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Cervical Disc Protrusion (c5-c6) with Arm/Leg Weakness and Shaky Hands
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Cervical Disc Protrusion (c5-c6) with Arm/Leg Weakness and Shaky Hands

Please help!  I am a 34 yr old healthy woman who was in a car accident (rear-ended) in February 2006.  Minor heck pain for a few weeks and thought I was fine.  Then in April terrible neck pain and tingling/numbness in left arm and leg.  Doctor prescribed 3 MRI's (C-spine, T-spine, and Brain).  T-spine and Brain normal, but C-Spine showed a small midline disc protrusion at c5-c6. They said it was touching the spinal canal but with no spinal compression or nerve impingement at the time of the MRI (April 2006). Referred to a Neuro who prescribed Sulindac(anti-inflammatory) and Muscle Relaxer.  However, in the last month things have been getting worse.  Have had what feels like weakness and burning or tiredness as well as numbness and tingling in both arms and legs, sometimes worse than other times, sometimes more one side than the other.  Then my hands have started shaking, more one than the other.  This is very scary.  Neuro says that that she does not know why, and I tried to get a follow-up appmt, but was told they could not fit me in. I have many unanswered questions.  
1)  Could the disc bulge has gotten much larger in just a month and could it now be causing spinal cord compression?  How likely is this?
2)  Should I request another C-spine MRI?
3)  What do you think is causing the wierd leg weakness?  I can understand the arms being affected by the neck injury but not the legs.
4)  Do most disc bulges heal on their own, or require surgery?

Thank you for your help.  If anyone who reads this knows of a Neurologist in NC who specializing in discs, please let me know.
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Avatar_n_tn
In general, symptoms of spinal cord compression are spasticity and weakness in the arms and legs, and loss of bladder function. There may be loss of sensation on one side of the body, and weakness on the other. Sensory symptoms alone would be unusual. I cannot give you a formal opinion on your symptoms, but none of them seem to be hard signs for spinal cord compression, and I would continue to consider other diagnosis.

The nerve fibers for the arms and legs pass together from the brain through the spinal cord - the leg nerves just continue on down the cord after passing through the neck region

The majority of discs heal with conservative treatment. Surgery is mainly indicated when there is evidence of neurological injury, to prevent further neurological injury

The MRI is done lying on your back, and everything sags down a bit, when standing there may be more contact with the cord than you think.
14 Comments
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Avatar_n_tn
Well, I am not a doctor. However, I may be able to answer some of your questions. The disc bulge can't get worse over time unless you were involved in a second accident. I have been in 2 car accidents within a 7 month period. I had previously a disc bulge at the C6-7 Level from the first accident. After the 2nd accident it got worse and is now a herniation.

However, I did find that the seat belt caused a lot of damage to the anterior and venous blood flow to the upper part of my body..hands, shoulders, etc. Try this simple test and see what happens.

Find your radial pulse( on your wrist) and then raise your arm up above your head and see if it disappears. This happened to me in both arms and now it's possible I could have pinched something in the clavicle area.

Some symptoms: Shaky hands, no grip strength, pain when writing/typing, hands turn blue, tiredness when holding 90 degrees..such as driving, aching in the wrist area..I also have pain in both feet as well as the ankles. If this sounds like something you are going through then I would recommend you seek the help of a vasular specialist. They can send you for further testing such as doplars, etc. Also, ask for an EMG test. That will determine if there are any pinched nerves anywhere.

Also this is a great site for TOS(Thoracic Outlet Syndrom (syndrome))

