Hello everyone!
My Case History & Current Situation
- Background: Former competitive/highly active hobby athlete (heavy strength training, e.g., squats up to 300 kg, cycling sprints up to 60 km/h). Currently working a desk job (switching between sitting and standing, high screen/phone usage).
- Timeline of Symptoms:
- Early to Oct 2025: Developed progressive weakness and pain in both distal biceps tendons during training. Strength dropped significantly. Eventually stopped training upper body/arms.
- Dec 2025: Suffered one night of extreme, acute neck/nerve pain (almost went to the ER). Managed it with heat packs.
- Dec 2025 – March 2026: Visited an orthopedist twice. X-ray showed no major issues from his view. He suspected biceps issues and only checked the HWS via X-ray after insistence. Night splints and anti-inflammatories didn’t help. A general practitioner (GP) finally suspected the bilateral biceps symptoms might stem from the cervical spine (C-spine) and ordered an MRI.
- Current Symptoms: Constant feeling of pressure/tightness in the neck. No acute severe nerve pain right now, but a massive drop in energy levels and fear of making things worse by working out.
- Treatments tried: ~15 physical therapy/naturopath sessions (provided temporary relief), currently trying decompression therapy (SpineMed) and conservative stretching/strengthening.
- Neurosurgery Consultation (April 2026): The surgeon did a very brief 1-minute review of the images and a quick strength test. Verdict: “No emergency, sufficient CSF (liquor) present, no relevant strength loss.” I was told I could theoretically resume heavy squats (just not too deep), but due to my high baseline fitness, I suspect my “normal” strength test might mask an actual deficit.
- Other relevant history: Diagnosed with lumbar spinal stenosis and an L5/S1 protrusion in 2012 (mostly manageable). Habit of carrying a heavy 15kg sports bag around my neck for years.
My Questions for the Community:
- Kyphosis Correction: Given my desk job (5-6h PC/day required) and daily targeted neck exercises, is it realistically possible to partially reverse or improve cervical kyphosis?
- Disc Protrusions & Ligament Thickening: Can C-spine protrusions remodel/regress over months/years through deep neck flexor training, and can a thickened posterior longitudinal ligament regain elasticity?
- Spinal Canal Space: Has anyone successfully regained a few millimeters of space (e.g., conservative management opening up a <7mm canal closer to 10mm), or is that medically unrealistic without surgery?
- Return to Sports: Is it safe or realistic to eventually return to heavy squats and high-intensity cycling sprints with myelonatrophy present, or is the risk of spinal cord shock/injury too high?
- Pain & Pressure Relief: What conservative therapies have worked best for you to achieve long-term pain reduction or complete symptom relief with a similar presentation?
- Understanding the Report: The report notes a “congenitally narrow canal” (constitutionally narrow) as well as “secondary spinal stenosis”. Does “secondary” mean the stenosis is solely driven by the recent disc protrusions and ligament thickening, layered on top of my naturally narrow canal?
Cervical Spine MRI (non-contrast) – April 30, 2026
- Clinical Indications / Question: Cervicobrachialgia, sensory-algetic syndrome, suspected radiculopathy due to herniated disc (BSV).
- Imaging Technique: Sagittal T2-TSE, sagittal T1-TSE Dixon, coronal T2-TSE STIR, transverse T2-TSE, 20-channel head-neck-spine coil combination, 3-Tesla MRI.
Findings (Messtechnik & Befund):
- Normal alignment of the craniocervical junction. No Chiari malformation.
- Straightening/kyphosis of the cervical spine. No instability/spondylolisthesis in the sagittal plane.
- Constitutionally narrow spinal canal (congenitally narrow canal).
- Segmental degeneration from C3 to C7, characterized by loss of signal intensity of the nucleus pulposus, partial narrowing of the intervertebral disc spaces, initial osteochondrosis without prominent inflammatory activation, spondylosis/uncovertebral arthrosis, and median (central) protrusions associated with thickening of the posterior longitudinal ligament.
- Long-segment secondary spinal stenosis with the punctum maximum (narrowest point) most likely at the C4/C5 level, showing a minimum sagittal diameter of just under 7 mm in the median plane.
- Myelonatrophy (spinal cord thinning) is present.
- No prominent intramedullary signal abnormality (no myelomalacia/cord signal change), though there is a long-segment, subtle prominence/accentuation of the central canal.
- No intraspinal mass. No suspicious bone marrow lesions. The soft tissue envelope is normal.
Impression / Conclusion (Beurteilung):
- Secondary spinal canal stenosis (SKS) superimposed on a constitutionally narrow spinal canal, with the punctum maximum (narrowest point) at C4/C5.
- Associated myelonatrophy (spinal cord thinning) without myelomalacia (no cord signal hyperintensity on T2).
- Multisegmental median (central) disc protrusions.
- Kyphotic deformity (kyphosis) of the cervical spine.
Thanks a lot for every Support!! 