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What Causes Pins And Needles Sensation Feet And Hands?
Question: Hi.. my name is XXXX and I am attaching reports in relation to my scans which are attached to my profile. I would appreciate if you could give me your opinion. I have pins and needles in my feet and hands (intermittent). I was meant to go for surgery (microdisectomy). My leg was getting better so I did not go. I would appreciate your opinion on my scan. I am seeing an excellent Spine Specialist however I would appreciate your opinion on the scan. Thanks so much XXXX
Brief Answer:
Scan shows compression of the nerve root
Detailed Answer:
Hi There XXXXXXX Thanks for coming to HealthcareMagic. I've gone over the the two scan images you've sent me.
The first "Scan Images.pdf" is a transverse view of the spinal cord and column in the neck. I can tell the exact level without having a few more slices, but from the muscle structures, i'm guessing it's somewhere between C4 and C7 (the C's stand for Cervical, which refers to the vertebrae in the neck). On the left side of that scan, it looks like the disc has pressed down on that nerve, it may not be the disc, it may be a severely arthritic bone doing the same thing. But the basic idea is that the nerve which is trying to leave the spinal cord and do it's job in the periphery of the body is getting squeezed.
Based on that picture. I would guess that you had signs and symptoms of neck pain and weakness of your shoulders or arms or hands on the left side. There would be pain along those areas as well. The pins and needles in your hands would be on the left, rather than the right?
"Scan Images - 2.pdf" is a coronal view of the spinal column. This particular slice seems to show a few of the vertebrae in the lower back and at the bottom of the chest. From what i can tell on this slice is that a few of the discs (the intervertebral discs in between the vertebrae) have started drying out and degenerating. I can't see what kind of effect that is having though without seeing something like that transverse view from the neck. I need to see the nerves as they pass through the canal to see if they are OK.
The pins and needles in your legs are signs that the nerves are getting pressed upon. If the symptoms were to get better with physical therapy and rest of the back, then I would avoid surgery as well. But that scan in the neck worries me and I think that eventually, that area may need to be operated upon and fused to prevent worsening of the pins and needles.
I hope this helps. Let me know what else I can clarify and if there was anything in this that you didn't get. I'll try and break it down for you better.
Vinay
Scan shows compression of the nerve root
Detailed Answer:
Hi There XXXXXXX Thanks for coming to HealthcareMagic. I've gone over the the two scan images you've sent me.
The first "Scan Images.pdf" is a transverse view of the spinal cord and column in the neck. I can tell the exact level without having a few more slices, but from the muscle structures, i'm guessing it's somewhere between C4 and C7 (the C's stand for Cervical, which refers to the vertebrae in the neck). On the left side of that scan, it looks like the disc has pressed down on that nerve, it may not be the disc, it may be a severely arthritic bone doing the same thing. But the basic idea is that the nerve which is trying to leave the spinal cord and do it's job in the periphery of the body is getting squeezed.
Based on that picture. I would guess that you had signs and symptoms of neck pain and weakness of your shoulders or arms or hands on the left side. There would be pain along those areas as well. The pins and needles in your hands would be on the left, rather than the right?
"Scan Images - 2.pdf" is a coronal view of the spinal column. This particular slice seems to show a few of the vertebrae in the lower back and at the bottom of the chest. From what i can tell on this slice is that a few of the discs (the intervertebral discs in between the vertebrae) have started drying out and degenerating. I can't see what kind of effect that is having though without seeing something like that transverse view from the neck. I need to see the nerves as they pass through the canal to see if they are OK.
The pins and needles in your legs are signs that the nerves are getting pressed upon. If the symptoms were to get better with physical therapy and rest of the back, then I would avoid surgery as well. But that scan in the neck worries me and I think that eventually, that area may need to be operated upon and fused to prevent worsening of the pins and needles.
I hope this helps. Let me know what else I can clarify and if there was anything in this that you didn't get. I'll try and break it down for you better.
Vinay
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for this...are you saying that the lower back area is ok..?