http://www.ecentral.com/members/rsanders/
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Avatar_n_tn
Also, if you are having pain radiating down your legs, you should have a lumbar MRI.
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Avatar_m_tn
i think dana may be on to something. it's called thoracic outlet syndrome. It's difficult to get a diagnosis-- most doctors are very unfamiliar with it. it may explain your upper extremity problems although i am not sure about your lower extremity. Basically what happens is whiplash injuries in a roundabout way create impingement in an already tight area around and under the first rib and clavicle. it can be bilateral. 2 docs who may help you are Dr. Julie Freishlag at Jons Hopkins and Dr. Richard Sanders in Denver colorado. I would choose the latter if expediency is a concern since he is in private practice. i think he also has a website. From your Mri report I think it is unlikely a disc is causing these problems if there is no nerve root impingement or foraminal stenosis.
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Avatar_n_tn
Thanks to dana for the link.  I've been dealing with similar problems since an accident in July.  Also have compromise at C 5-6, and low back issues.   The description of symptoms for TOS is the closest I've come to an answer.  Phys therapy has compounded the problem for me once we've moved beyond stretching into strengthening.  Too bad I have to wait 6 weeks to see my specialist again!
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Avatar_n_tn
I am not a doctor, but I have had disc problem in my neck since the age of 17.  I am now 53 yrs old.  I had a car accident when I was 17 yrs. old, resulting in whiplash.  Through the years, there has been degeneration throughout my neck & spine.  I have had constant chronic headaches every day of my life since the age of 17 yrs.  No doctor, chiropractor, physitherapist, accupunturist, neurosurgeon, or anyone else has been able to help me. I noticed that someone said that your disc cannot get worse.  Well, in the year 2000, I had another whiplash. I was referred to a Neurosurgeon, who took a CT scan and an MRI.  The Neurosurgeon told me at that time I had 2 herniated discs protruding on the nerve roots compressing on the spinal cord.  He told me that the 3rd disc is already starting, and this will get worse with time, and with degeneration, it will go down to every disc in my spine one by one.  I have had severe pain in my left neck, shoulder and arm.  With time, it has also gone to the right side.  Two years ago, I had such severe pain in my legs, I could hardly walk.  At night, I could not lay on my side for more than 5 minutes at a time, it was on my left side because of the pain, and had to roll over. Then the pain was again on my right side, shooting all the way down.  This went on & on, rolling over from one side to other, onto my back, and not sleeping for months and months.  I was referred to the Pain Clinic at the hospital.  They told me this arm and leg pain was coming from the neck. The neurosurgeon told me that surgically, there is nothing he can do for me.  They put me on drugs and painkillers, but to no avail.  I stopped using all of them, as even the highest does of Morpheine that they could give me did not help the pain.  They told me that I would be in a wheelchair within 4 years if I did not walk, and walk and walk and keep moving.  I have not slept more than 4 hours every night for the past 6 years, since 2000.  Now, in December 2005, I started getting dizzy.  I would lay down and stand up, put my head up, put it down, and the room would spin like I was on an amusement ride.  I recently had another scan, and it showed that things have gone from bad to worse.  That now, I have 5 herniated bulging discs. C2/3 - C3/4 - C4/5 - C5/6 - C6/7.  Since the neurosurgeon told me there is nothing he can do surgically, I am waiting to see the Neurologist in July, 2006.  He has told me I must urgently see him, as the neck is causing not only severe pain, but dizziness as well.  The worse bulging discs are C4/5 and C5/6, with narrowing of the lateral canals and calcified posterior bulge of the disc annulus significantly encroaching the central spine canal and impinging on the spinal cord. The spinal canal is markedly reduced and narrowed and very severe.  There is significant compromise and lesion of the spinal cord at this level.  Also, there is a bony spur in the center of the anterior aspect of the central spinal canal extending down behind the superior C5 vertebral end plate.  There is nerve damage at the root, and the doctor has told me that I have a spinal cord of a woman 20 years older than I am.
So, yes, degeneration can get worse with time...and I am wondering if there is anything that can be done for my pain throughout my whole body....headaches, neck, shoulder, arms, legs and spine.  I am also wondering if anything can be done for the bony spur which is growing. I am wondering if anything can be done for my dizziness. I will have to wait to see the Neurologist.  I have heard of a treatment of injections that shrinks the bulging discs back into place.  I would be interested to find out more about this procedure, as since I already have 5 bad discs, and the rest will follow, I am seeking some help and relief.  My headaches on some days are like a train is going through my head.  I cannot understand how scientist can fly to the moon, but there is no help for this kind of pain. I may have to quit my job and go on a disability or invalid pension, as the pain is so severe, at times I cannot sit for more than 15 - 20 minutes and have to stand to get relief. Even now as I write this at the computer, I must stop and walk away due to the pain in sitting. I guess my question is, can anything be done for these bulging discs and the bony spur?  Is surgery an option?  Or is there anything else?  I have seen 2 specialist already, both Neurosurgeons.  I have seen a Pain Specialist.  I am now waiting to see the Neurologist.
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Avatar_n_tn
Hi Sandra,

