cervical herniated disk - tingling, etc.

[meghanmcc]

I’m a 28 year-old female and in good shape—run 3 miles 4 times a week. I possibly have two problems going on at the same time but I’ll mention all symptoms in case they’re at all related.

My back/leg problem started a year ago when I developed severe leg pain that would shoot down my leg (sciatica?). Lower back pain soon followed. Pain is worse when standing and walking. Pain relieved by sitting and bending forward. The leg pain has subsided but I’m getting tingling that won’t go away (started in my rt. foot) and sometimes a pulsating pain in various locations in my legs in small areas.

Neck/arm problem: First noticed a tingling and hot feeling in my lower right arm. On occasion I have gotten a severe neck ache that would not go away for 2 or 3 days with a headache. Sometimes I get an electric shock feeling that shoots partway down my spine and a periodic ache /pain in my shoulder that sometimes radiates down my arm. I have lots of tingling in my fingers and some numb-type sensations on the fingertips on occasion.

Two weeks ago I had an MRI of both my lumbar and cervical spine. The lumbar spine came back clean. Here’s the “impression” for the cervical spine:

“Right paracentral C6-C7 focal disk herniation with focal narrowing of the left side of the subarachnoid space but no spinal cord impingement or foraminal narrowing. Single focus of hyperintensity noted on sagittal T2-weighted images within the spinal cord opposite C3-C4.”

Since I’m getting conflicting opinions as to what is going on, here are my questions:
Is it possible for my cervical herniated disk to be causing sensations in both my legs and arms?  Could the narrowing of my spinal canal cause pressure or irritation on my spinal cord even though the report says “no spinal impingement”? Do I need treatment for my neck? Is it possible for my symptoms to continue to worsen if left untreated?

Thanks for any wisdom you can share!

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

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms you describe seem to be more concerning for demyelinating disease (Multiple sclerosis or a variant) than disc disease.  The MRI of your cervical spine demonstrated a T2 hyperintensity (can be caused by demyelination (or the loss of the "insulation" around nerve "wires")) in the C3-C4 region (not in an area that has disc disease).  Also your disc disease at C6-C7 (although I am unable to see your films) sounds relatively minor from the impression.  A disc that compressed your cervical spine to the point that it caused leg symptoms would show signal abnormalities (none noted in your spine at C6-7).
  Mutliple sclerosis often presents with isolated numbness and pain in an extremity that then improves over several weeks.  Demyelinating disease can also affect the C-Spine without much brain involvement (Devic's syndrome). The electrical feeling that shoots down your spine sounds like a L'Hermitte's sign (which is often seen in MS/spinal cord inflammation).  Other things that would be possible (but less likely) include partial transverse myelitis, spinal cord tumor, or syrinx.
  There are ways to differentiate MS from radiculopathy (disc disease) on exam, such as increased reflexes and eye problems often found with MS vs. decreased reflexes, atrophy and/or weakness often associated with radiculopathy.
  That being said, you need a comprehensive workup, before you will know what you have.  First, I would recommend an MRI of your Brain and C-spine with and without contrast (there was no mention of contrast on your previous c-spine). You will need a lumbar puncture to evaluate for spinal fluid inflammation(Tourtelotte panel, oligoclonal bands). An EMG would be able to evaluate for signs of radiculopathy. Either way, you will benefit from physical therapy.  
  The diagnosis of multi-focal pain/numbness symptoms is often frusterating and it is not uncommon to go to several doctors before you gets answers.  I would recommend you see a neurologist that specializes in multiple sclerosis. I hope this has been helpful.

[meghanmcc]

Oops, I accidentally deleted the line at the end of the MRI report-- "Single focus of hyperintensity noted on sagittal T2-weighted images... While this represents a focus of demyelination this finding cannot be confirmed on other images or sequences and therefore it may be an artifact." The neurologist sent me for an MRI of the head to rule out MS but I don't have any visual problems, etc. so it's doubtful that the spot really exists (I think so anyway).

I should also add that the neurologist said the tingling in my arms is caused by the herniated disk BUT a doctor (I don't have a primary care physician) told me the disk is no big deal and wasn't causing any of my problems. The tingling won't go away and it's driving me nuts!

thanks
meghan

[tropicalgarden]

When does the numbing and tingling of the hands/fingers happen mostly?? I wonder if the hand/finger tingling/numbness is related to carpel tunnel syndrome. I have it in both wrist and my arms/ hands  have pain, numbness and tingling sensations and tends to "go to sleep" alot. When it first started, I was waking up at night with sharp radiating pains/numbness from my shoulder to the my fingertips.

[meghanmcc]

The tingling started about 4-5 months ago and was just in the pinky and ring finger on my right hand. Then a few months later it started in the left but in a middle finger. Now I get the tingling all the time--non stop--in various fingers. The same with my legs/feet (the feet seem to mostly tingle right below my toes, on the padded area).  I notice the tingling mostly while trying to sleep or reclining while watching TV. It's always present but sometimes the sensations are more powerful.

I have been going to PT for 3 months for my back so that's probably why my back doesn't hurt as much... yet the tingling in the legs has worsened.