I was due to have an operation in my lower back but this was cancelled as I was improving. My doctor was going to do a microdisectomy. (l4l5). He wrote to me in feburary to say that he was not concerned about the neck..as yet..he mentioneod that there was some disc bulging in the neck and spondolytis at c5c6..The pins and needles are only on my feet and hands intermittently. Pins and needles are on both hands but no arm pain and intermittent pins and needles on the hands.. no shoulder pain.. I really want to avoid surgery at all costs and have been getting physiotherapy almost every week since February.. I am concerned about what you have said as my own consultant as not highlighted any of this..would surgery make this any better? or can I continue on as I am for the moment.. do you think the l4l5 disc is causing the bulge sciatic pain which has improved on the right leg.. or do you think the neck is causing the full problems..i am very worried about this.. thanks
note there are no neurologic symtoms as yet in the arms or legs.. I mean no numbness
is all this relating to the neck or the back.. my surgeon is a spine surgeon and has not highlighted any of this.. do you think it is worth getting another scan of the neck? the last one was done in February.. my surgeon was more concerned by the back.. please note the brain scan was perfect.. which was done in febuary.. thanks XXXX
I was due to have an operation in my lower back but this was cancelled as I was improving. My doctor was going to do a microdisectomy. (l4l5). He wrote to me in feburary to say that he was not concerned about the neck..as yet..he mentioneod that there was some disc bulging in the neck and spondolytis at c5c6..The pins and needles are only on my feet and hands intermittently. Pins and needles are on both hands but no arm pain and intermittent pins and needles on the hands.. no shoulder pain.. I really want to avoid surgery at all costs and have been getting physiotherapy almost every week since February.. I am concerned about what you have said as my own consultant as not highlighted any of this..would surgery make this any better? or can I continue on as I am for the moment.. do you think the l4l5 disc is causing the bulge sciatic pain which has improved on the right leg.. or do you think the neck is causing the full problems..i am very worried about this.. thanks
note there are no neurologic symtoms as yet in the arms or legs.. I mean no numbness
is all this relating to the neck or the back.. my surgeon is a spine surgeon and has not highlighted any of this.. do you think it is worth getting another scan of the neck? the last one was done in February.. my surgeon was more concerned by the back.. please note the brain scan was perfect.. which was done in febuary.. thanks XXXX
Brief Answer:
Symptoms are the most important
Detailed Answer:
Hey there, Thanks for following up. When I was reading the scans you sent me, all i was doing was going by what I saw on the scan. Thats not the most important aspect to take into consideration when deciding upon our course of action here.
Your symptoms are the most important. As you said, you're not having any neurological symptoms in the upper limbs as yet and your symptoms are better in the lower limbs. To me that means that what i saw on the scan is not BAD enough yet to cause you symptoms (in other words.. yes i see a degeneration of the disc in the neck.. but it part and parcel of aging and is not causing you any real symptoms).
You said that Physical Therapy (PT) has improved the symptoms in the lower back. That is good news. I would defer surgery in such cases and see how this plays out. Keep up the exercise and keep in mind, that if the pins and needles return, or if the legs or feet become numb or weak.. then the nerve compression process, that was slowed down by the PT, is getting worse again. At that point you may need to undergo the surgery anyway. The symptoms are key, scans are only supposed to serve to backup the actually physical findings.
Hope this helps,
Vin
Symptoms are the most important
Detailed Answer:
Hey there, Thanks for following up. When I was reading the scans you sent me, all i was doing was going by what I saw on the scan. Thats not the most important aspect to take into consideration when deciding upon our course of action here.
Your symptoms are the most important. As you said, you're not having any neurological symptoms in the upper limbs as yet and your symptoms are better in the lower limbs. To me that means that what i saw on the scan is not BAD enough yet to cause you symptoms (in other words.. yes i see a degeneration of the disc in the neck.. but it part and parcel of aging and is not causing you any real symptoms).
You said that Physical Therapy (PT) has improved the symptoms in the lower back. That is good news. I would defer surgery in such cases and see how this plays out. Keep up the exercise and keep in mind, that if the pins and needles return, or if the legs or feet become numb or weak.. then the nerve compression process, that was slowed down by the PT, is getting worse again. At that point you may need to undergo the surgery anyway. The symptoms are key, scans are only supposed to serve to backup the actually physical findings.
Hope this helps,
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks vin.. do herniations subside in time? i had sciatic pain for thirteen weeks and then it suddenly went away..i am hoping my neck settles itself and by back
i meant to ask.. are you saying there is no damage to the spinal cord at the moment in the neck.. also are the lower disc problems l4l5 l5s1 related to the spinal cord at all.. would a microdis. solve any problems.. thanks
i meant to ask.. are you saying there is no damage to the spinal cord at the moment in the neck.. also are the lower disc problems l4l5 l5s1 related to the spinal cord at all.. would a microdis. solve any problems.. thanks
Brief Answer:
Herniations don't subside, but they do get ignored
Detailed Answer:
Hi there, thanks for coming back.
So to answer the first question. Disc herniations don't really go back to normal. Discs cant really protect or heal themselves. But what does happen is the spinal coloumn, a dynamic, living organ is able to adapt to the pressure symptoms brought on by the disc and essentially 're-route' nerve impulses around the irritated area. The process is slow, but physical therapy helps in this 're-mapping' process immensely.
As for damage to the cord in the neck. No, i don;t see any direct damage to the cord. But the spinal nerve that is leaving the cord 'LOOKS' like it might be getting squeezed a bit. That is what may be causing the pins and needles sensations in your hand.
Now, would a microdiscectomy help? It would help only if the symptoms you are suffering from are those due to nerve compression. That basic idea boils down to judgement. If the surgeon is convinced that the symptoms you have are due to such a disc compression, then they would embark on a discectomy.
Make sense?
Vin
Herniations don't subside, but they do get ignored
Detailed Answer:
Hi there, thanks for coming back.
So to answer the first question. Disc herniations don't really go back to normal. Discs cant really protect or heal themselves. But what does happen is the spinal coloumn, a dynamic, living organ is able to adapt to the pressure symptoms brought on by the disc and essentially 're-route' nerve impulses around the irritated area. The process is slow, but physical therapy helps in this 're-mapping' process immensely.
As for damage to the cord in the neck. No, i don;t see any direct damage to the cord. But the spinal nerve that is leaving the cord 'LOOKS' like it might be getting squeezed a bit. That is what may be causing the pins and needles sensations in your hand.
Now, would a microdiscectomy help? It would help only if the symptoms you are suffering from are those due to nerve compression. That basic idea boils down to judgement. If the surgeon is convinced that the symptoms you have are due to such a disc compression, then they would embark on a discectomy.
Make sense?
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks Vin..can physio help with the neck.. also i don t think the disc in the neck is a herniation..think it is just a bulge.i know my surgeon was not concerned about it and there is no major arm pain or numbness just a little..my physio does mobilisation techniques.she is excellent..also .. the reason i do go for the microdiscectomy is the pain eventually went away in my leg..more or less.. amazing..when my back settle s the neck acts up..it more pain in the neck area and not arm area..i go to physiotherapy. do you believe in osteopaths or chiractpractioners? my physiotherapist uses a technique called maitland mobilisations.tks
do all herniations in the neck get operated on.. this is a major operation.. I would imagine the symptoms would have to be very bad to take that route?.thanks
how would you know if you had that condition fibromyalgia..how can it be diagnosed? thanks
do all herniations in the neck get operated on.. this is a major operation.. I would imagine the symptoms would have to be very bad to take that route?.thanks
how would you know if you had that condition fibromyalgia..how can it be diagnosed? thanks
Brief Answer:
Osteopaths, physio and the rabbit hole.
Detailed Answer:
Hey there XXXXXXX
My opinion on Physical Therapists is that they do more good than I do.. period. Osteopaths are basically trained the same way we (MD) are when they do their specializations, so I'm not worried about them either. Chiropractors on the other hand... well, i have never seen any evidence that they have helped the patients I have managed when they went to them. I have seen plenty of evidence that they can do great harm though. Badly manipulated necks end up in surgery quite often. So when it comes to Chiropractors.. I would not recommend them.
