cervical disc herniation

[Joyce]

hi . in the middle of february i had some severe neck spasm. which i have had for years. but with some motrin it uasually went away. but this time it did not and the pain went into my right arm with no relief form the motrin. i went to my family md and i had a cervical xray and she gave me flexerial and my motrin up to 800mg tid. one week later she called and said i had to have a mri.which i had done on 3/6/00. in the meantime the pain became very severe in my whole arm and numbness in my indexfinger and my middle finger and up my arm to and above the elbow. the pain also was very severe in my elbow  finally my md gave me a a med hyrocodone. which did give me some relief finally. i saw the neuro surgeon. and i was very nervous.so i know i did not get all the info straigt. my mri impression. said right sided disc protrusion at c6-7  and left paracentral disc protrusion at c5-6 neural foraminal narrowing. diffuse degenerative disc disease. cervical straightenging  which may reflect paracervical muscular spasm.  the is some damage to the nerve but iforgot what one. she put men on decadron for thee day. if my pain is better next week i may sart some therapy. i think she said surgery was the best option but will see if conservative treatment helps.  i had a similait problem in my elbow last year i thought it was a bursitis. so i waited it out after a fer months it went away. the ns said it was form my neck. then too. what do you think i shold do .i am nervous. about surgery  and if i do not have the surgery . the numbness remain. also she said my muscle in my upper arm  was damaged and it may take up to a year to get back.  i know this lenghty  but i need to think about the surgery. -

[CCF Neuro[P] MD, RPS]

Dear Joyce:

Sorry to hear about your neck and arm problem.  It sounds like the cervical disc and foramen may be the problem.  Usually the best progression of treatment for spinal cord problems is a good trial at rehab, done with a PT and rehab specialist.  If this fails then the alternative is surgery.  Surgery would be the last option as results can be variable from patient to patient.  I think I would also see a neurologist and get his/her opinion concerning the numbness of the index and second finger.  Does this happen during the night? Do you find yourself shaking the hand due to numbness?  Any itching on the palms?  Anyway, this will help identify any other nerve problems.

Sincerely,

CCF Neuro MD

[joyce martin]

thank you so much. the numbness is al the time and it is also in my arm and in my elbow . no i do not shake my hand due to the numbes . during my. rest time in your opion what should i be doing  or should i say not doing. should i use my right arm or should i just rest it .i want ot do everything so i do not need the surgery. also i am off work for a few weeks. how long do you think i will need to stay off work and how long  will the therapy be needed. i have some home neck traction i used it once and i used 8 lbs of water. but it did hurt and it sent pain into my arm again any further suggestion would be greatly appreciated. thnk you

[Mark]

Joyce - I went through similar experience as your 09 years ago...
ending up having a cervical fusion.  I have a lot to say about
surgery vs therapy etc.  It you would like to call me please
do...415-421-8663 or Email at ***@****

[maggie]

Had the same exact thing.  I went to a hospital Pain Clinic and the doctor gave me an epidural filled with cortisone.  The procedure is painless and takes only a few seconds.  I am 49, but I feel as healthy as a child now.  All of the pain, etc. is absolutely GONE.  There is no need for surgery. Look into this.  Insurance usually pays for the entire thing.

[CCF Neuro[P] MD, RPS]

thanks for the comments.

CCF Neuro MD

[Joyce]

dr  what is the medicine decedron for. and when do think the pain will go away and the numbess. and how long will i need the physical therapy. my arm almost fells foreign to my body.thank you for the time and answers.

[Jim]

decadron is a powerful steroid used to reduce the inflamtion and hopefully reduce the disc impingment on the nerve root.

[Barb]

7 yrs ago i was in an auto accident and even thought all tests  MRi's etc..were normal i had numbness in arm,,,'6 months ago i had another accident and numbness in arm again but is much worse and burning.  All emg and mri show disc problems and nerve damage.  Could this be stemming from the accident 7 years ago?

