Is my nerve-related muscle atrophy reversable?

[TonyDisc]

Dear Doctor,

3 Months ago, I had an accident and Herniated my C5/C6 disc quite badly.  The pain resolved within a month, but my left arm remained weak.  I had surgery 2 months after the accident (posterior microdiscectomy without fusion, to remove the broken part of the disc).

Now, I am 1 month post op, and my arm is still weak.  I have muscle wasting / atrophy in the left arm, mainly in the deltoid and teres major, latissimus dorsi.  I still do not feel an improvement in strength.  The doctor told me that after surgery, my nerve was decompressed and looked completely relaxed.

My questions are:

1.  I was told that nerves heal at 1mm per day. Since my nerve injury was at the nerve root,  does this mean I have to wait for the nerve root to heal only, or do i have to wait until the nerve heals all the way down the arm?  How long will I be waiting until my arm gets strong again?

2.  Is the muscle atrophy reversable?  Should I be exercising the atrophied muscles, or is that a waste of time until the nerve heals?  How will I know when the nerve has healed so i can start doing weight in the gym again?  Will the muscle always remain small?

Thank you Doctor for your help and advice, I look forward to hearing from you.

Many warm regards,

Tony

[TonyDisc]

Actually yes, I have more questions.  Thanks.

The Doctor said that my Nerve Conduction study came back normal.  But needle EMG showed active denervation.  How can that be?  If the nerve is conducting normally, does that mean that my root injury was a Neuropraxia, and the nerve is still intact?  If so, does that mean the recovery should take less time?

[Abhijeet Ghosh]

Hi Tony,
I apologise for a late reply.
Please find my answers -


1.  I was told that nerves heal at 1mm per day. Since my nerve injury was at the nerve root,  does this mean I have to wait for the nerve root to heal only, or do i have to wait until the nerve heals all the way down the arm?  How long will I be waiting until my arm gets strong again?

The Maximum speed is 1 mm per day. We really can't comment as how soon you will recover. There are few rules of nerve regeneration/recovery -
a) Recovery may happen till 12-18 months.
b) The higher the speed of recovery post surgery, the better the chances of complete Recovery.
c) The more time taken to relieve the nerve compression, the slower are the recovery chances.
So it's really unpredictable.And we need to wait, to see the recovery.

2.  Is the muscle atrophy reversable?  Should I be exercising the atrophied muscles, or is that a waste of time until the nerve heals?  How will I know when the nerve has healed so i can start doing weight in the gym again?  Will the muscle always remain small?
Please start up the physiotherapy, else the muscles will remain atrophied.
Sometimes active physio helps in the recovery of the nerves also.
The sooner your nerves are regenerated/recovered, the better are the chances of your muscles to get normal.
I hope you understood my point.
The muscle atrophy is mainly due to nerve involvement (nerve damage), so the normal rules of physiotherapy (for muscle rehabilitation) will not apply.
However, the physiotherapy will help us to some extend, to regain muscle girth, and moreover it will help to regain the nerve power.
Feel free to discuss further, in case of any clarification required.
Regards..