15/12/2025
MRI -Cervical spine
The patient presented to me for an initial assessment complaining of: – tingling and numbness affecting the jaw – paraesthesia in the upper limbs – persistent neck and shoulder discomfort
🔍 Based on the clinical assessment, the symptoms did not fit a simple musculoskeletal pattern. For this reason, I referred the patient for imaging and neurophysiological investigations, prioritising safety and diagnostic clarity.
📌 What the investigations revealed: – multilevel cervical degenerative changes
– severe foraminal narrowing at C5–C6 and C6–C7
– an intradural, extramedullary lesion at the C3–C4 level, with imaging characteristics suggestive of a cervical meningioma, causing spinal cord compression, but without intrinsic cord signal change
– EMG findings consistent with chronic C6–C8 radiculopathy, with no evidence of acute denervation
🧩 Why is this a complex and serious case?
Because it involves: – genuine neurological symptoms
– spinal cord compression
– a benign tumour located in a highly sensitive and critical anatomical area
– severe degenerative changes that can both mimic and exacerbate neurological symptoms
👉 In such cases, physiotherapy must be carefully dosed, highly individualised, and integrated within a multidisciplinary framework.
🤝 The patient is under my clinical observation and is currently undergoing tailored physiotherapy treatment, with clear objectives: symptom management, neurological protection, and functional preservation, alongside ongoing specialist monitoring.
📚 Key educational message:
Not all numbness should be treated with generic exercises. Sometimes, the most important step is knowing when to pause, investigate, and choose the safest pathway.