I have a very similar situation to you... I'm 35 and had a car accident in March and developed tingling in my arms & a little in my legs more than a month later. An MRI showed a midline herniation at C3-C4, as well as some slight bulging of some discs lower in my neck. I've gotten different opinions from 2 neurosurgeons and have been pretty scared about this all, and wondering how to proceed from here. If you'd like to compare notes & info with me, or just have some support through this, please e-mail me at ***@****. Hope to hear from you...

Amanda


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Avatar_n_tn
A few more comments to add to my previous post...  I saw my neurosurgeon today. I also have arm/leg symptoms from a midline disc protrusion towards my spinal cord (mine is at C3-C4). He believes my arm/leg symptoms are coming from compression on the spinal cord. He wasn't too concerned about it last month, but is now recommending fusion surgery because I have shown no improvement. He said I have a greater risk of spinal cord bruising/damage should I take a fall, have a collision, etc. I don't want fusion surgery, but he has me 50% talked into it. Although there is always a chance it may heal on its own, I'm not sure I want to walk around in fear of something happening.

Sandra, I'm surprised your neuro would shrug her shoulders and not make more time for you. Seems like you would also be a candidate for surgery if your symptoms don't improve.

Amanda
***@****




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Avatar_n_tn
I had 2 back surgeries last summer. I had fusion on my L5-S1 up a couple levels. Then a month later they went back in because I had leg pain in my right leg which I did not have prior to surgery. Now I'm having issues with C6 according to one of my Dr's. It has been going on for over a month now and my right arm goes numb all the time and my left index finger tip down to the first nuckle is numb 75% all the time.

Not sure what to do since I have no insurance and absolutely can't afford a big hospital bill. I need to get x-rays done to see what is going on with my upper back now. Still having problems with low back pain and every now and again when I step down I get a shooting pain down my leg that about sends me to the ground. I'm only 37 and it seems like I'm gonna be having back problems from now on. I had a hemilamenectomy when I was 21 also! I will post my MRI if anyone is interested from last year prior to the fusion surgery I had.

If you can avoid surgery at all cost but sometimes it is the ONLY solution and should be taken. Losing weight, never sleeping, and being in constant pain all the time is no way to spend your life! I'm not looking forward to finding out what is wrong cause I know it's not good and summer is just starting again...

Good luck to you all and thanks for listening... AO
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Avatar_n_tn
Hi AO,

  I would be interested in seeing your lumbar MRI.  I was diagnosed with spondylolisthesis L5-S1 last year. No surgery yet.  I have a lot of right thigh pain, calf pain and some foot tingling.  Also, recently diagnosed with pinched nerve at C5-C6 with right arm pain and occasional tingling in fingers. No surgery yet.  As well, I possibly have "atypical facial pain"...right sided ear,head, eye, cheek, teeth affected. I thought it might be trigeminal neuralgia, but MRI of head without and with contrast showed none.  As you see, most of my pain is right side of body. ??

  Just this week I was switched from Ambien CR due to side-effects to a small dose of Valium.  So far, it seems some of my pain has decreased.

  I was also diagnosed with fibromyalgia several years ago.
Female, age 47.