Now, do all herniations get operated upon.. definitely not. It all depends on the symptoms that herniation is causing and how badly it's affecting the patient. Surgery is about the PATIENTS symptoms.. not what we see on scans. Yes, the symptoms have to be REALLY bad for the patient before I think about taking them into the OR.
To your last question about Fibromyalgia. Now this disease is not a real disease.... Let me explain. The word 'Fibromyalgia' just means "Pain in soft tissue and muscle tissue". Here, we don't know what is causing the pain. if we did, we wouldn't use the term fibromyalgia. The whole problem with a catchall phrase like this is that ANY unknown process can be stuck with the term Fibromyalgia.. as long as there is pain and the doctor can't figure out what is wrong.
So, in practice. No one uses that as a diagnosis UNTIL every other cause THAT CAN BE TESTED FOR has been explored. It's a diagnosis of elimination. The drugs that treat it and the methodology are all very preliminary at this point. One drug, Lyrica (pregabalin) seems to help.. but then again, you could give pregabalin to a person with any number of neurological conditions that cause pain and it would help. Its a very blunt instrument. It just dulls the nerves in general. It does nothing to combat the underlying cause of the pain.
So, how do you know you have fibromyalgia... you would know because the neurologist is scratching his or her head and going "Hmmmmm" way too often.
Make sense?
Vin
Osteopaths, physio and the rabbit hole.
Detailed Answer:
Hey there XXXXXXX
My opinion on Physical Therapists is that they do more good than I do.. period. Osteopaths are basically trained the same way we (MD) are when they do their specializations, so I'm not worried about them either. Chiropractors on the other hand... well, i have never seen any evidence that they have helped the patients I have managed when they went to them. I have seen plenty of evidence that they can do great harm though. Badly manipulated necks end up in surgery quite often. So when it comes to Chiropractors.. I would not recommend them.
Now, do all herniations get operated upon.. definitely not. It all depends on the symptoms that herniation is causing and how badly it's affecting the patient. Surgery is about the PATIENTS symptoms.. not what we see on scans. Yes, the symptoms have to be REALLY bad for the patient before I think about taking them into the OR.
To your last question about Fibromyalgia. Now this disease is not a real disease.... Let me explain. The word 'Fibromyalgia' just means "Pain in soft tissue and muscle tissue". Here, we don't know what is causing the pain. if we did, we wouldn't use the term fibromyalgia. The whole problem with a catchall phrase like this is that ANY unknown process can be stuck with the term Fibromyalgia.. as long as there is pain and the doctor can't figure out what is wrong.
So, in practice. No one uses that as a diagnosis UNTIL every other cause THAT CAN BE TESTED FOR has been explored. It's a diagnosis of elimination. The drugs that treat it and the methodology are all very preliminary at this point. One drug, Lyrica (pregabalin) seems to help.. but then again, you could give pregabalin to a person with any number of neurological conditions that cause pain and it would help. Its a very blunt instrument. It just dulls the nerves in general. It does nothing to combat the underlying cause of the pain.
So, how do you know you have fibromyalgia... you would know because the neurologist is scratching his or her head and going "Hmmmmm" way too often.
Make sense?
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thafnks Vin..i have a great physiotherapist..i would try and avoid surgery if I could..especially in the neck.. do you think that physiotherapy is good for the neck?..also I got that neck scan done in February..when do you think I should get another scan..? is neck surgery serious and does it always work.. also I told you I was meant to have a microdiscemony..I cancelled..because my sciatic pain went away just before the operation.. I still have disc pain in my back.i understand that the operation would not of cured that..it would only of cured the leg pain. Woud a lamentomy cure the back pain..thanks for all your help
meant to ask..i get pins and needles in my feet. in both feet..does this mean I should of gone for the microdisec...I am a little nervous that symtoms could get worse and I could do nerve damage..the surgeon did not push me to have surgery.the leg pain went away by itself.it could easily return..i hope not. I have heard of people coming out worse from these operation and in particular when it is getting better..i did not want to risk that operation.. also could the pins and needles in the feet be coming from the neck
vinnay what is spondolytis and what can be done about it? what is a good medication?
meant to ask..i get pins and needles in my feet. in both feet..does this mean I should of gone for the microdisec...I am a little nervous that symtoms could get worse and I could do nerve damage..the surgeon did not push me to have surgery.the leg pain went away by itself.it could easily return..i hope not. I have heard of people coming out worse from these operation and in particular when it is getting better..i did not want to risk that operation.. also could the pins and needles in the feet be coming from the neck
vinnay what is spondolytis and what can be done about it? what is a good medication?
