I figure that I might as well should start a new thread, even though going back several years on this forum, I see that there is actually a reasonable number of discussions regarding the cervical spine and herniated discs.
I am currently facing a dilemma...that is made much worse by the absence of pain. I have a severely herniated C6-C7 disc. The first three weeks after the herniation, were all about pain and discomfort (lack of sleep, etc). And about 2 weeks into the injury I came to find that I was and still am missing 75-80% of strength in my right tricep. -This is what drove me to visit a doctor...
On day 3, I visited a Chiro, who adjusted me and said nothing seemed abnormally out of place...and he referred me to a CMT, who found nothing out of the ordinary -aside from tight shoulders common to desk jockeys. And in a world wide first for a Chiropractor, he did not ask to schedule my follow up visit, only stating that if things did not improve to feel free to come back!!! Anyway, that was two-three days after my neck pain started, and that was when the neck pain started to transition from my neck to my shoulder and arm.
Day 5 was when I visited the CMT, and it was the most painful experience for me. My arm was in so much pain lying on my stomach that I spent the entire 90 minute session just trying to mentally talk myself into finding a way to ignore the pain. (at this time I still did not realize that I had a herniated disc). Again, CMT found nothing...
Day 7, I spend an hour in a spin class, and actually feel pretty decent afterwards, so grab a 10lb dumbbell to stretch my right arm as my arm feels strangely weak. Standing, I take the weight behind my head, and I cannot lift it back up. No pain, simply could not lift it as if it was simply too heavy. For reference, I usually work out tricep extensions -seated -with 45lb dumbbells, and did so with my left arm just to confirm. At this point I am actual frightened, so the wife calls her girlfriend who is a personal trainer and she says she believes it to be pinched nerve at C6-C7 and to not lift any weights at all for a while, and that the strength would return, but that it could take as long as several months in her experience.
Day 9 I schedule a Dr appt with the medical group that performed my three knee surgeries as I trust these guys, and they have a spine specialist (Orthopod), but the appt is a week away (Day16). I have to travel this week, so the appt time is acceptable to me, but at the advice of the Personal Trainer, she advises that I start taking lots of NSAIDs to help with the aggravated nerve...
Day 16, meet with Surgeon and after observing symptoms, weakness in rt Tricep, and numbing/tingling of the index and middle fingers, he asks what is important to me. I say, getting back on Tennis court (and getting a full night's sleep). Then he says I need surgery. But that we should get MRI to confirm what he thinks is compressed nerve root at C6-C7. Prescribes Nuerontin and a muscle relaxer to help with sleep -works great.
Day 17 -MRI
Day 18 -Follow up. Doctor says that I should be in a LOT more pain than I am in based upon the MRI, but that I should proceed with PT at this point. I am shocked as 2 days earlier, he is saying Surgery. I ask what is different now than on Monday, and he says that massive atrophy/weakness of the rt Trapezoid and manageable pain levels suggest that I should try the conservative treatment approach...which if it does not work, to try CESI (cortisone inj), and surgery as a last resort. That the pain should subside over time as the sensory nerves mend, or we proceed with cortisone...I look at him and ask him what he is talking about "Trapezoid??", and he asks me whether my Trap is weak and I say I don't know, but my Tricep is presently useless (washing my hair is difficult -and I don't have much hair, I can't even throw a ball, and washing dishes feels like pushing heavy weights). So he tests my Tri, sits back and says I need surgery. The sooner the better.
This is a lot to soak in, so I leave, schedule an appt with another Dr and he says I can wait...but that there is a chance that I might have permanent muscle loss in my Tricep. He even admits that surgery would give me the best chances of regaining that strength, but it was no guarantee...and that he suggests I try conservative treatment. He never asks me what is most important to me however.
Day23 -Back to original Dr to talk about options and ask more questions. I even want to schedule the surgery but while waiting for a date -assuming this could be weeks away, that I would like to try PT and CESI, and he agrees and write the orders. He still feels surgery will provide the best chance of regaining muscle strength, though it is no guarantee that I will...just the best chances. Says I am in good physical condition, and should recover quickly, and that the procedure is a relatively easy one, in that he has done many hundreds of them. He also feels that TDR is best, but that he is not aware of any insurances that cover it (Total Disc Replacement). Mentions Peyton Manning did the ACDF and he had TDR option at his disposal...neither of us understand why he went w fusion.
