Question
Hi, I'm a 39 yr old rugby player and have been noticing muscle spasms in the triceps of my left arm. I have had a stiff neck but no pain. Visited my GP because internet searches show up all manner of nasty neuroligal conditions (MS and ALS etc). My Gp sent me for blood work and MRI scan. The scan came back showing slight bulging at C5-C6-C7 on the left and some stenosis?. Recently I have noticed atrophy of my lower left deltiod muscle although there is no evidence of weakness in the arm. The spasms are continuing on both sides, no pain but just annoying. Is muscle atrophy a condition of C disc bulging or do I need to go back to my GP? Thanks in advance.

Answer
Ryan;

Stenosis, by definition, is the closure of a hole somewhere in the human body.  In the case of the spine, it means the hole between the bones is closing... this is a problem as the nerve roots exit from there, and go off to power things, sense things and control things in the body.

The deltoid muscle is innervated by the axillary nerve, from levels C5,6,and 7.  That means the muscle is electrically powered from these levels.  If the muscle isn't getting the electrical energy it needs, then it will start to atrophy, like you are mentioning, the old use it or lose it rule.

I can't say without examining you, but atrophy of the deltoid is DEFINITELY a wake up call for you.  I would go to a physiatrist, chiropractor, or PT, anyone who can do some proper evaluation of you, and the deltoid, in particular.  There are three heads that can be tested independently.  If done properly, they can determine whether there's weakness or not.  Should there be atrophy, you are a candidate for surgical correction, as well.  (sorry to say that)
If pressure from the disc is causing the problem, you need to get the pressure off somehow, sometimes with a "roto-rooter" surgery to increase the diameter of the holes the nerve comes out through.

It goes without saying you need to stop abusing your neck!!  (quit playing rugby- or coach it/ officiate it) If you imagine your neck as a bowling ball on a stick, you can visualize the forces that your neck is placing on the discs of your spine.  How do you feel about swimming to stay in shape? Water polo?  It looks a lot like rugby!

The spasms could definitely be due to the disc injury as well... you need to follow up on this, and do it this week, before you are.

Dr. Peter Carr
Seattle, Washington
www.dynamicclinic.com