Brief Answer:
Avoiding surgery is a good idea in most cases.
Detailed Answer:
Hey there, so let me try and state the obvious (Avoiding surgery = good) but then tell you why risking surgery might be a good idea in your case.
Physical therapy is always a good option to delay or avoid surgery altogether. It works well on any complex set of joints like the neck and I think that some basic physical therapy and exercise for the c-spine should be part of a middle aged womans REGULAR exercise regime to avoid the effects of osteoporosis and arthritis.
I think it will help you avoid surgery on your neck. The Canary in the coal mine here though is numbness, tingling or pain in your hands and arms and shoulder. If you notice any new symptoms along these lines, or the previous minor tingling comes back or gets worse... then you will need to repeat and MRI of the neck. I don;t think you should be going for a scan regularly.. i think waiting and watching for the symptoms is the more efficient and prudent course.
You've repeatedly mentioned the pins and needles in the feet though, and the disc in your back is a significant bulge. The other issue you mention is the local back pain that persists in spite of the sciatica having been relieved. Now, this grouping of symptoms is pretty complex. There is a component of nerve impingement from the lumbar spine on a spinal nerve root, but there is also a very significant inflammatory component of the spine itself (AKA Spondylitis = Inflammation / Arthritis of the spine).
Now, the important question here is "Why is there inflammation in the first place?" Why do see the thickening and inflammation of those joints on the MRI? This is caused by a great many factors working together. In middle age, women tend to suffer from demineralization of the bones (osteoporosis), couple with with a lack of exercise and other factors like being overweight or smoking (i'm not saying you are overweight or that you smoke.. just generalizing). This demineralization just makes the bones softer and more susceptible to microfracture when stressed (think of the difference between a piece of solid marble and a piece of soapstone). The discs between the vertebrae too tend to dry out and become coarse, which makes the friction on the bones worse when you move.
All of this just goes together to end up in a situation where day to day wear and tear get worse and worse on the softening bones which aren;t being cushioned as well anymore. This causes arthritis in the spine.. spondylitis.
I do not believe that these issues in your lower back will resolve with physical therapy alone.
I think that a better option might be a surgery where the lumbar spine is stabilized with a disc replacement.
Better yet, a fusion of 2 of the L-spine vertebrae so that the rubbing and movement that is causing the spondylitis is stopped and the nerve root is released with a plain discectomy.
A microdisc procedure would handle one component (the nerve impingement component) well, but would not address the cause of the spondylitis directly. The advantage of a microdisc procedure is well.. it's micro.. less stress on the body from the surgery.. quicker recovery time, shorter hospitalization and overall less risks to the surgery. You have to discuss the pros and cons of these different surgical techniques with your spine guy, he or she can walk you through it better in person.
I don't think a laminectomy would address both issues either. It would help with the nerve compression though.
So here's the issue. I think you would benefit from surgery on your lower back. Sooner or later, i think the degenerative processes happening in there will come to a point where surgery is an emergent necessity. If I were your surgeon, I would rather fix the spine preemptively, take the time to tune you up for it and get physical therapy in the post op period.
Now, when it comes to medications for spondylitis. You combat inflammation with antiinflammatories. Drugs like Ibuprofen, Acetaminophen, Naproxen and even certain steroids can do this job. The problem with each and every anti-inflammatory you take, is that it has a side effect. They can put stress on the kidney, or the liver.. they can even interfere with the natural processes that heal the bones in the spine and accelerate the osteoporosis long term. So i don't want to encourage your use here as an alternative to long term solutions. For occasional pain relief, OTC Naproxen or Ibuprofen should be enough.. but don't start popping them like candy. I've seen people do it and in the long term, their spines end up melting.
