Disc prolapse - pins and needles in fingers

[Chanaka]

Hi, After a MRI scan I have recently been diagnosed with : C6-C7 disc protrusion in right paracentral location and moderate posterior potrusion in C5 C6 causing obliteration of CSF space but no evidence of spinal cord compression.Also there is reduced height in C5-C6. C6 C7 protrusion is causing compression of the exiting nerve root.

I recieved my injury in Jiu Jitsu where my head was forced down and to the left side and my shoulder was forced away from my head.

I initially had severe pain in my right side upper back to the point where i caould not walk for more than 5 mins. The pain radiated down my right triceps to the first two digits of my hand.

4 weeks later (after physiotherapy) I have no pain, however I do get frequent episodes of'pins and needles' in my right thumb and first two fingers. Also when my shoulders are relaxed and my head is pulled backwards this triggers the pins and needles inmy fingers (spurling test i think they called it).

Does this suggest my herniated disc has recovered and the nerve is simply just raw? How does a herniated disc recover and how long does this usually take (using non surgical methods). When do you think would I be able to return to Jiu Jitsu??

I would greatly appreciate some advice, Thanks.

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

First of all keep in mind that I am unable to diagnose you since I am unable to examine you, this forum is for educational purposes. The symptoms you describe indicate you have sustained a peripheral nerve injury involving the C5/C6 fibers.  When the neck is injured and a disc protrudes it can injure the nerves as they exit the foramina (holes) in the veterbrae. Another common instance with the type of injury you describe is a brachial plexus stretch injury.  This can cause the same type of symptoms, but the nerves injured are located between the neck and the clavicle.  The symptoms can vary with these injuries causing in some causes weakness/tingling and pain.  Often the sensory symptoms resolve first and the weakness takes longer.  The pain generally resolves quickly, but can occasionaly develop into chronic pain.



The nerves can be injured in 3 different ways.

  1-A mild injury that hurts the coating on the nerve (myelin) that slows conduction through the nerve causing weakness/tingling and pain.  This will then get better rapidly in ~3weeks.

  2-A more severe injury will also disrupt the axons (wires)which causes some axon loss along with myelin injury, the weakness/tingling and pain that result will take longer ~3-6 months.

  3-The most severe injury disrupts the axons to the point that wires are no longer able to reconnect, for example severe crush injuries, nerve severing, and root avulsion injuries. The injuries do not get better.



The diagnostic tests for these types of injuries include MRI of C-spine and EMG.  As people age, cervical disc buldging is common and it is hard to differentiate acute vs chronic changes.  EMG (after 3 weeks form the injury) is able to differntiate axon loss from de-myelination and can aid in the prognosis of recovery.



With your recurrent symptoms of numbness/tingling in the thumb and first 2 fingers suggest some continued pressure on the C5-C6 nerve roots as the exit the vertebral column. This can improve over time with posture training (chest-out) to open the foramina, strengthing exercises and avoiding further injury.  However, this been said, it may not improve and require surgery.



Returning to your athletic activities would require that you are able to have a full range of motion in your neck without symptoms.



I would recommend seeing a neurologist to for an EMG to evaluate the prognosis of your recovery, and to find out if you had a brachial plexus stretch injury as well.  The most important thing will be to work with a physical therapist to strengthen your neck, modify your posture and assess the range of motion of your neck. I hope this has been helpful.

[Bazz]

I have been diagnosed with a haemangioma at C7. I have a central disc potrusion at C3-4 which is causing narrowing of the spinal canal;and there is a left para-central disc potrusion at C5-6. I have done a very heavy job for the last 6 years continually handling between 10-15 tonnes of stock per day, 6 days a week.I frequently had to lift stock weighing 30kg above head height. I beleive I injured my neck as a result of the lifting and now suffer  chronic neck and back pain. I have weekness in my arms, shoulders and hands and have tingling in my fingers. I have been referred to a neurosurgeon for a further diagnosis, the waiting list is approx 6 months. I don't think I can wait that long as the pain is very bad. What do you recommend and do you think the heavy nature of my work has caused the injury. As I have never suffered any other injury to my neck before and have now had this pain for the past two years.

[llanbaddon]

A related discussion, pins & needles was started.