[Theresa]

Dear Dr.

I feel as if I am falling apart. I have just been diag. with a herniation at C6-7 impringing on the nerve as well as carpal tunnel in both hands. I was involved in a auto accident several years ago which caused me to have left knee surgery and another one causing me to have right shoulder surgery. I have no idea where to begin. I am not working due to the disc problem because of the pain.  I suffered with the knee and hip pain all of which I understand the knee pain is caused by the hip. But, now I do not know where to start if I have to have surgery.I hurt all the time. The knee I had surgery on is starting to bother me. I went to see a pain specialist, who has ordered several blood test to rule out lyme disease or other blood disorders. The specialist also stated I could receive injections to relieve the symptoms  but, feels I will need surgery. I think I should have seen a neurosurgeon first or a orthopedist. Please advise.


Thank You.

[[e-mail]]

Hi Joyce-I was diagnosed with tennis elbow 2yrs.ago at work ended up with a c4-5, c5-6, c6-7 herniation from my job. I tried isometric exercises, injections, traction, P.T. with no relief from the continuous pain and numbness running from my neck to my fingers on both sides. I had severe occipital headaches and lost most of the use of my hands. After careful consideration I had an anterior cervical discectomy with keystone fusion. They fused three levels with bone taken from my hip. I wore a neck brace for 7 months as I had no plates and had to wait for the fusion to take. The fusion took well but I am in worse pain now than before the surgery! Spinal surgery is very tricky no matter who your doctor is. Please try all other options first and shop around for different opinions before you consider surgery. I feel as though my life has been taken from me. I can no longer function normally. I am being treated by pain management and am heavily medicated. I go to P.T. twice a week and they have relieved my headaches. I have had epidurals,trigger points and am still suffering from pain and numbness. New MRI shows disc below the fusion starting to bulge--frequently happens--This is an unending nightmare! PLEASE be very careful with you decisions. I wish you the best of luck and hopefully relief from your pain. Debbie

[Clara Mahoney]

My question is concerning Lupus and disc problems.  I was told about 15 years agao that I has Lupus, yet when I went to a specialist he told me that there was a precentage of people who have about 3% of the disease in their bodies and not all have the disease.  I was about7% at the time, this all done through blood tests. I had problems walking, it felt like I had someone elses legs attached to my body(the only way I can describe it).  Anyway the pain was unbareable, I could not walk without pain.  It seemed to affect my legs and my hips.  I do not get many flare ups, but when I do, it affects the same area of the body.  Now the question is, I have a herniated disc in the c5-5, it gives me a lot of back pain, but I am at the point that when I sit my legs go numb.  I do not know if it is from the Lupus or disc problem now.  I have had the epidural block done twice and it worked for me.  I am now on Naproxen for the swelling and empracet for the pain.  Would the epidural block help against Lupus, seeing as how there is am anti-inflammatory, cortizone and other drugs?  Thank you in advance for your help.

[CCF Neuro[P] MD, RPS]

Dear Clare Mahoney:

It is difficult for me to tell you anything real definitive.  I can't see the films nor do a proper neurological exam.  A C5 cervical disc should not induce numbness with sitting, for the most part.  There can be efffects in the lower extremities, such as spasticity, increased DTRs or reflexes, some muscle weakness, but these should be present on neurological exam.  Episodic numbness would likely be from another source, maybe your SLE.  Usually, a C5 problem would be found in the upper extremities.  The epidural, was it for pain or as an anti-inflammatory medication?  Usually we think of an epidural as for pain.

Sorry, I can't help much.

Sincerely,

CCF Neuro MD

[Arceli]

I had injury at work.  X-ray showed calcification in anterior longitudinal ligaments anterior to the D10/11/12.My MRI showed cervical herniation to c5-6 pushing the spinal cord and also showed mild spinal cord deformation.  My numbness, tingling to both legs and arms are getting worse.  I'm now getting severe headache, dizziness, blurry vision.  My GP prescribed gabapentin.  I'm reluctant to take it besides its side effect.  What are other alternative therapy or medicines to improve my condition.

