15:years of neck pain, ALS?

[Sunchild]

I am 40 years old, and a veteran athletes. Approximately 15 years before now I had a neck trauma which has always been painful when tilt my head backward. About 3 years after the injury to my neck I began to feel pain radiate down my right hand most when I wake up in the morning. Then numbness in my right hand fingers. I did an x-tray and severe cervical spondylosis was diagnosed. I treated that with neck traction but I stopped and the pain continues down the years. In 2023 I felt chronic pain on my shoulder for months while I play Badminton. Then my fingers began to fold up. Then the pain extended to the other shoulder with muscle twitching, dull pain, and painful spasm. August 2023 after 8 months of twitching the doctor diagnosed ALS. MRI show neuropathy on both side of the cervical vertebra, and I was not told what significance the EMG means. I still have neck pain and numbness in toes and fingers alongside twitching that changes location except for both shoulders. Later on I discovered the shoulder x-ray should an overlapping soft tissue on my right shoulder. I know this is complicated but my hands seem weak and atrophied. I know the history of the injury and I only expected cervical stenosis, could the MRI miss it?

 

[lgelb]

We always recommend a second opinion on an ALS diagnosis. A history of neck injury and neuropathy, even more so. Usually the history, exam, and EMG, coupled with the MRI and routine labs would provide enough info to say, "spine issues + ALS," but again, all neurology is not created equal, so you want that second look.