HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Bilateral Radiculopathy In Arms

Posted on Thu, 7 May 2015

Question: My 53 year old husband has experienced bilateral radiulacaphy in his arms for 3.5 years. He experiences a tingling or "buzzing sensation" with no weakness associated. Not present when wakes up and becomes progressive over the day. He is in good health except for allergies and slightly elevated BP controlled by Bystalic. Normal weight. He take several prescribed meds for allergies. In the last year, he had a shoulder surgery repairing a rotator cuff tear, bicep tendon tear and a bone spur. The Ortho surgeon thought it might help the radiculapthy but it did not help the sensation. He also had, in November, a cervical fusion c5-6 for bone spur and nerve impingement. That has not reduced the sensations in his arms as it was thought to be the culprit. He is back at square one and frustrated. My husband thinks it could be stress related. He feels it is muscular and related to feeling stressed that are tightening and affect the nerve roots. Massage does not help, nor did traction. Yoga has been good for stress relief but not the radiculapthy. Where do we turn now? He saw a Neurologist who felt it was the C5-C6 issue. Do we seek another Neurologist? Just go to PT or do myofaciale release work? Not big on chiropractic stuff but maybe accupuncture? Any directions would be helpful. I'm his strong advocate at this point - he is just frustrated by what has not worked.

Answered by Dr. Ajay Panwar (2 hours later)

Brief Answer:
MRI Cervical spine/NCS-EMG

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I can well understand your concerns.Surely,neuropathic pain and symptoms can be refractory to symptoms,sometimes.

However,to settle the diagnosis of Stress induced symptoms or radiculopathy,we must have a MRI(Magnetic resonance imaging) of cervical spine.MRI can help delineate the extent of nerve radicles compression by the bony spurs or discs.

Nerve conduction studies and electromyography(EMG) can be well supportive.I would like to know,beforehand that what is the magnitude of the disease.

I am sure you must be having his MRI images and reports.If yes,please upload them as well as the NCS-EMG.That will help me form a better opinion.

Waiting for your follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ajay Panwar (21 hours later)

Dr. Panwar,

Thanks for your response. I do not have the MRI report - but one was done before the cervical fusion. I do have before and after X-rays which I have downloaded. The surgeon was being conservative in fusing C5 and C6 noting that there were additional bone spurs above and below those discs. Is it possible that one of those is causing an impingement? Further, would the sensation be originating in the nerve root at the spine? Is that the only place such nerve sensation could radiate from? Would muscular tension even have an effect on the nerves? He has not had an EMG - would that be indicated next? My feeling from your response is that his sensation would be more of a bone/cervical spine issue than any soft tissue cause?

Answered by Dr. Ajay Panwar (31 minutes later)

Brief Answer:
It is likely radiculopathy,not soft tissue pathology.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up.

Here follows your answers pointwise-
1)Yes,quite possible that those spurs may have grown further,causing nerve radicle impingement.
2)This clinical history,is indicative of radiculopathy and that obviously means that the abnormal sensations originate in the nerve roots at the spine.
3)With this history,Yes-it appears,for sure,to be radicular in origin.So,I would say-Yes.That's the only place,it is originating and radiating from.
4)No,muscular tension don't affect nerves.
5)Next to do is repeat MRI cervical spine to see further degeneration and present state of radicular compression.If MRI indicates compression as we are expecting,EMG and Nerve conduction studies of upper limbs(NCS-upper limbs) will help confirm the diagnosis of radiculopathy.
6)Yes,it appears to be a cervical spine issue rather than soft tissue.Cervical spine pathology causing radicular compression.

Hope that I have answered your query.If you have any further questions,I shall be glad to answer else,please close the thread-rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj