Do You Know How to Interpret a Cervical Spine X-ray?

[Eric N]

Does anyone here to know how to interpret a Cervical Spine X-ray? I know it's not a substitute for doctor or etc.

I just want to know if anyone could spot something that could contribute to tinnitus.

If so please comment and I will post them.

 

[Eric N]

https://ibb.co/iGLOOp

This xray is from 2013 I will try and get a new one soon the results said something about facet arthritis in c7-t1 if I remember

Questions: Did you have muscle tightness or spasms with back or neck - days or weeks leading up to onset of tinnitus?

I don't remember anything out of the ordinary expect some tightness in the ears and then ringing switched on I assumed is was from the ear plugs as I used to sleep with them


Did you ever have an injury to neck or back in a fifteen year period before onset of tinnitus? Did you have any dental work done prior to tinnitus onset?

I had a back sprain at the gym but recovered a week later but sometimes the pain comes back if I do a wrong movement so it must have done something permanent

dental work: Yah I had a few feelings on the left side which also happens to be my bad ear and wisdom teeth from the top extracted, but that was maybe a year or so before T started.

 

[Lane]

I had a back sprain at the gym but recovered a week later but sometimes the pain comes back if I do a wrong movement so it must have done something permanent

I moderately strained a groin muscle on my left leg a few days ago. Pretty soon, I was walking differently, and some moderate pain showed up in my lower back. The next morning my neck was tighter than normal on the left side, and my tinnitus spiked in my left ear. The spike began to subside in the following days as my groin strain healed. I don't think it was a coincidence the unusual spike in my left ear began at the same time I strained my groin muscle. It's all connected.

 

[Greg Sacramento]

@Eric N I notice slight joint hypertrophy and facet arthritis with mild neural foraminal narrowing at C6-7 bilaterally and it does extend, but not remarkably into T1. Sight disc space narrowing and spondylosis C6-C7. - sight loss of normal lordosis - straightening of c-spine. Alignment is anatomic. Prevertebral soft tissues are within normal limits. There's no multilevel degenerative changes and without evidence of acute fracture or dislocation. Overall your XR is remarkable, but I think that I know what is causing your T.

Slight loss of normal lordosis is common with age, Thoughts - possible muscle pressure. Do you have one shoulder lower than the other when looking into a wall mirror? When you answer this question, we can talk treatments - treatment on muscles, downward pressure stress of neck and freeing pressure on nerves going to the brainstem and the affect on facial.

 

[Eric N]

@Eric N Do you have one shoulder lower than the other when looking into a wall mirror? .

Nothing noticeable but I don't have a trained eye. You think my T is neck related?

 

[Greg Sacramento]

Yes, I do think that's it neck related. Your neck may not be sore, but your X rays say maybe soon. It's good to know that you don't see one shoulder being lower as that may indicate neck (sternocleidomastoid) and shoulder (trapezius) imbalance. Everything that I say from here on consider discussing with a neurologist or a doctor of physical therapy. A physical therapy doctor will have you repeat cervical X rays.

I say this with politeness, but hey try these simple treatments - it may make a difference - a big difference. It will take a few months. Focus on body posture 24/7. I don't know which posture training methods would be best for you. There's posture videos on You Tube. I would do only the standing ones such as standing against a wall and gently placing arms up. I do know that correct walking is important. Use your eyes to look down when walking, not by bending the neck. Use correct posture at the computer. A proper headrest while driving. Use a small pillow under neck while sleeping so that there's no air space under neck. Use just one pillow for head. Sleeping in any position is OK - but on the stomach. Use a warm towel around neck before neck therapy. Something cool after therapy.