So to sum up
- Physiotherapy is great, except when we have unrealistic expectations that it can fix everything.
- I think your neck will benefit from PT alone for the time being. If and only if your symptoms worsen.. scanning and a re-eval of the situation will be needed.
- Your L-spine (lower back) on the other end will not get better with PT or meds alone (at least in my opinion, factoring in the scan's i've seen, your age, etc).
- I think fusion and discectomy in your L-spine would help you the most. But I think you should discuss the intricacies of the different surgical options available to you with the operating surgeon. I've seen two pictures.. they've seen the whole scan.. and more importantly.. they've seen YOU.
So, how's I do? Did I answer everything? Let me know how else I can clarify the situation for you.
Vin
Avoiding surgery is a good idea in most cases.
Detailed Answer:
Hey there, so let me try and state the obvious (Avoiding surgery = good) but then tell you why risking surgery might be a good idea in your case.
Physical therapy is always a good option to delay or avoid surgery altogether. It works well on any complex set of joints like the neck and I think that some basic physical therapy and exercise for the c-spine should be part of a middle aged womans REGULAR exercise regime to avoid the effects of osteoporosis and arthritis.
I think it will help you avoid surgery on your neck. The Canary in the coal mine here though is numbness, tingling or pain in your hands and arms and shoulder. If you notice any new symptoms along these lines, or the previous minor tingling comes back or gets worse... then you will need to repeat and MRI of the neck. I don;t think you should be going for a scan regularly.. i think waiting and watching for the symptoms is the more efficient and prudent course.
You've repeatedly mentioned the pins and needles in the feet though, and the disc in your back is a significant bulge. The other issue you mention is the local back pain that persists in spite of the sciatica having been relieved. Now, this grouping of symptoms is pretty complex. There is a component of nerve impingement from the lumbar spine on a spinal nerve root, but there is also a very significant inflammatory component of the spine itself (AKA Spondylitis = Inflammation / Arthritis of the spine).
Now, the important question here is "Why is there inflammation in the first place?" Why do see the thickening and inflammation of those joints on the MRI? This is caused by a great many factors working together. In middle age, women tend to suffer from demineralization of the bones (osteoporosis), couple with with a lack of exercise and other factors like being overweight or smoking (i'm not saying you are overweight or that you smoke.. just generalizing). This demineralization just makes the bones softer and more susceptible to microfracture when stressed (think of the difference between a piece of solid marble and a piece of soapstone). The discs between the vertebrae too tend to dry out and become coarse, which makes the friction on the bones worse when you move.
All of this just goes together to end up in a situation where day to day wear and tear get worse and worse on the softening bones which aren;t being cushioned as well anymore. This causes arthritis in the spine.. spondylitis.
I do not believe that these issues in your lower back will resolve with physical therapy alone.
I think that a better option might be a surgery where the lumbar spine is stabilized with a disc replacement.
Better yet, a fusion of 2 of the L-spine vertebrae so that the rubbing and movement that is causing the spondylitis is stopped and the nerve root is released with a plain discectomy.
A microdisc procedure would handle one component (the nerve impingement component) well, but would not address the cause of the spondylitis directly. The advantage of a microdisc procedure is well.. it's micro.. less stress on the body from the surgery.. quicker recovery time, shorter hospitalization and overall less risks to the surgery. You have to discuss the pros and cons of these different surgical techniques with your spine guy, he or she can walk you through it better in person.
I don't think a laminectomy would address both issues either. It would help with the nerve compression though.
So here's the issue. I think you would benefit from surgery on your lower back. Sooner or later, i think the degenerative processes happening in there will come to a point where surgery is an emergent necessity. If I were your surgeon, I would rather fix the spine preemptively, take the time to tune you up for it and get physical therapy in the post op period.
