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Have mild posterior disk bulge and mild spinal stenosis. Have pain in neck and numbness in arm and hand. What should I do?

Nov 2013
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Practicing since : 1994
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I have a mild posterior disk bulge more prominent on the right which effaces anterior CSF spce and mild spinal stenosis and mild narrowing of the rt neural foramen at c3-4. at c4-5 mild posterior disk bulge more prominent on the rt side which effaes and is CSF space and abuts the cord. Probable rt uncovertebral degenerative change. Mild narrowing of the rt neural foramen. C5-6 Mild to moderate posterior disk and osteophyte complex which effaces the anterior CSF space and abuts the cord with slight indentation. Mild to moderate spinal stenosis. Bilateral unovertebral degenerative changes with mild narrowing of both neural foramina worse on the rt. C6-7 Rt uncovertebral degenerative changes with moderate narrowing of the rt neural foramen. I experience terrible pain in my neck and numbness, tingling in my left arm and hand. I have limited mobility with my neck and left arm and actually feel my nerve pinching as I try to raise my arm above shoulder height and my hand starts to go numb when I do this. I cannot sit for long periods as I find that my head becomes too heavy for my neck...does all of this sound normal for the injuries incurred in a MVA. I have been like this, and progressively getting worse for the last five years...I finally see a neurosurgeon on Monday regarding sleep and mood. Thanking you in advance for any advice you can give me.
Posted Thu, 3 Oct 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 15 minutes later
Brief Answer:
You are on the right track

Detailed Answer:

Thank you for posting your query.

I have read your symptoms and have gone through your MRI spine report in detail.

Your symptoms of neck pain and arm numbness/pain can be explained on the basis of MRI findings.

Initial treatment is always with medications (such as pregabalin or gabapentin) and physiotherapy, including IFT, ultrasound, neck extension exercises, use of soft cervical collar, etc. With this treatment, about 50% people with similar symptoms as yours would improve, however, the rest 50% would not improve.

In them, the treatment options include epidural injections and surgery (as you mentioned).

So, I think you are on the right track.

Please keep me informed about your progress.
I would be pleased to answer any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
Follow-up: Have mild posterior disk bulge and mild spinal stenosis. Have pain in neck and numbness in arm and hand. What should I do? 18 minutes later
Thank you for your quick response. I initially had physio that involved neck traction approx. 10 mos duration and this was stopped when a neurologist stated it was hurting and not helping my condition... I was relieved as I found relief during treatment but hours later the pain would become almost unbearable. In the past five years I have tried various medications - gabapentin, lyrica - resulting in severe edema so I had to discontinue use. I have tried several different injections including epidurals and botox all of which produced minimal relief. I would like to know if the amount of pain I am in is normal based on these injuries or have I entered a heightened state of Neurosurgeon - perhaps you have heard of him - he is very well known) - he stated (Sept. 2011) that over time my condition would deteriorate to a point where I would be in a wheelchair, but surgery may have the same outcome; it made more sense to wait and hope that normal degeneration would be slow and therefore provide better quality of life without being bound by a wheelchair. In your opinion does surgery seem to be the best solution and which surgical procedure would you advise?
Answered by Dr. Sudhir Kumar 18 hours later
Brief Answer:
Surgery may be the best option for you

Detailed Answer:
Thank you for getting back and providing detailed account of your treatments so far.

It is unfortunate that all conservative measures (medications, physiotherapy, epidural injections, botox) have failed to provide you a good relief.

In this situation, surgery seems to be the best option.
I leave the choice of the type of surgery to Dr Fehlings; he is a well known and respected doctor in this field all over the world.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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