Tingling,Cervical degeneration

[TPJW]

A neurosurgeon has informed me that I have degeneration in C5-6 and mild in C4-5.  I have tingling in hand and shoulder pain that radiates thur chest and back as well and numbness on left side of my face.  Told me surgery was not an option(which I didn't want anyway)and wanted to wait on Myelegram(spinal tap) and that I should call him if it gets worse.  My symptoms seem to be worse at certain times during the month and has decreased to some degree with a diet modification (cut out cheese and went to soy based products) I also am on aciphex because originally thought pain was from GERD (test negative for that)however the aciphex helps also.  He told me that the pain I am having is not from my neck and that I should take Ibuprofen.  I can't believe this is this is the only thing available. EMG normal, but the tingling I felt during that is similar to the pain I get in hand and arm.  I will take any advice on what to do to help.  I do have some neck excercises to do, and was thinking of going to chiroprator. I know alot of people suffer from this, seems like most DR's have a closed mind on causes and effects.  Thank for letting me vent.

[Baseballman]

A related discussion, Any answers? was started.

[edkrane]

Looking for feedback on this very subject...it seems next to impossible to get a question posted. An accident 2 years ago bought me some unusual symptoms -- and delayed by three months. I had a moderate whiplash which I recoverd from fully with 3 weeks of physical therapy. But 3 months later I woke up with stiff lower legs, generally weak legs, poor balance. I finally went to a neurologist who had a cervical MRI done on me, and I clearly had "mild to moderate" cervical stenosis. The doc said C4 to C7. 10 days of prednisone and another anti-inflammatory cleared up all symptoms totally, but they returned around 3 weeks later at about 1/3 of their original severity, and have remained there. I've chosen no further treatment since the steriod keeps me awake at night, and I can work normally with mildly weak legs and a mildly weak left arm. The neurologist said I would need surgery 'someday' but the steriods should work for now. FYI, the cervical MRI was clearly stenosis with no lesions. I did test positive on Babinski, but nothing else. Back with the original 'more marked' symptoms I had clonus for a short time, but again, the prednisone cleared up all symptoms. I can reproduce a mild L'hermittes' sign in my legs only, and only when I'm walking. I also have suffered from some of the less definable symptoms of MS my entire life--anxiety, depression, irritation, and intermittent tip-of-the-tongue word retrieval.
  But now I'm reading articles lately about a delayed onset of MS after trauma (accidents), or the 'unveiling' of preexisting benign MS due to the trauma, even minor trauma. I am now concerned since the last 15 years I've wondered about the origin of some occasional flu-like symptoms which I had attributed to sinus. I'm inordinately healthy and rarely get colds or flu, and never longer than a day. I don't think I've ever had an MS 'attack' as I've read them described on various forums.
   Since I am concerned that my spinal degeneration is mimicking MS, or visa versa, my main questions are the following:
   1. Would a regimine of anti-inflammatories clear up MS
      symptoms so quickly and completely?
   2. Does anyone reading this also have any insight regarding
       cervical spine compression mimicking MS?
   3. If prednisone cleared up the 'marked' symptoms, does the
       stenosis explain their return, albeit to a reduced level?
   4. Do the milder symptoms of cervical compression ever go
       away all by themselves? From what I've read, I'm pretty
        lucky so far.
                   Any replies are greatly appreciated. thanks.

[stalker]

I had a really bad whiplash accident 3 years ago. I was sat on the back of a stationary motorcycle with no head or back support of any kind. We were hit by an accelerating car, which I would estimate was doing about 25-30 mph when it hit us. I was wearing a crash helmet, and somehow managed to hang on to the pillion belt with my right hand which gave me a nasty traction injury to my right shoulder, arm and wrist. I saw a Doctor the same day, who just gave me some reflex tests and then sent me home with painkillers. For the first year I had terrible pain in my back,(thoracic), neck and right shoulder blade, and down my arms, (stabbing), repeated muscle spasm in my neck, mainly left sided, and tingling in the left lower neck/shoulder area. I also suffered repeated headaches. I have had NCS and EMG, this was nearly one year after the accident. It showed Ulnar comp. at elbow and some nerve root irritation. Sorry, I was not told which nerve root or roots. There is litigation pending. I have seen a private Neurologist, who sent me for further tests which were apparrently all clear!!! The MRI showed a slight change in a cervical disc, but this expert insists that it has nothing to do with my symptoms, and that I should have fully recovered within six months of this accident. I know this is rubbish. Although I do not get much nerve pain now my neck still hurts when I turn to the left, and my Osteopath says my neck and back are full of tight hard muscle knots.  I know these injuries will get worse as I get older. My lawyer has advised me not to go to Court because of lack of evidence!!!No one seems to give a damn, and I am sure thaey all think I am making it up!!!! This is British 'justice'for you.