The neurologist said I didn't have carpel tunnel syndrome... but who knows. None of this makes a lot of sense to me.

meghan

[meghanmcc]

There are a few other odd symptoms I didn't mention. For 3 days (happened once and never happened again) I felt like I had to go to the bathroom nonstop. I got a tremor in my thumb that lasted for several hours--that never came back, either. I also on occasion experience what seems like muscle fatigue, but only in my rt. leg and rt. arm. I can still function normally but doing things w/the right arm is tiring when I'm experiencing it and walking, especially down stairs, is also. The leg and arm weakness don't seem to happen together.

meghan

[lee77]

Not sure what I have, but I have had vibrations,tingling and numbess in my legs and sometimes my hands for a substantial period of time.  It started out mildly about 2.5 years ago and was attributed to my Hashimoto's.  Within time, it went away or was so mild that I barely felt it.

Now it's back and as of the beginning of June, it's been mainly on my left side - my left foot on the bottom is numb. I have vibration feelings in my legs and sometimes some weakness in my left leg.  Also, now my stomach - only on the left side is numb.  It's been this way for about 2 months now.  I started taking synthroid but have felt no relief.  I'm getting really scared.  Any thoughts? Can this all be from my thyroid? I'm thinking no...

Also, meant to mention I feel dizzy and lightheaded (not really vertigo) a large part of the day.

Thank you.

[jcverive]

Please insist on a thorough MS work-up. You are at the right age for MS symptoms to show up, and a proper diagnosis is the first step towards proper treatment.  I know that the prospect of a diagnosis of MS can be scary, but *not* knowing what is causing your symptoms can be worse (and delaying proper treatment just makes it harder to deal with everything).

[caregiver222]

You have two unrelated problems, but both are due to nerve compression in the spine. A $35 axial traction device plus Motrin should relieve your arm pain. Then range of motion activities moving the head through the limits of pain. The axial traction device should be used for three or four minutes three to six times a day. The inflamation (inflammation) has to be brought down. Prednisone for three days is helpful, but not as a long term treatment. After three days switch to motrin. Oxycontin works, but it is addictive, and you will soon be swallowing them like candy. The leg pain is often treated surgically with a laminectomy, but I woulkd be hesitatnt to get one without exploring other options.

[jcverive]

Traction must be used with extreme care, as it is not rare for traction to cause nerve trauma (particularly in patients with long-standing,  chronic neuropathies). Traction may tear nerve fibers, leading to widespread pain.

In this case, where there is some evidence of demyelinating disease, it is probably best to agressively seek a detailed diagnosis. It is not clear that pain is caiused by nerve compression, so traction should not be used until other causes are ruled out.

[drjkpink]

I  can relate to some of these except i had a neck injury back in 1998 and i had surgery then i had a car wreck in 2001 and just now started having problems bad ones. at first it started tingling sensations in my fingers now it is in my hands and my legs and my feet. sometimes i feel numbness in my feet the sensations r driving me crazy i dont like them. how ever i did see a neruologist last week and he is not sure what is happening to me. he did an mri and looked at my neck for scar tissue y he is looking for scar tissue i have no clue. and then they injected me with this stuff to look at my brain. all i know is i am scared i dont understand y he is looking at scar tissue in my neck anyone with some of these problems maybe  u could relate to. also only sometimes i lose my balance. i was told by someone that if it was my neck then i wouldnt be having tingling sensations in my legs and feet . im so scared the sensations have been going on for about 3 months and losing my balance hasnt been going on for to long.also if it was my neck wouldnt i have had these symtoms a long time ago.thanks for listening

[Kathi49]

Along these same lines...
I had a cervical fusion done in 2004 at the C3/C4 level due to osteoarthritis and cervicogenic headaches.  About 6 months after after the fusion I was diagnosed with idiopathic small fiber neuropathy.  I was tested THOROUGHLY and no cause was ever found.  Hence, the term idiopathic. I am also not diabetic. However, I am due to have another fusion at the C5/C6 level in September.  In the meantime, the L2,L3,L4,L5 and S1 are basically lying on a "long nerve".  Anyway, the burning in my feet and now in my arms has worsened.  Oh, and prior to all of this I was put on every med known to mankind.  What worked for me, to take the burning "down' was Klonopin.  So, now I have many questions.  My neurologist says that the neuropathy is INDEPENDENT of my fusion.  Somehow I disagree with this because what I believe is that I have some kind of compression neuropathy.  Would a compression type of neuropathy come from the cervical area along with the lumbar area?  Could the fact that C5/C6 encroaching on the spinal cord cause these burning symptoms?  Could Vicodin cause this burning?  I notice if I increase the Vicodin from one to two a day, there is an increase of the burning.  Also, could having another cervical fusion increase the neuropathy?  Am I also at risk for Guillain Barre?  And last but not least, the humidity and heat ALWAYS make the burning symptoms worse.  Is heat the enemy of people with PN?  I just have tons of questions! :)  And I would appreciate any advice anyone could give me.  Thank you!

