Possible relief of symptoms in shoulders, neck and left arm and hand.

[deedee1958]

I started having numbness and tingling in my left hand in Feb of 2011.  Went to see GP.  Prescribed PT for three weeks.  Definitely did NOT get better, may have even gotten worse.  Had MRI in June 2011.  Results read: 1mm anterolisthesis at C7-T1 is due to facet joint hypertrophy.  Posterior borders normally aligned. Mild stenoses are seen in the left C2-C3 and bilateral C5-C6 foramina. A 2 mm central protrusion at C4-C5 and 2mm bulge at C5-C6 mildly affect the ventral surface of the hecal sac w/o causing central stenosis.  GP stated it was nothing major, that I simply had some arthritis in the upper part of my spine between my shoulder blades.  Did two more weeks of PT.  Nothing.  Went to Neurologist.  He looked at the MRI, said that it was a bit unclear, but had me do a couple of arm movements and tapped my left palm and said that I definitely had carpel tunnel.  Sent me for an EMG.  EMG results confirmed the carpel tunnel, but Neuro doc said it wasn't severe enough for surgery.  Told to stop PT and wear a wrist brace that causes the hand to lean a bit back.  Have done ALL of the above.  My entire left arm, especially the muscle right above the bend, is in constant pain, my forearm still has numbness and my hand is still tingling and I feel like it is being shocked constantly.  AND, now my shoulders and neck area have started feeling extremely tight, sore, and sometimes painful.  I am on Lyrica, 50 mg, once a day.  The only way I can stop any of it is to either lay flat on my back, or hold my hands above my head.  Any suggestions.  I will take any and all.  THIS IS DRIVING ME NUTS and I don't have far to go. :)  No other physical problems EVER.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It is difficult to say if your neck is causing your symptoms based on the imaging description, but based on your symptoms, it would be high on the differential. Just to give you some background: The vertebrae (bones of the spine) have material between them to cushion and allow for mobility. This material may be squished out. This is called a herniated disc. It can be squished out centrally or laterally. In most people the pain associated with a herniated disc may resolve within 4-6 weeks. A minority of patients do not respond to medical/conservative management and require surgery.  Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, and progressive pain.

Typically, an EMG/NCS is then performed to determine the extent of neural damage. You have already had this performed, which is good.

Since you are still having symptoms, I would suggest you follow up with your neurologist and discuss your symptoms again. When was the MRI performed? If it has been a while, repeating the test may be worthwhile. Additionally, you should discuss with your neurologist you medication dosing. You may have room for adjustment.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[deedee1958]

Thank you for your response Dr. Newey.  

I am scheduled for surgery this Wednesday.  I had a mylegram done this past week and the results were a pinched nerve due to one vertebrae having moved completely over another causing the nerve to be almost completely closed.

I have all the faith in my doctor and am looking forward to being rid of the pain and numbness that I have been dealing with over the past months.

Thank you again for responding.