Now, when it comes to medications for spondylitis. You combat inflammation with antiinflammatories. Drugs like Ibuprofen, Acetaminophen, Naproxen and even certain steroids can do this job. The problem with each and every anti-inflammatory you take, is that it has a side effect. They can put stress on the kidney, or the liver.. they can even interfere with the natural processes that heal the bones in the spine and accelerate the osteoporosis long term. So i don't want to encourage your use here as an alternative to long term solutions. For occasional pain relief, OTC Naproxen or Ibuprofen should be enough.. but don't start popping them like candy. I've seen people do it and in the long term, their spines end up melting.
So to sum up
- Physiotherapy is great, except when we have unrealistic expectations that it can fix everything.
- I think your neck will benefit from PT alone for the time being. If and only if your symptoms worsen.. scanning and a re-eval of the situation will be needed.
- Your L-spine (lower back) on the other end will not get better with PT or meds alone (at least in my opinion, factoring in the scan's i've seen, your age, etc).
- I think fusion and discectomy in your L-spine would help you the most. But I think you should discuss the intricacies of the different surgical options available to you with the operating surgeon. I've seen two pictures.. they've seen the whole scan.. and more importantly.. they've seen YOU.
So, how's I do? Did I answer everything? Let me know how else I can clarify the situation for you.
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank s XXXXXXX .gosh... i hope i don t have to have this surgery..this is a concern..i will have to discuss this issue with my consultant..thanks for all the great advise.. in your opinion. have you seen surgery to be a success? in particular the neck. and what if i don t have surgery. what will happen?
Brief Answer:
Surgery works when we get the symptoms right.
Detailed Answer:
Hey there. I'm hoping that whole speil I gae you doesn't make you more worried. I'm pretty confident that you won't need surgery on your neck in the near future. I don't think you will need to even contemplate it UNLESS the PT fails or your nerve compression symptoms get worse. Is the surgery successful in general? Yes, when we select our patients carefully and make sure that the symptoms match the issue we are treating.. then things go well.
If you don't have surgery on your neck, i don't really think anything bad will happen. But we have to see. That's why I want you to be on the lookout for worsening symptoms of nerve compression. Those "Canary in the Coalmine" symptoms like numbness, tingling, pain and weakness in the arms and hands would be what you have to look out for.
Make sense?
Vin
Surgery works when we get the symptoms right.
Detailed Answer:
Hey there. I'm hoping that whole speil I gae you doesn't make you more worried. I'm pretty confident that you won't need surgery on your neck in the near future. I don't think you will need to even contemplate it UNLESS the PT fails or your nerve compression symptoms get worse. Is the surgery successful in general? Yes, when we select our patients carefully and make sure that the symptoms match the issue we are treating.. then things go well.
If you don't have surgery on your neck, i don't really think anything bad will happen. But we have to see. That's why I want you to be on the lookout for worsening symptoms of nerve compression. Those "Canary in the Coalmine" symptoms like numbness, tingling, pain and weakness in the arms and hands would be what you have to look out for.
Make sense?
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks vin..need to keep an eye out for both the neck and the back.. do you notice spondolytis there.. is spondolytis a regular condition? is there any specific medication for it. thanks
XXXXXXX .just another question - I do get numbness in my hands when I wake up and pins and needles.. no weakness - just wondered if this is something to be concerned about
XXXXXXX .just another question - I do get numbness in my hands when I wake up and pins and needles.. no weakness - just wondered if this is something to be concerned about
Brief Answer:
There are signs of spondylitis in the neck, mild
Detailed Answer:
Hi there, thnaks for coming back. Yup, there are signs of spondylitis there. Now, I only have one imgae to look at, but there seem to be signs of inflammation there. As to specific medications. Really, there's nothing very good.
A single small dose of Asprin per day can help (75mg), and a diet high in Omega 3 and Omega 6 fatty acids can help (think Flax seed oil.. it tastes like oily paper.. but it's good for you unfortunately).
Really though the best way to manage inflammation is to get rid of the cause. This kind of issue can be due to osteoporosis etc. So exercise and maintaining a healthy weight goes a long way.
Now, when it comes to the numbness in your hands. You mentioned this before. These are definite neurological signs of nerve compression. But they may get better with PT alone. The only thing I would be concerned about if I were in your place would be WORSENING of those symptoms (bit of a fib there, I'd be concerned about tons of stuff. I'm a big baby when I'm sick). IF they stay the same or even get better, things are good.
