Is it time to see a Neurosurgeon

[ferret5]

I have been in pain management for about 2 years now, mostly for my neck (I have several herniations in back also and advanced arthritis, but my neck has been the bigger issue).When I first went into treatment, I had very limited ROM, severe neck, shoulder,arm pain and headaches.I have been in PT several times. I take Tizanidine 8mg QD, Mobic BID, Cymbalta 90mg QD (fibromyalgia) and Percocet TID. I have regained alot of ROM, probably as best as it will be again. I had cervical epidural without help. I had Rhizotomy about a year ago that helped moderately for headaches. But, even with the Rhizotomy, I have been getting injections every 2 to 4 weeks (Lidocaine and sometimes Cortisone). These give only minimal relief for very short time. Headaches now getting very severe again. Stabbing throbs L wrist, sometimes L clavicle & ankle. Pain mgmt wants to do another Rhizotomy. I dont think it did enough the first time, but am willing to give it one more try. But, I am thinking if this doesnt give adequate relief, should I now seek the opinion of a Neurosurgeon? I dont think getting injections every 2 to 4 weeks for the rest of my life is a successful treatment--and these injections are getting more and more difficult to tolerate. I just had a repeat MRI (last was in '97). These are the highlights of MRI impression:  Mild increase spondylosis since last study most noteable C3-4 where new small posterior central disc osteophye herniation INDENTING ventral thecal sac.....Interval increased magnitude C4-5, broad based disc osteophyte complex EFFACES & FLATTENS ventral portion of cervical CORD & NARROWS bilat neual foramina right greater than left....At C5-6 left paracentral disc herniation & endplate spur more prominent EFFACING the left aspect cervical CORD....C6-7 left asymmetric disc osteophyte complex asymmetrically INDENTS ventral thecal sac (new finding). ...Marked NARROWING & desiccation C4-5 disc. ...C7-T1 no abnormality......Thank you for your help

[Abhijeet Ghosh]

Dear Friend,
Your MRI is mentioning about disc space narrowing and compression which is effecting the nerves (from the point they leave the spinal canal). Hence it's important for a neurosurgeon, to evaluate the severity / extend of canal compromise, as it may warrant a need for surgery.

[Abhijeet Ghosh]

Dear friend,
Its very nice that you have mentioned about the latest MRI report,I would suggest you to go for surgert only and not to waste much time.
You would require a good neurosurgeons opinion as physical examination is vital, before deciding for the type of surgery. Deffering a surgery would result into permanent weakness.
Hence please act soon.
Regards

[Bala71261]

Dear Dr Ghosh,

I’m 48 year old healthy man who went to gym three times a week and did a lot of weight training. In March 2110I developed slight pins and needles on my lower left inner leg. This moved to whole left leg, left arm and now all over my body. I have now constant burning/tingling sensation everywhere and occasional numbness in fingures. I have had all the blood tests two MRIs on my head,cervical,lumber and sacral.Head was clear of any lesions, but all cervical disks are dehydrated, C3-4 lost height, there is a minimal bilateral exit foraminal narrowing caused by neuro central joint hypertrophy, in lumber sacral L1-2 and L3-4 disks slightly dehydrated and lost small amout of height, L3-4 on the left is far lateral disk protrusion but this does not impinge upon L-3 nerve root. My Neurologists recommended physiotherapy. Please explain the Radiographer’s comments, are my symptoms in line with these findings?

Unfortunately, I am still worried about potential sinister diseases as these symptoms have not gone away and its 24/7 except when I am asleep after three months of rigorous exercises, chiropractic care and physiotherapy. Moreover, as per Radiologist’s report although there was far lateral disk protrusion on the left of L3-4 disk, this does not impinge upon L-3 nerve root, hence it may not be sciatica.

Whilst I am waiting to see a Consultant Orthopaedic & Spinal Surgeon on 12th November, owing to the unremitting burning, tingling, prickling, occasional numbness and recently developed involuntary muscle twitching all over my body and insect crawling feeling in my head, I went see another Neurologist on 4th October. He conducted the usual rapid alternating movements, point-to-point movements, gait and reflexes test. Although he was happy with my responses, he ordered an EMG test rule out potential sinister diseases.

I am generally a real worrier and a very anxious person. Hence, this involuntary muscle twitching makes me worried about ALS (MND) and Fibromyalgia. Insect crawling in my head makes me crazy.

It has been over three months and no improvement. Could you please, please advice?

Thanks in advance.

[ferret5]

?? Why is it the doctor at pain management did not see any reason to see a neurosurgeon?? I'm not worried, but curious as to why you said to act soon and not waste much time going to see a neurosurgeon?  I dont have any weakness that I have noticed??