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Tightness in throat and numb feeling in arm. Lumbar issues causing tingling-numbness in foot. Should I go for spinal surgery?

Nov 2013
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Practicing since : 1994
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I have tightness in my throat area coupled with radiant, kind of numb feeling in left arm and hand. Mri's of cervical and soft tissue have ruled out neck related causes, endoscopy has ruled out upper GI, throat related cause. I do have lumbar issues causing severe tingling-numbness in right foot but that has been directly connected to L5-S1. I am going to have spinal surgery but I think I have muti disorder here. What do you think?
Posted Sun, 26 May 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 4 hours later

Thank you for posting your query.

First of all, I would like to reassure you that there is no need to worry, as your symptoms are not suggestive of any serious neurological illness.

L5-S1 disc prolapse resulting in radiculopathy (tingling, numbness, pain in right foot and leg) would resolve after surgery. The surgery is major for you, however, it is safe and usually free of any risk.

Regarding upper limb (hand) symptoms, you have had a thorogh evaluation, including MRI cervical spine and nerve conduction studies. Normal MRI excludes disc prolapse in cervical region and normal EMG/NCS excludes carpaltunnel syndrome (compression of median nerve at the level of wrist) as the likely causes. This means that no significant illness requiring surgery is present.

Treatment at this stage would consist of gabapentin or pregabalin, along with physiotherapy.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
Follow-up: Tightness in throat and numb feeling in arm. Lumbar issues causing tingling-numbness in foot. Should I go for spinal surgery? 14 hours later
You didn't mention the tightness in my throat which has become too familiar. In addition, the tingling/numbness (I don't know what else to call it because it doesn't involve weakness) sometimes flares in my right arm as well.
I have been through months of phisiotherapy, including water therapy. Admittedly, the focus has always been on my foot and the cramps the frequently followed. I realize that I need surgery to open the space for the nerve to breathe and this will hopefully fix BOTH my feet but I'm worried about a multidisordered situation here. Something that has nothing to do with surgery. I think the tightness in my throat, the nerve flareups in each arm (way more pronounced in my left), and sometimes even my face feels funny (aka numb) ... they seem connected to me and that's what I'm worried about.
Answered by Dr. Sudhir Kumar 1 hour later
Thank you for getting back and providing more details.

I have noted all your symptoms, and can not think of any serious neurological disorder. So, there is no need to worry.

Regarding a multi-system disorder, the commonest is a collagen vadcular disease. A simple work up to exclude them would involve doing blood tests such as ESR (which is elevated) and XXXXXXX (which is positive) in collagen vascular disease.

In some cases, depending on the symptoms, we may decide to do a nerve biopsy to exclude vasculitis (however, in the absence of abnormalities on NCV and EMG, vasculitis is less likely). In vasculitis, there is inflammation of small blood vessels, leading to ischemia (decreased blood supply) of nerves.

I hope it helps.

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