Cervical disk problems

[anndee4835]

Good morning all.  

Three rear end collisions over the years have left me with neck problems which have now radiated into my right shoulder, and down into my arm and hand.  I've had x-rays and an MRI and have been diagnosed with narrowed disk space in one of my cervical disks.  The only treatment the orthopedist recommended was physical therapy, which did not relieve the pain.  Lately, I've had episodes of the right hand and arm freezing up for short periods of time, with the pointer finger pointing downward.  I've tried living with this problem, continuing with home therapy, but I type for a living, and I'm afraid the situation will worsen to the point where my hand becomes unusuable.  Pain in my neck and arm wakens me at night.  My main question is who do I consult -- another orthopedist or a neurologist.  I would like to continue with conservative treatment, but physical therapy is not helping.  Thanks for any recommendations.

[JainMD]

Hi,
I am indeed surprised that you are still working and would always pray that if possible you can leave the job.
I am happy that you have got an appointment with a good neurologist. I would like to tell you that make sure the visit are fruitful and there are no questions unanswered when you leave the clinic.
Imaging study is a must.
Keep me informed if you have any queries.
Bye.

[anndee4835]

Yes, I AM still working.  I type for 3 court reporters and really enjoy doing it.  I know it's exacerbating my condition, but I need to do it to keep my sanity and also to be able to pay my bills.

No, I do not smoke.  Haven't smoked for several years.  I had an MRI in October by which the osteopod diagnosed the problem with the cervical disk.  

I have an appointment with a well-known neurologist here in St. Louis  and hope he'll be able to offer me some measure of relief.  

Thank you for your concern.  I'll let you know my progress in this matter.

[JainMD]

Hi,
I indeed feel sorry that at this age you have to go through all this. Your age you said it right is not by your side and also that you have been secretary for whole of your life suggests that you must be having symptoms because of occupational hazard.
Are you still working? If yes, I am surprised to know and that will worsen your condition further.
Are you a smoker too?
I think it is must for you to visit orthopaedician and neuro-surgeon as early as possible.
Imaging study is also one definite thing you have to do.
Keep me informed if you have any queries.
Bye.

[anndee4835]

I guess my age (79) doesn't help and I've been a secretary most of my life which also doesn't help.  I have already made an appointment with a neurologist here in St. Louis, recommended to me by one of his patients who suffers from MS.  I know I have osteoarthritis in the neck which I've pretty much ignored over the years.  Guess old age makes things harder to take.  I'll do anything to retain the use of my arm and hand since I type for court reporters and need to continue in order to eat, a bad habit I got into years ago.  I'll keep you posted.

[JainMD]

Hi,
Your problem needs to be addressed by both neurosurgeon and also an orthopedist.
They need to work as team for further management.
You have though not mentioned regarding the spinal disc pathology as what is causing the narrow disc space.
But nevertheless the symptom remains same.
There are many different terms used to describe spinal disc pathology and associated pain, such as “herniated disc”, “pinched nerve”, and “bulging disc”. The bones which form your spine are called as vertebrae. The space between two vertebras is cushioned with disc. When disc bulge or break open due to any reasons like ageing, or trauma to spine, it is called as herniated disc and this can cause pinching of nerve. It can happen in any region, but is more common at lower back in lumbar region and cervical region.
It is advisable for you to do physiotherapy for relief of pain and spasm of muscle, pain killers and pain management specialist for conservative management.
But if this fails, the option left is surgery.
You can try a Transcutaneous Electrical Nerve Stimulator, which is an electronic device that produces electrical signals used to stimulate nerves through unbroken skin. The unit is usually connected to the skin using two or more electrodes. TENS works to decrease pain perception and may be used to control acute and chronic pain. It helps in regenerating nerve.
Nerves regenerate, or heal, at a rate 1 millimeter/day. The only nerves that can regenerate are the nerves outside of the spinal cord, or peripheral nerves. The nerves in the spinal cord, once damaged, cannot regenerate. However, if the peripheral nerve is severely damaged or stretched it may never heal.
Hope this helps.
Bye.

[anndee4835]

Thanks, dragonfly.  A second opinion is ALWAYS helpful and I thank you for yours.  

I looked at your profile.  Sounds like you have a full and interesting life.

Again, thanks.

[dragonfly819]

Hi there,
This is my opinion only as I am not a doctor, but everyone is entitled to a second opinion.  The general way to go with a cervical spine disorder is the "non-aggressive" treatments first, ie: physical therapy, analgesics, epidural injections.  After all these "non-aggressive" treatments are exhausted with no real change in symptoms, or symptoms getting worse, then surgical avenues are talked about. I underwent all the non agressive treatments for 7 months, including therapy w/traction, epidurals etc. After the second MRI (6 months after the first one was taken), this second one at my request, anyway, the second MRI showed that the disc was no longer bulging but had indeed herniated. I requested a SECOND opinion with a neurologist, whom, after seeing the results of "non-aggressive" therapy, put me on a fast track to ACDF with plating.  Anyway, get a second opinion with a neurologist!!!
Good Luck
Heather