[drjkpink]

Also forgot my foot keeps going to sleep and getting numb. my doctor said i could have ms he is testing me for this. my fusion was in my neck and therefore i cant have surgery there again due to the possilbilty of being paralyzed. my doctor is concerned that it might be ms with all the symtoms i having losing some of my vision on and off. been having some buzzing sensations in my foot. could this be ms if it were my neck wouldnt it only be in my arms and hands. desperate here. very scared of what it might be. already tested neg for lyme disease.

[meghanmcc]

thanks everyone for the comments/advice.

I got my MRI results back of the brain and they're fine! I'm so relieved. I will admit I was a bit frightened, especially since my cousin has MS and I know what he's gone through.

Now I have to repeat the cervical MRI and get an MRI of the thoracic spine to see if there is inflammation of my spinal cord.

I wonder if all of this is necessary, though. What if I got treatment for my neck and took some anti-inflammatory drugs first to see how that goes? Tests, tests, tests. Is there a point to them? My healthcare is now covering 100% so this isn't a money worry at this point. I would really love to know what's going on with me, though. I haven't been to see a doctor in 10 yrs until all of this happened. I suppose I've learned my lesson there.

meghan

[patsy10]

If I were you, I'd get all the tests done just so you know.  It's horrible not knowing.  I have all the same symptoms you have and many more.  It started over a year ago.  They told me it was C-5/6 herniated disk pushing on my spinal cord.  I had a fusion.  I got much worse after surgery..have numbness and tingling all over, twitching etc... too much to list.  Anyway, I've had every test known to man for MS, all have come back normal.  I don't know what I have but it feels like MS to me.  Three doctors have told me since that I never needed the surgery to begin with.  I wish you best of luck finding out.

[drjkpink]

I have new symtoms last night my legs started burning and buzzing through my whole body and the room was spinning it would stop. please help me im so scared.

[drjkpink]

im here again well im going to go stay in a hospital and they r going to do a spinal tap on me check me out they still think i have ms. let everyone know when i get out wish me luck..

[patsy10]

Any problem in the cervical spine can cause symptoms from the neck down like numbness, tingling etc...That's probably why they are looking at the spine.

[grandmaJ]

Hello,

I had a car wreck. C 5/6..C 6/7 Fusion-Allograft, herniated, to collapse, as Neuro put it. Collapse was not said to me before surgery, only after!! And, two Osteophyte removal. C 3/4 Bulge found in MRI, nothing done there. Degeneration found too, some narrowing.

Now, I had an MRI done prior to surgery, would he have seen the collapse, done immediate surgery? I mean really stress to me the importance of surgery, NOW? And NOT let me do something else that could have aggrevaited, worsen the neck?

Instead, I go through the routine of THERAPHY REHAB(not being able to continue all suggested)NECK INJECTION, wait and wait, till I just couldn't take the pain anymore. Nothing here worked...I ENLISTED SURGERY, almost "ONE YEAR" later.

A couple of months prior to surgery, I also had a second opinion , she says GET IT DONE!  This scared me enough to set a surgery date, to say the least! (Neurologist said this). It had been almost a year since a car wreck I had, which threw me into all this pain, restricted neck movement, numbness, burning legs, shinns, spasms and tingling, wierd head sensations.

She said I had HYPERFLEXIA also, which had to do with FAST legs reflexes.

Anyway, if surgery would have been suggested right after car wreck, MRI showing collapse disk, why wouldn't the Neuro say GET IT DONE?? Lost here in these TWO very different sugesstions, routes to take...I do feel, my Neurologist was being more honest.


Todate, since surgery, IM WORSE OFF! Can't walk a block and back, no bicycle riding, hiking, running, no carrying any heavy objects, can't hang my head and read a book(stressing),numb after sitting long periods(pelvis-hips-low back pain-leg numbness too), hard to drive(muscles ache in legs)to NO physical love making with husband...and more of course.

After surgery...ALL MY TOES....WERE ON FIRE!!!! WHY?? No one said why! 5 days later, the walk issues came in, I WAS MAD!! Dr's said to just keep walking!! Pretty much depressed today. Taking continous MEDS too. My future work, is affected also.

NOW, having to live with Xrays that shows my back, L 1 and S 1, also was collasped. But, was it cause of wreck, or Fusion, being I had OSTEO. 3 days after wreck, I had to see my Dr, then was referred to Bone Specialist for MRI.

Lost in all this!!!

GrandmaJ

[katsta]

I have very similar problems to yourself. Only wish i could shed some light onto it.

Take care

Katsa

[NJS777]

Since my cervical/thoracic injury 7 months ago I have had constant tingling (numbness and a burning pain to the touch) in my left palm 5th (pinky) and 4th (ring)digit fingers, for at least the past 5 months. My doctor has excluded my neck injury as a cause and claims that it may be ulnar neuropothy vs cervical radiculitis. I am not sure this helps at all, just telling you what one doctor thinks ... not that I believe him either lol but it may be good to look into?

[Joso]

Hi Meghan,

How are you?

Did you have your resulta back from the MRi of spine yet?

I have the same symptoms as you, and also a clear brain MRI.....

Hoping to hear from you.

Jo.