Cervical Radiculopathy - No Pain but Severe Weakness in Triceps and Lats (with video)

[Mugaaz]

Hi Mugaaz, your healing timeline is interesting, and I'm glad you were able to bounce back twice. In the 3 month period, did you seek non-operative treatment like physical therapy, massage therapy, etc?

I tried a couple chiropractors, but I couldn't find anyone except complete quacks. They'd try to insist on e-stim and other "modalities" other than adjustment. They seemed obviously reluctant to adjust or try anything with radiculopathy. I understood why, but if so then what is the point of their service. I suspect there are good chiros out there, but I couldn't find any.

I tried massage, and got some minor pain relief for 24-48 hours. The effect was minor and temporary, so I didn't continue it after a couple sessions.

I started using a cervical traction unit within a couple days. It was *very* effective for 7-10 days after the first injury. I didn't feel much after that time period, but continued using it multiple times daily for 4 weeks. The second time I got injured, the traction unit didn't noticeably help.

They scheduled me for PT, but I didn't see the point. I was able to squat and bench without worsening the symptoms any. I was benching around 250x5x5 before the injury, but failed the first rep of a warmup at 165 the week after. I had to "re-learn" how to bench because I had lost so much strength in my right arm. I had constant issues with keeping the bar horizontal without my torso starting to rotate under it. I could deadlift, but it was worsening the radiculopathy, so I held off for 6-8 weeks. When I was able to deadlift without worsening the symptoms I started training it again.

[VNV]

Any experience with the difference between a hospital MRI and storefront MRI?

It is said that hospitals have stronger magnets and better trained staff which both imply higher resolution over the latter.

The other notable difference is cost. A hospital MRI can cost upwards of $3K, while a storefront/walking might cost less than $1K.

So it can be a trade between accuracy and cost.

[Mark Rippetoe]

I don't know that your assumptions are true, at all. Why would you assume that a small-group-owned facility is equipped with an older shittier machine/radiologist?

[VNV]

I don't know that your assumptions are true, at all. Why would you assume that a small-group-owned facility is equipped with an older shittier machine/radiologist?

Sure. But it's not my assumption. The CEO of an orthopedic firm told me this. He did not seem to have a vested interest, since the imaging would not happen at his firm, but at an independent hospital.

[Mark Rippetoe]

We'll have to wait for another opinion, especially considering the fact that his firm may shop all their MRIs to the independent hospital.

[VNV]

We'll have to wait for another opinion, especially considering the fact that his firm may shop all their MRIs to the independent hospital.

Another data point. I brought this MRI issue up with a colleague whose doctor also told him that resolution/skills at the imaging clinics are lower than at the hospitals.

Anyway, I'm listening.

[johnnys]

Another data point. I brought this MRI issue up with a colleague whose doctor also told him that resolution/skills at the imaging clinics are lower than at the hospitals.

Anyway, I'm listening.

You guys know that many of those off-premise imaging centers are owned by Ortho providers with privileges at the nearby facilities? In the HMO days (before high-deductible plans) the imaging shops were a way to capture revenue by sending the practice’s patients. Now that there’s competition, they have cost advantages.

[JFord]

If you need the surgery, it's because things will not heal, so get it NOW.

Correct answer.

I don't know that your assumptions are true, at all. Why would you assume that a small-group-owned facility is equipped with an older shittier machine/radiologist?

Correct question.

Hospitals have tremendous overhead expenses that stand-alone imaging centers don’t have. They also depend on their “name” in the community to drive sales. Stand-alones have only their quality and their technology to compete with.

I’ve had private imaging centers market to me my whole career in medicine. They always tout having the most modern and up to date equipment (facts that are easily verifiable). Hospitals have many constraints that make them less likely to upgrade equipment (and less incentive given their reliance on reputation within their community).

This would also apply to the quality of the radiologists as well. However, the surgeon’s reading is usually more important anyway because they rely on the actual images more than on the radiologist’s reading to guide decision-making.

[Mark Rippetoe]

This would also apply to the quality of the radiologists as well. However, the surgeon’s reading is usually more important anyway because they rely on the actual images more than on the radiologist’s reading to guide decision-making.

Absolutely. If your surgeon doesn't read your MRI/relies on the radiologist, I recommend that you get up and leave.

[VNV]

Correct answer.



Correct question.

Hospitals have tremendous overhead expenses that stand-alone imaging centers don’t have. They also depend on their “name” in the community to drive sales. Stand-alones have only their quality and their technology to compete with.

I’ve had private imaging centers market to me my whole career in medicine. They always tout having the most modern and up to date equipment (facts that are easily verifiable). Hospitals have many constraints that make them less likely to upgrade equipment (and less incentive given their reliance on reputation within their community).

This would also apply to the quality of the radiologists as well. However, the surgeon’s reading is usually more important anyway because they rely on the actual images more than on the radiologist’s reading to guide decision-making.

This is helpful.

The surgeon told me he'd be reading the images himself. He did ask for a "closed" MRI instead of an "open" one. Otherwise, according to his front desk, private imaging centers were acceptable.