I was recently referred to rheumatologist back pain clinic after four years of severe upper back pain. They took my history (chronic pain generally from endometriosis) and did a neurological exam and have referred me for an MRI. It came on while I was pumping for my twins and when I’ve seen physios they reckoned it was the relaxin plus posture, but I have altered sensation on the skin across my upper back and my spine is painful to touch.
They didn’t say much about the exam and I’m having the MRI on Saturday and will then get a follow up call from the practitioner I saw recently, but her manner suggested it’s all normal and that she thinks it’s probably at least partly due to years of chronic pain (endometriosis and adenomyosis).
I’ve just had the clinic letter through which details the exam and there’s a few things I really don’t understand and Google has left me more confused.
Obviously I will talk to them when I have my follow up after my scan but just wondering if anyone could explain these things to me? In summary it says they are “subtle neurological findings” and they’re scanning me particularly because they are bilateral (that word I understand!).
The things raised in the letter are:
- Bilateral upper limb myotome weakness at C7/8 of 4-/5
(I assume that’s just very mild weakness as the rest are 5/5 so that’s probably not significant?)
- Normal Babinski but positive jaw jerk and absent Hoffman reflex
(This is what has really confused me - I looked it up and some sites suggest that an absent Hoffman reflex is bad, others suggest a positive Hoffman reflex is bad and I assume positive means present? Same with the jaw jerk - I can’t work out if it’s supposed to be present or not? It’s the fact it says “but” in the sentence that makes me think this is the “subtle findings” she’s referring to)
I’ve been really fobbed off by GPs about my back for years and they referred me very reluctantly. In addition to all this I have a diagnosis of ME and lots of unexplained symptoms (burning in limbs, generally feeling really unwell, crippling fatigue, hair thinning, weight gain etc etc but blood tests all normal). I’m just wondering if these little things might suggest anything so I can ask questions. Fully appreciate I am probably clutching at straws but I’m so fed up with feeling so ill all the time.