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  • 30 year old with cervical herniation - scared (please share your experiences)

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    Old 06-22-2014, 03:01 PM   #1
    mustluvfitness
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    Unhappy 30 year old with cervical herniation - scared (please share your experiences)

    Hey everyone. Just about 4 weeks ago, I experienced some of the worst pain ever (severe neck spasms going into my shoulders, left pec, peri-scapular area, into my biceps and triceps and down into my fingers) -- all on the left side. I was a mess for 3 weeks.

    I am an avid weight lifter, so I kept thinking it was muscle soreness or possible tear (at worst). To make a long story short, I got an MRI and here are the findings: central to lateral disc herniation at C6-C7 resulting in mild central canal stenosis and severe left neuroforaminal stenosis.

    The neurosurgeons I have heard good things about aren't available until late July and early Aug for new patient appointments. I am doing physical therapy 2-3 x week and making progress with strength, and the pain has gone down a lot. I am taking Voltaran and Flexeril (prn).

    I am just so worried that this is going to get worse. I have made myself sick (literally) that I actually got an upper resp. infection that had me coughing and sneezing like crazy. I am sure it made things worse for myself.

    I know that herniations are permanent, but how long do they take to resolve (the acute symptoms)? I just want to know when I can go about living my life normal again -- although I know this is something only a surgeon can address. I just don't want my weight lifting days to be over (I know I will have to modify things).

    For those of you who are going through this, what do you know about surgery? How long do fusions hold up/last? Please share your prognosis.

    Thanks, and God Bless.

     
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    Old 06-23-2014, 01:12 AM   #2
    Alizarin
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    Re: 30 year old with cervical herniation - scared (please share your experiences)

    Just about 4 weeks ago, I experienced some of the worst pain ever (severe neck spasms going into my shoulders, left pec, peri-scapular area, into my biceps and triceps and down into my fingers) -- all on the left side.



    Hi I have exactly the same pain as you and it's caused primarily by the exiting C6-7 nerve, the numbness in the index and middle finger confirms this. Sorry to say but your herniation was probably caused by weightlifting, too much pressure on the neck so I would be very careful about pushing yourself. Your disc is pushing mildly on your spinal cord but severely compressing the exit nerve, causing that awful pain and pins & needles, numbness etc. I am not a great believer in PT and with your condition, it is easy to aggravate the nerve more. At least you can take anti-inflammatries but this is a short-term solution.

    I also have to wait until July-August before getting to see a neurosurgeon, you must be English, lol. I am worried about the amount of time taken to see someone and permanent nerve damage but generally, the longer it lasts, the harder it is to recover. I don't think herniations are permanent, surgery will be an option but I do not know enough to help you there. Chuck is the man to ask on here and no doubt he will reply too. In the meanwhile, I would take it easy, hard though that may be and I don't hold much hope for your weightlifting future

    Wishing you well. You are not alone, it's scary to see how so many people suffer with spinal problems. Take it easy...

    Alizarin.

     
    Old 06-23-2014, 03:17 PM   #3
    ChuckStr
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    Re: 30 year old with cervical herniation - scared (please share your experiences)

    To be clear I'm not a Dr, I'm just a guy with (more than) his share of spine issues that has read stuff and listened to many spine surgeons. Herniations causing issues are very commonly caused by a specific traumatic event (such as a MVA, or possibly lifting weights ). I would be very careful about lifting with your current situation. Your PT should be able to give you guidance about this.

    I personally think PT is fantastic, and like you, have experienced significant reduction of pain (actually mine is pretty much gone since about 6 weeks from the start). However, the efficacy can be affected greatly by what's causing the symptoms. Often, as in my case, there is a component of inflammation and/or muscle/joint instability which can be addressed by PT modalities. Since you've had improvement, it's likely there is some component of this in your case as well. I've also seen studies that show herniations can be at least partially corrected in some cases by strengthening supporting muscles and other PT modalities although I don't know how often that happens (alas this is not the case for degenerative changes like I have). If the symptoms are due only to severe compression, then PT may not be as effective and in the case of cord compression certain modalities (like traction) are contra-indicated.

    As to how long acute symptoms last it depends on if there is continued compression.
    From your post it sounds like you've lost some muscle strength. Which muscles may I ask? That can indicate continued compression but if you are gaining strength back that is a good sign. You also have severe narrowing of the neural foramen which, regardless of PT or other conservative measures, may cause persistent compression. If that is the case, you'll have to make a decision about surgery to relieve the compression. I've seen studies that suggest that most radiculopathies resolve within 2 - 3 months if they are going to but that would be something to discuss with your spine surgeon, especially if you have continued weakness (which can become permanent).

    Nearly all of the surgeons/neuros I've seen as well as my GP view surgery as a last resort for radiculopathies. There is a range of opinions on this as well as surgical techniques and such, so if surgery is ever recommended I strongly suggest a 2nd (and maybe more) opinion. It is possible in your case, since you have only the single herniation, that should you need surgery they could do an ADR (anterior disc replacement) which is less invasive then a fusion. Only some surgeons do these, which is one reason to have multiple opinions when it comes to surgery.

    I wouldn't worry too much about fusions until your surgeon and you agree you need one. In general though, they are quite successful with one large study showing persistent very favorable outcomes in about 70% of patients after a mean follow up of 13 years. The main long-term complication of fusions is degeneration of the segments above and below the fused ones due to added stress. This happens in about 25% of cases over 8 years (according to a long term study). This may or may not lead to requiring more surgeries.

    Overall, I'd say the fact that your pain is better and your strength improving are good signs after 4 weeks. If that improvement stops short of your expectations, cervical traction and steroid injections are other possible conservative options to discuss with your spine specialist.

    Good Luck...

     
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