From your X rays, I'm pretty positive that you need semispinalis capitis and sternocleidomastoid treatment. Eye modulation, C7 and tinnitus are the reasons. You may need longus colli, longus capitis, scalene muscle and masseter lateral treatment. For the sternocleidomastoids talk to a PT about the pull exercise. Dr. Mandell has a video on this - You Tube. Before any trigger point therapy is done on muscles, I would stretch your suboccipital muscles by upward neck stretching. That requires relaxing shoulders, breathing in and out and very gently stretching neck upwards. This will relieve facet joint tenderness, help with deep vertical and occipital nerves which would help most with tinnitus.

You do have any jaw problems? Other than eye movement to sound, is there any other facial concerns?

 

[Eric N]

You do have any jaw problems? Other than eye movement to sound, is there any other facial concerns?

Thanks for your detailed response

In the beginning of T I went to see a chiropractor who ended up being a bad one and actually gave me TMJ for a while, he tried hammering the side of my jaw with some gun like device where he applied pressure and it released pulses to try and get it adjusted, he though I had TMJ because one side of the bone at the top of the jaw near the ear protrudes more than the other when I open my mouth. For a while after that I would get episodes where my jaw started clicking from time to time and I could hear crunchy sounds while chewing. It's mostly better now 6 years later but thankfully it did not affect my T in any way.

I will look for a good PT and follow up + the exercises, however maybe was the trigger but my T has gotten much worse from noise related issues over the years, namely the MRI of last year which nearly doubled the intensity and it remains to this day. And now the Tylenol incident of last week which left me with a horrible reactive low frequency tinnitus that sounds like a revving engine and can hardly be masked and mixes with other sounds.

 

[Greg Sacramento]

@Eric N I would start with posture improvement and control extreme forward head heading. For example - if you need to pick up a piece of paper that fell on the floor lower your body instead of bending over. The impressions of your X rays show a little lower c spine facet pressure that appears to extend into your back. This is probably caused from downward pressure and stress of neck from computer use. This maybe caused a slight straightening of your c -spine. Normally this is age normal, but findings may point to cause as muscle tension. You may have started to develop this years ago where a little jaw imbalance also took place. This can pressure the spinal accessory nerve.

You mentioned no hearing loss when you started posting so improvement of posture may help with the effects of taking Tylenol. Maybe get an updated hearing test, but I would focus on posture. I would see only a doctor of physical therapy for consultation about gentle neck stretching (head lifting) of m. trapezius m., levator scapulae, sternocleidomastoid, semispinalis and suboccipital. You are basically doing this when you look up at a ceiling.

There's nothing better for the mind than doing something rewarding and that includes doing something for someone else. Listen to some gentle pink music of a moving stream.

 

[Eric N]

I will see an PT next Thursday, I won't be able to do an MRI if they ask for one hopefully it wont be needed

 

[Eric N]

wording if I should try some prednisone I have some stashed, but I am worried to make things worse but this new tone is so bad.

 

[Greg Sacramento]

It might depend on if prednisone has helped you in the past. We are all different, but for me magnesium chelate stops a spike every time.

 

[Eric N]

It might depend on if prednisone has helped you in the past. We are all different, but for me magnesium chelate stops a spike every time.

I never took it regularly 30mg/day for a 3 days was my max in the past did not help nor made it worse, I will try it just 15mg which should be a very low does I am 82kg.

 

[Eric N]

updated cervical xray https://ibb.co/i8mxQf

 

[Greg Sacramento]

Eric, from these X Rays and prior information that you have given, I have no clue as to what is causing your tinnitus. The updated X Rays appear to show that some healing adjustment has been made. Neck muscle stress placed on nerves is always a concern when tinnitus is cervical.

Maybe discuss with your doctor a CBCT for observations of dental, TMJs, sinuses, the oropharyngeal region and the external auditory canal. You could also get this done on your own from a Beam Reader Center.

Maybe discussion with your doctor about a CT of neck and MRA.

How bad is your tinnitus? No hyperacusis?

 

[Eric N]

Eric, from these X Rays and prior information that you have given, I have no clue as to what is causing your tinnitus. The updated X Rays appear to show that some healing adjustment has been made. Neck muscle stress placed on nerves is always a concern when tinnitus is cervical.