[spinalmanu]

Degenerative changes in the verterbral discs of the neck can cause compression of the supportive joints: facets.

Cervical facets, when chronically imbricated, can refer pain between the shoulder blades and the shoulder joint proper. Typically, facets become irritated when the disc's integrity is diminished (via injury or chronic "creeping"), resulting in an overloading of the facet (a structure otherwise meant to provide less than 25% of weight transference.

The neurological signs (ie: hand tingling, face numbness) may be due to irritation of the peripheral nerves (which innervate the arm and hand) and upper cervical nerves (which innervate the neck and part of the facial skin). Disk herniation usually does not "pinch" the nerves, but instead the micro-tearing of connective tissue brings forth an inflammatory reaction which permeates and irritates the sensitive nerves flowing in and out of the area.

As long as you DO NOT EXPERIENCE THE FOLLOWING:

       - on and off clumsiness while using your hands/feet
       - sudden increase in symptoms (any symptoms) when coughing or straining at the stool
       - black outs

Then you have no Central Nervous System difficulties and your problem is mainly one of peripheral nerve entrapment.

If conservative methods (e.g.: physical therapy, chiropractic, acupuncture, nutritional/lifestyle changes) are ineffective and your symptoms worsen (especially the facial numbness), then further testing by either a neurologist or cardiologist may be beneficial.

[paininneck]

I had c5-6  herniation 3-02 and ant cerv discectomy with fusion & harware  4-03, surgery over 2hours.... have have arm pain an numbnes, arm and hand nerves and muscles tested and ok (mylenography & nerve conduction) mri shows scarring of cord where disc protruded into cord...  haven't found anything that helps & i've taken them all over past 14 months....

[azurerain]

There seems to be a common thread seen with many of the posts on these boards of people with mysterious symptoms who have cervical disc disease that is apparent on MRI, yet their MDs tell them that the cervical disease cannot possibly be responsible. I just saw another doc who told me again that it isn't possible, even though the bad C5-6 disc is the only thing that is apparently wrong with me, and I have symptoms that would be consistent with irritation of the left side spinothalamic tract in my spinal cord which could cause numbness on the RIGHT side of the body (and the herniation is adjacent to this region of the spinal cord and does appear to distort it). I wish there was some way to break through this dogma that it can't be. The docs must have this notion drilled into them in medical school. I don't believe it. There are too many people with similar stories. These so-called "mild to moderate" disc protrusions have to be able to cause significant nerve irritation and disablilty in some people. I've had two docs tell me now that my disc can't be causing me trouble because there are people with protrusions 5 times as large with no symptoms at all. That is like comparing apples with oranges.

[azurerain]

I've had very similar symptoms (with additional leg and bladder symptoms due to apparent spinal cord compression) and I also have C5-6 disease. I've had a full cardiac workup for my chest pain (no abnormalities and the cardiologist said that my coronary arteries were the cleanest he had ever seen). I also get facial symptoms sometimes. There seems to be a dogma that all of the symptoms have to be BELOW the bad disc, but the major player here is inflammation and that goes both ways. Prednisone helps me greatly and I'm doing much better since I started taking 800mg of ibuprofen around the clock. I also take 3000mg of Neurontin per day. I'm hoping for surgery soon, as this has been going on for way too long for me (3-1/2 years).

[CCF-Neuro-M.D.-JT]

The disc degeneration does not explain the face and chest symptoms. However, if you do have chest pain radiating down to the arm, a cardiac workup should be considered. Another consideration is an MRI of the brain depending on the degree of suspicion from your docs about the nature of your symptoms.  You may want to seek a second opinion from a neurologist as sometimes neurosurgeons are focused on whether or not a patient needs surgery. In the meantime, you may want to try neurontin which is a medication that helps with nerve pain. Good luck.