  I wish you well.
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Avatar_n_tn
Amanda,
I had a 4-7  cervical fusion done 6/13/05. The surgeon scared me into having it.  I had some tingling going down my arm but then it stopped.  I wish i would have waited a year or two before i had the surgery because surgery should be the last resort.  The surgeon brought my neck forward a half inch. I am caved in in the back of my neck. My throat sticks out,i look like a swan. I can only turn my neck just a little each way.
I had two bulging discs and a herniated disc.  The herniated disc was herniated to a small degree only. The surgeon agreed to fuse 5-7 when i awoke from my surgery he had fused 4-7. He was a spine surgeon instead of a Neurosurgeon. My hand tingles now and my left foot goes numb.  I have more problems now than before. Everyday I regret having this surgery.  Surgery is the last resort. I wish I would have waited what was the rush.
Debbie
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Avatar_n_tn
I was rearended in Dec 1997. I had horrible pain. After several MRI's, and multiple ESI's (epidural steroid injections)that did not work, my pain Dr. suggested that I see a Neurosurgeon. He took one look at my MRI, and told me that "It's not a matter of life of death, but a matter of QUALITY of life".In March of 2001, I had a cervical discectomy of the C4-5, and C5-6. He found bone fragments (splinters) in the ligaments in my neck, and removed them a well.These splinters did not show up in any of the MRI's or X-Rays for some reason. I spent one night int the hospital. Within two weeks, I was mowing my lawn. I felt better than I had in years!!
In November 2004, I was rearended again. After 9 months of pain, again I was sent to see a surgeon. He recommended surgery to decompress my spinal cord. This time he would be going in through the back of my neck. My Neurologist told me "Don't do it". I did it anyways, thinking that my first surgery went so well, that this one would too. WHAT A MISTAKE!! It has basically cost me my life. My muscle has separated, causing a deep indentation in the back at the incision site, and according to the surgeon, my muscle has separated. I'm 40 years old, and I have a hard time brushing my daughters hair, let alone my own, due to the weakness in my right arm and hand. My 75 year old in-laws can physically do more than I can.
Now my C3-4, C6-7, and my T-1 are going. According to my last MRI, the C3-4 is hitting my nerve root.
Meanwhile, with all the pain, I have been on so many drugs to help control the pain, that I have been high actually since August of last year.
I think that if surgery is necessary for anyone, and they can go through the front of your neck to fix things, do it. DON'T let them go through the back.
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Avatar_n_tn
intolerable pain in left shoulder.
2yrs ago radiology report   states this
disc space narrowing at c5-6
bone spur's whixch project into the neural foramen bilaterally at this level..

so last couple months shoulder pain gradually increasing. unable to sleep on left side.   at the current date 7- 2006
i'm beside myself. making me crazy .never having  this  before.

so whats going on?  all on the left side pain to my elbow
using a hot gel pack, vicodin mides well eat a snail. useless!!
anything for me to worry about, will it just get so bad i seek medical help.. i'm there actually.  treatment? how to fix.
hurry up  i'm waiting. will check after i get home today..
appreciate  any effort made... teri
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Avatar_n_tn
What a relief to find some that have had rear end accident following with neck ,hand weakness and pain and leg  -weakness. Aug '04 I had fusion C5-7 with complete recovery of arm pain and weakness and gait improved, free from horrible headaches and pain in shoulder arm and hand were gone. rear end accident Jan 06 on  frwy  within minutes all the symptoms prior to surgery came back. After about five  days I thought I was in clear and on the road to healing. This is month 5 post accident and the surgeon who originally did the fusion (and head of neurosurgery at major teaching university) says he can't see spinal cord compression and that fusion is intact. Docs threatening to send me to Pain Mgmt. (He thinks my cord was struck in the accident and is not sure if I will get well. The symptoms are much worse after sleeping, and physical exertion. I think the fact that some time the symptoms are less may mean they cannot see the damage or what's causing it since MRI's and mileograms are static tests, and pain is in dynamic moving environmeent. Physical therapy made it much worse. )Slight bulge above the fusion. Most days my R arm and left three fingers are weak, my R hand stay slightly blue and cold with numb fingers pinky, index and middle fingers, severe headaches, now I am limping and drag my right leg. NO leg pain only when the pain and numbness is present in arm and hand and shoulder. Some days I have been doing better and them BAM...worse with all the symptons again. Most times the symptoms are present.  AFter accident I went on my honeymoon (yes I got married 3 days after the accident)  I thought I was in the clear, but as I returned to a job 14 days post accident sitting at computer with lots of multi tasking, the symptoms are severe most days. I now have second opinion scheduled and wonder if the tests are not showing that something is striking my cord that they cannot seen. Any ideas or similiar symptoms out there?
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