Maybe discuss with your doctor a CBCT for observations of dental, TMJs, sinuses, the oropharyngeal region and the external auditory canal. You could also get this done on your own from a Beam Reader Center.

Maybe discussion with your doctor about a CT of neck and MRA.

How bad is your tinnitus? No hyperacusis?

Interesting my neck now looks better? I would have figured worse with 5 more years after bad posture. I did some light exercises that last few days not sure if that helped.

I don't have hyperacusis in the sense that noises seems louder than they were prior to T, but my T is very reactive and will mix with other sounds and try to get louder than them.

it is pretty bad overall I have least 10 pure tones across many ranges and list keeps growing,
e.g. most notably 160hz 1khz 1.9khx 2.6k 3k and high frequency 10khz probably

it's very difficult to find a masking combination that works as one masking music will spike the other, so I put many to try and mask as my frequencies as possible

Can Xray make T worse? I had a chest xray with the cervical and my high frequency T seems spiked.

 

[Greg Sacramento]

Eric, been studying and researching some notes taken from information that you have provided.

I don't have hyperacusis in the sense that noises seems louder than they were prior to T, but my T is very reactive and will mix with other sounds and try to get louder than them.

it is pretty bad overall I have least 10 pure tones across many ranges and list keeps growing,
e.g. most notably 160hz 1khz 1.9khx 2.6k 3k and high frequency 10khz probably

With this and your last hearing test showing a very small hearing loss - hundreds of possibilities can be crossed off because they don't pair with your goings on - there's only a few things left to consider. I will discuss four that may top the list.

http://www.dartmouth.edu/~rswenson/NeuroSci/chapter_7B.html I often use Dartmouth data.
The spinal trigeminal nucleus caused from weakness of the lateral pterygoid muscle from injury.

The second - fourth possible is in ( purple titles) in this link. They are: The vertebral Arteries. Below that: The vertebral and Deep Veins. http://www.chiro.org/ACAPress/Cervical_Spine_Trauma.html

X Rays won't make T worse.

I would consider taking to your doctor about getting a MRA test. It's just a little ultrasound device that's moved around your neck.

I think there's a good chance that T can tossed out the window with treatment. We just need to find the exact cause. I don't see any of the possibilities that may going on as untreatable.

I would try to use correct posture and control extreme neck movements in any direction. It's difficult to do this as I know. Lets stay in touch.

 

[Eric N]

Eric, been studying and researching some notes taken from information that you have provided.



With this and your last hearing test showing a very small hearing loss - hundreds of possibilities can be crossed off because they don't pair with your goings on - there's only a few things left to consider. I will discuss four that may top the list.

http://www.dartmouth.edu/~rswenson/NeuroSci/chapter_7B.html I often use Dartmouth data.
The spinal trigeminal nucleus caused from weakness of the lateral pterygoid muscle from injury.

The second - fourth possible is in ( purple titles) in this link. They are: The vertebral Arteries. Below that: The vertebral and Deep Veins. http://www.chiro.org/ACAPress/Cervical_Spine_Trauma.html

X Rays won't make T worse.

I would consider taking to your doctor about getting a MRA test. It's just a little ultrasound device that's moved around your neck.

I think there's a good chance that T can tossed out the window with treatment. We just need to find the exact cause. I don't see any of the possibilities that may going on as untreatable.

I would try to use correct posture and control extreme neck movements in any direction. It's difficult to do this as I know. Lets stay in touch.

I am having some blood work done next week to test to liver, kidney and thyroid issues and vitamin b12 deficiency.

I should also mention I am a musician, I always used to war earbuds when using my electric keyboard and then used earbuds at work a lot back then plus loads of caffeine / energy drinks, unfortunately this is the most likely cause, T actually started while I was using them

thanks for you help I will keep you posted on updates