[libby --re: "window of opportunity??"]

dear arceli (and others with cord compression)

not the doc!!, but i've have been thru cervical fusions 3 times now.   once for c 5-6, then several years later the disc below this herniated (c 6-7) and after trying physical therapy for a looong time, the cord compression simply continued to worsen.  

the 3rd surgery was because the 2nd one failed to fuse for whatever reason and needed to be stabilized.

arceli, many of your symptoms sound similar to what i contended with when i had severe cord compression.    --although i never did encounter blurred vision.  

i would imagine you're seeing a spine surgeon under the present circumstances?  ------my point to all of this rambling (there really is a point :0) )  -----is that i notice the symptoms seem to be pretty varied with c-spine problems.    but in my honest opinion, once you begin dealing with compression to the spinal cord itself, the symptoms become so severe--- so nerve wracking--- so constant---- so downright frustrating.  

i have no idea how the docs here feel about this ---- but i've read where some patient's are told that with cervical spine problems, leg symptoms are not a symptom.     ------this is SOME surgeons.    ---there are also the spine surgeons who explain ((WHY)) leg symptoms are actually quite common with c-spine compression.  ---(why the difference in opinion on leg symptoms?_--i have no idea)      --in my case, i developed what is referred to as "myleopathy".  

this, according to the surgeon, was the culprit in the leg weakness/heaviness/pain.

the one thing that frustrates me more than anything in this whole ordeal, --has been the confusion there seems to be when patients ask about the "window of opportunity" for leaving cord compression "as is" and seeking out various conservative measures.

if the doctor stops back in, i simply do not understand <<WHY>> this is such a difficult question for spine surgeons to answer (timeframes for leaving spinal cord compression)---    

i'll bet this is the number ONE asked question among patients, yet it's the one question rarely addressed-----anywhere.

if the spine docs themselves were also experiencing the constant pain, numbness and tingling of cord compression (and i realize some have)----   but if more could feel what severe compression feels like, i would wager that their top question also would be ---"is there a window of opportunity when nerve damage can ?? ---or when these symptoms can become irreversable?"   ----here's one other great question  "---am i putting myself at any safety risk by continuing to live with spinal cord compression?"

one more unanswered question  ----"if i fall or am involved in a vehicle accident, is the potential for considerable injury worsened because i already have cord compression?"

---these are the questions you won't find anywhere it seems in print.   but they really are the ones that are most frequently asked by those contending with spinal cord compression.   ---i can only "assume" that the only reason that no one has taken the time to provide the answers to the questions that top our list, is that "everyone is different"..

----this is the only thing i can think of on WHY there is no information and no answers in print that answer these questions.

during my 2nd surgery, my fusion collapsed and did not fuse.   the bone graft reabsorbed, and i developed cord compression yet again from an osteophyte.

while i feel that trying all options is important, i also learned that if a patient leaves major cord compression "as is", it should be monitored occassionally via repeat mri or whatever it takes to ensure the surgeon is aware of the current status.     ----i developed severe nerve damage in one arm after the 3rd herniation and can no longer use one hand.   i should have had the revision surgery sooner, but who knew.

i've gone through three emg's now to confirm the nerve problems.  someday----- i hope so much-- that some spine surgeon somewhere--- anywhere-- will step forward and provide those of us with spinal cord compression some sort of timeline.     ---even a rough guess-ta-mate on a "window of opportunity".

why this can't (or won't) be done, i'll never know.

one last thing to all.   ---if anyone here does wind up having to have cervical spine surgery, it's not that bad!   ---i never had a problem with the surgery itself--  only in leaving cord compression for "too long" ---although no one really ever knew how long "too long" was --- sheesh!  ---libby