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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for herniated disc

Answered by
Dr.
Dr. Chander Mohan Singh

Orthopaedic Surgeon

Practicing since :2003

Answered : 1041 Questions

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Posted on Tue, 8 Apr 2014 in Back Pain
Question: Hi Doctor XXXXXXX some time has past since I originally ask you my previous questions. I have seen an Orthopedic spine surgeon and a local Neurosurgeon and neither one of them suggested surgery. What I want you to know is that my diagnosis of a "congenitally small spinal passage way was a surprise. I played basketball for many years very aggressively and was never injured. Though I am 57, I swim 2 miles per day and am very fit. I idea that I have pressure on my spinal cord bothers me because it makes me wonder what will happen as I age. I look like I am in my late 30's or early 40's, I work hard and I want to be active for the next 20 years. I lost my father when I was 12, so I have always been determined to live a long healthy life, now this diagnosis. My question is this: during the last 4 weeks I have made a number of changes and I am seeing a physical therapist. I am taking large amounts of Vitamin C and sleeping more. I am drink more water and still swimming 2 miles a day, five days per week. Swimming makes my condition feel better than anything else. So the question, is it possible that the herniated disc I have that is pressuring the cord will get smaller if I continue to do the right things? Is it possible that I can get pressure off of my cord without surgery? What are the chances of me living another 20 years without pain, impairment and without surgery? My best friend is a hand surgeon from India by the way, he has been helping me. Please give me you thoughts. My symptoms are much, much better than 4 weeks ago. I am wondering if I can control how this progresses for the next 10, or 20 years? Thanks again, XXXXXXX
doctor
Answered by Dr. Chander Mohan Singh 9 hours later
Brief Answer: Yes. Detailed Answer: Hi Thanks for the query my friend . It is amazing that you take care of your health very well, actually man is young only if his heart is young and I think you are young by body and heart both. You must not do any kind of heavy exercise if you want to remain health and live a long life. It is possible that the herniated disc you have that is pressuring the cord will get smaller if you continue to do the right things e.g doing static cervical spine exercises, electrical simulation, avoiding heavy weight lifting, applying hot packs for 30 mins in morning and evening. So, if you get out of a bad position and keep you out (with postural re-training, strength improvements, exercises, etc), the symptoms can go away and the disc can heal optimally. You can do swimming up-to 2 miles if your body allows you. You can get pressure off your cord without surgery if you take care of you properly and follow my advise. There are 99 percent chances that, you can live more than 20 years without pain and impairment and without surgery if you follow above advise and avoid smoking and alcohol throughout your life. Take balanced diet. You can do yoga i.e anulom vilom pranayam as uploaded on you tube. My friend one thing you must know that excess of every thing is bad so you should not take excess amount of vitamin C. Normal adult-dose of vitamin C is 65 to 90 milligrams (mg) a day. When ever you come to India please meet me , I want to learn tips of swimming from you. At-last I would like to say that, you must have regular follow up with your doctor every 6 months. I hope it helps. You are welcome to ask further health related queries. If not, you may close the discussion and if possible you may rate the answer 5 points for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: http://doctor.healthcaremagic.com/doctors/dr-chander-mohan-singh/67013 Thanks. Dr.Singh.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Chander Mohan Singh 13 hours later
Hi Doctor, I am still trying to get a handle on this mentally. Tonight, I swam again, after I was finished my shoulder was very "active ", it ached...various sensations, etc. I did flip turns tonight and was trying to keep my head tucked. My right arm was extended upward too much and I could tell I strained it. I stopped doing flip turns after I learned of my condition 30 days ago, then I started again 3 days ago. The first two nights, I had no pain and the swimming improved everything, tonight the flip turns hurt my right should because I did them improperly. My question is on a separate topic, I just wanted you to have information. This is my question: I had an MRI that shows pressure on the cord and an abnormal cord signal at C-4; yet I have no neurological impairment. I do have pain in my neck and sensations down my right shoulder. The two surgeons I saw did not recommend surgery because their is no neurological symptoms. Both of them think my condition "may have been caused by a very hard collision I had playing basketball in my late 20's. After this collision, for the first time, I felt the same sensations in my shoulder and arm that I feel now. The surgeons believe my spinal cord situation may be stable. My question is this, do you believe the pain in my C7 area and down my right deltoid is related to the compression at C4, or is that pain a separate Radiculopathy? Tonight after swimming, I iced my C7 area after getting frustrated and it immediately got better. I was surprised. This made me wonder about whether the C4 compression on the MRI was possibly unrelated to the pain I have at C7 in the neck and shoulder. When I iced that area he pain and sensations in my shoulder almost went away. Is it possible that I have had spinal compression and an abnormal signal at C4 for 30 years and never knew because of no MRI, or do you think my pain in my neck and shoulder is related to C4 and is a myelopathic symptom instead of a separate Radiculopathy? If it is a separate issue that would explain why icing helped and I am having no neurological symptoms. I do not mind the pain, I am concerned about becoming impaired neurologically when I am older. Finally, as I mentioned before, the pain in the neck and shoulder are much better than 30 days ago, I just need to know if this pain is a myelopathic symptom, or a Radiculopathic symptoms. I am sorry for the length of this. I am trying to understand, so I can monitor symptoms and fight this thing. Thanks, friend.
doctor
Answered by Dr. Chander Mohan Singh 6 hours later
Brief Answer: Stop swimming for at least 30 days. Detailed Answer: Hi, Thanks for the query again my friend. You are correct this pain is due to radiculopathy C5-6 which supplies deltoid and supinator my friend. Most injuries cause swelling and inflammation of tissues and ice helps to relieve them upto 3 days and after 3 days you should apply hot packs for 30 mins morning and evening. My friend I thinks you should stop swimming and all heavy exercises for at least one month till every thing becomes ok, instead your can do muscle strengthening exercises as uploaded on you tube. If pain persist more than 2 days then you should again consult orthopedic surgeon who may advise you MRI scan of cervico-dorsal region to know the exact condition of soft tissues. If you follow my advise along with previously given advise you will never encounter any neurological problem in future life. I hope it helps. If you have any further query, I would be glad to help you. If you find my answer excellent, you may close the discussion and if possible you may rate the answer 5 points for me, so that I get a good feedback. Thanks. Dr.Singh.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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