Day 25 -CESI. I get the Steroid injection to the nerve root. Uneventful, the most painful part was the IV being put in place and then the sedative that they put into the IV in the surgery room.
Day 29 -Pain free for the most part. BUT. Still no improvement in strength. Have been to PT 5 times, traction, massage etc and some light exercises and stretching drills. I am happy to be pain free, but my Dr has said from day 1 that he is not concerned about the pain, the Tricep strength is his marker for suggesting one treatment over another. Now the ball is in my court.
It has been almost 5 weeks since the "day" in injured my neck. I am now pain free, so the idea of surgery is concerning, but so is the consensus from the doctors as well as the Physical Therapists that the longer the strength is absent, the greater the odds against full recovery. My nerves could still be pinched, but have repaired themselves (the sensory nerves at least) but the motor nerves may not ever repair if they remain pinched. Which is impossible to determine without actually cutting into the body to see.
Talk about a difficult spot..
For background, the "day" I woke with a very slight creak in my neck. Barely even noticeable. At lunch I went to the gym to workout, and ran into a friend that wanted to hit balls, so we ended up on the courts. While hitting, my neck seemed to stiffen up a bit, and after drilling, we decided to do some server receive -which really ramped the pain. I hit maybe 50-60 serves total and by the end, I was just spinning them in.
I am considered one of the bigger servers at the club, so it is not uncommon for folks to want to receive my serves. While I was just klicking my serves in, I was doing so with far less control than is usual for me, and I recall that I was actually frustrated with myself at the time. Knowing what I know now, I imagine that it was very likely the onset of my Tricep weakness.
The massage table issue was likely a result of the cradle holding my head up too high, and in a subsequent visit to get a massage, I had them lower the cradle, and I was comfortable on the table...
Day 35, It has been a learning process, and one that is unfortunately not over.
In the gym yesterday, I was able to get 10 lbs off of my neck, but only once at a time. I still need to decide on the surgery. In fact, if ADR was on the table, I would simply do it...my thought being that it is less permanent than Fusion, and even if there are issues several years down the road, fixes will likely be longer term and more robust...
I am currently facing a dilemma...that is made much worse by the absence of pain. I have a severely herniated C6-C7 disc. The first three weeks after the herniation, were all about pain and discomfort (lack of sleep, etc). And about 2 weeks into the injury I came to find that I was and still am missing 75-80% of strength in my right tricep. -This is what drove me to visit a doctor...
On day 3, I visited a Chiro, who adjusted me and said nothing seemed abnormally out of place...and he referred me to a CMT, who found nothing out of the ordinary -aside from tight shoulders common to desk jockeys. And in a world wide first for a Chiropractor, he did not ask to schedule my follow up visit, only stating that if things did not improve to feel free to come back!!! Anyway, that was two-three days after my neck pain started, and that was when the neck pain started to transition from my neck to my shoulder and arm.
Day 5 was when I visited the CMT, and it was the most painful experience for me. My arm was in so much pain lying on my stomach that I spent the entire 90 minute session just trying to mentally talk myself into finding a way to ignore the pain. (at this time I still did not realize that I had a herniated disc). Again, CMT found nothing...
Day 7, I spend an hour in a spin class, and actually feel pretty decent afterwards, so grab a 10lb dumbbell to stretch my right arm as my arm feels strangely weak. Standing, I take the weight behind my head, and I cannot lift it back up. No pain, simply could not lift it as if it was simply too heavy. For reference, I usually work out tricep extensions -seated -with 45lb dumbbells, and did so with my left arm just to confirm. At this point I am actual frightened, so the wife calls her girlfriend who is a personal trainer and she says she believes it to be pinched nerve at C6-C7 and to not lift any weights at all for a while, and that the strength would return, but that it could take as long as several months in her experience.
Day 9 I schedule a Dr appt with the medical group that performed my three knee surgeries as I trust these guys, and they have a spine specialist (Orthopod), but the appt is a week away (Day16). I have to travel this week, so the appt time is acceptable to me, but at the advice of the Personal Trainer, she advises that I start taking lots of NSAIDs to help with the aggravated nerve...
Day 16, meet with Surgeon and after observing symptoms, weakness in rt Tricep, and numbing/tingling of the index and middle fingers, he asks what is important to me. I say, getting back on Tennis court (and getting a full night's sleep). Then he says I need surgery. But that we should get MRI to confirm what he thinks is compressed nerve root at C6-C7. Prescribes Nuerontin and a muscle relaxer to help with sleep -works great.
Day 17 -MRI
Day 18 -Follow up. Doctor says that I should be in a LOT more pain than I am in based upon the MRI, but that I should proceed with PT at this point. I am shocked as 2 days earlier, he is saying Surgery. I ask what is different now than on Monday, and he says that massive atrophy/weakness of the rt Trapezoid and manageable pain levels suggest that I should try the conservative treatment approach...which if it does not work, to try CESI (cortisone inj), and surgery as a last resort. That the pain should subside over time as the sensory nerves mend, or we proceed with cortisone...I look at him and ask him what he is talking about "Trapezoid??", and he asks me whether my Trap is weak and I say I don't know, but my Tricep is presently useless (washing my hair is difficult -and I don't have much hair, I can't even throw a ball, and washing dishes feels like pushing heavy weights). So he tests my Tri, sits back and says I need surgery. The sooner the better.
This is a lot to soak in, so I leave, schedule an appt with another Dr and he says I can wait...but that there is a chance that I might have permanent muscle loss in my Tricep. He even admits that surgery would give me the best chances of regaining that strength, but it was no guarantee...and that he suggests I try conservative treatment. He never asks me what is most important to me however.
Day23 -Back to original Dr to talk about options and ask more questions. I even want to schedule the surgery but while waiting for a date -assuming this could be weeks away, that I would like to try PT and CESI, and he agrees and write the orders. He still feels surgery will provide the best chance of regaining muscle strength, though it is no guarantee that I will...just the best chances. Says I am in good physical condition, and should recover quickly, and that the procedure is a relatively easy one, in that he has done many hundreds of them. He also feels that TDR is best, but that he is not aware of any insurances that cover it (Total Disc Replacement). Mentions Peyton Manning did the ACDF and he had TDR option at his disposal...neither of us understand why he went w fusion.
Day 25 -CESI. I get the Steroid injection to the nerve root. Uneventful, the most painful part was the IV being put in place and then the sedative that they put into the IV in the surgery room.
Day 29 -Pain free for the most part. BUT. Still no improvement in strength. Have been to PT 5 times, traction, massage etc and some light exercises and stretching drills. I am happy to be pain free, but my Dr has said from day 1 that he is not concerned about the pain, the Tricep strength is his marker for suggesting one treatment over another. Now the ball is in my court.
It has been almost 5 weeks since the "day" in injured my neck. I am now pain free, so the idea of surgery is concerning, but so is the consensus from the doctors as well as the Physical Therapists that the longer the strength is absent, the greater the odds against full recovery. My nerves could still be pinched, but have repaired themselves (the sensory nerves at least) but the motor nerves may not ever repair if they remain pinched. Which is impossible to determine without actually cutting into the body to see.
Talk about a difficult spot..
For background, the "day" I woke with a very slight creak in my neck. Barely even noticeable. At lunch I went to the gym to workout, and ran into a friend that wanted to hit balls, so we ended up on the courts. While hitting, my neck seemed to stiffen up a bit, and after drilling, we decided to do some server receive -which really ramped the pain. I hit maybe 50-60 serves total and by the end, I was just spinning them in.
I am considered one of the bigger servers at the club, so it is not uncommon for folks to want to receive my serves. While I was just klicking my serves in, I was doing so with far less control than is usual for me, and I recall that I was actually frustrated with myself at the time. Knowing what I know now, I imagine that it was very likely the onset of my Tricep weakness.
The massage table issue was likely a result of the cradle holding my head up too high, and in a subsequent visit to get a massage, I had them lower the cradle, and I was comfortable on the table...
Day 35, It has been a learning process, and one that is unfortunately not over.
In the gym yesterday, I was able to get 10 lbs off of my neck, but only once at a time. I still need to decide on the surgery. In fact, if ADR was on the table, I would simply do it...my thought being that it is less permanent than Fusion, and even if there are issues several years down the road, fixes will likely be longer term and more robust...
