that the x-ray picked up, but it also showed a tear in my supraspinatus tendon and nerve impingement, which wouldn’t show up on an x-ray because x-rays generally won’t pick up tendon or muscle injuries and can’t give a three-dimensional picture of my shoulder joint to show what’s getting pinched by what, where.  The MRI of my neck showed some circumferential bulging of the intervertebral disk between my 4th and 5th cervical (neck) vertebrae, and between my 2nd and 3rd dorsal (chest) vertebrae which the x-ray showed as disk space narrowing, but it showed disk protrusion on my 5th and 6th vertebral disk with impingement of the spinal nerve that exits there and becomes the lateral cutaneous nerve  in my arm. The findings fit my symptoms.  The tingling and electric shock feelings I’m having in my arm coincide with the route of the lateral cutaneous nerve.

shoulder joint anatomyThe shoulder joint is made up of the clavicle (collar bone), the humerus (upper arm bone) and the acromion (pointed end) of the scapula (shoulder blade) all strapped together with tendons and ligaments.  Ligaments are fibrous bands attached to bone on both ends.  Tendons attach a muscle to a bone.  These tendons that attach the muscles of the arm and shoulder to the bones that form the shoulder are called the rotator cuff because these are the muscles that enable the arm to rotate (Such as the circular motion the arm makes when you are swimming).  I’ve had surgery on this shoulder before, and it was to fix a rotator cuff injury.  The supraspinatus muscle is underneath the clavicle and attaches to the humerus (upper arm bone)  via the supraspinatus tendon.  This is the tendon where I have a tear.

brachial plexusThe vertebrae are the bones that form the neck and backbone.  They are strung like beads onto the spinal chord.  There are seven cervical (neck) vertebrae (C1-C7).  The 12 vertebra in the area of the chest are called the thoracic vertebrae (T1-T12). In between each pair of vertebrae is a tough fibrous disk of cartilage called the vertebral disk, which is like a padding between the bones.  The vertebrae have three projections called spinous processes, one that sticks out behind the vertebra and two that stick out to the side.  The ligaments that hold the bones of the spine together and the muscles that attach to the vertebrae attach to these projections.  The nerves that control the muscles and carry sensation branch off the spinal cord and exit between each pair of vertebrae. If a disk becomes too flattened, it can bulge outward and press against the nerve where it goes past the spinous processes to the side and “pinch” it. You can “backtrack” the problem by finding what part of the body is affected, which tells you what the nerve does, and where it leaves the spinal chord.

In my case, the pinched nerve is pinched both in between the bones in my shoulder and because the disk in between my 5th and 6th cervical vertebrae (C5-6) is bulging out enough to put pressure on that nerve. This means I will likely require surgery on my neck to “unpinch” the nerve there.  I will probably require a second surgery on my shoulder to free the pinched nerve, remove the bone spur from the acromion of the scapula (the pointy end of my shoulder blade) and repair the supraspinatus tendon.  I will have to be examined by the neurosurgeon (at the VA hospital in Dallas) and/or by the orthopedist (the VA hospital at either Amarillo or Dallas).  Should surgery be required on my neck, that will take place in Dallas.  The surgery on my shoulder if required would take place in Amarillo.  I have been put in the queue, and the wait is long enough that it will be at least 3-4 months until it’s my turn to be seen, giving me time to move house and get settled in. If surgery is required, it may not take place until the fall.  All in all, things could be much worse.  My parade is not getting rained on, exactly, just slightly drizzled on.