So that's what i think is going on, XXXXXXX for your thoughts?
Vin
There are signs of spondylitis in the neck, mild
Detailed Answer:
Hi there, thnaks for coming back. Yup, there are signs of spondylitis there. Now, I only have one imgae to look at, but there seem to be signs of inflammation there. As to specific medications. Really, there's nothing very good.
A single small dose of Asprin per day can help (75mg), and a diet high in Omega 3 and Omega 6 fatty acids can help (think Flax seed oil.. it tastes like oily paper.. but it's good for you unfortunately).
Really though the best way to manage inflammation is to get rid of the cause. This kind of issue can be due to osteoporosis etc. So exercise and maintaining a healthy weight goes a long way.
Now, when it comes to the numbness in your hands. You mentioned this before. These are definite neurological signs of nerve compression. But they may get better with PT alone. The only thing I would be concerned about if I were in your place would be WORSENING of those symptoms (bit of a fib there, I'd be concerned about tons of stuff. I'm a big baby when I'm sick). IF they stay the same or even get better, things are good.
So that's what i think is going on, XXXXXXX for your thoughts?
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks vin..what do you mean bit of fib..? just wondering. I have a wonderful physio who check s me regularily..anything you can suggest for cervical headaches.. bases of scull headaches.. also.. is there an operation for spondolytis? Thanks vin.. i keep a very closes eye of this.. what is spondolytis?thanks
Brief Answer:
PT cervical headaches
Detailed Answer:
Hi, thanks for coming back!
Bit of a Fib.. what i meant was that I was 'Fibbing' ie lying (i would be very concerned)
As far as treatment of cervical headaches. I want you to check out a youtube video that i'm going to link you to. Watch it and try it out. Safe to do at home and easy to do every day.
http://youtu.be/Wa6XjHtKhoQ
Let me know what you think about that.
Spondylitis, as we discussed in an earlier mail, is inflammation of the spinal column.
Operation for spondylitis? No, no surgery can get rid of inflammation directly. Any surgery would have to address the CAUSE of the inflammation.
Hope this helps, looking forward to your reply,
Vin
PT cervical headaches
Detailed Answer:
Hi, thanks for coming back!
Bit of a Fib.. what i meant was that I was 'Fibbing' ie lying (i would be very concerned)
As far as treatment of cervical headaches. I want you to check out a youtube video that i'm going to link you to. Watch it and try it out. Safe to do at home and easy to do every day.
http://youtu.be/Wa6XjHtKhoQ
Let me know what you think about that.
Spondylitis, as we discussed in an earlier mail, is inflammation of the spinal column.
Operation for spondylitis? No, no surgery can get rid of inflammation directly. Any surgery would have to address the CAUSE of the inflammation.
Hope this helps, looking forward to your reply,
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
THanksVin.. saw the video it is great
When you mention spondylitis.. (in the back area) do you mean anxonising spondylitis? thanks..
When you mention spondylitis.. (in the back area) do you mean anxonising spondylitis? thanks..
Brief Answer:
Ankylosing spondylitis, no evidence here
Detailed Answer:
Hey there, welcome back.
I think you mean Ankylosing spondylitis. This is a specific type of Spondylitis where the inflammation becomes so bad that it sort of liquefies the bones and makes them fuse together.
This type of spondylitis would show up very clearly on the scans that you have had done. There's no evidence from the pictures ive seen to worry about this type of inflammation.
Ankylosing spondylitis is associated with pretty severe autoimmune diseases like sjogren syndrome etc. You don't have anything of the sort. So don;t worry.
So to sum up, no.. i'm not talking about Ankylosing Spondy. Its just general spondy i'm talking about.
Ankylosing spondylitis, no evidence here
Detailed Answer:
Hey there, welcome back.
I think you mean Ankylosing spondylitis. This is a specific type of Spondylitis where the inflammation becomes so bad that it sort of liquefies the bones and makes them fuse together.
This type of spondylitis would show up very clearly on the scans that you have had done. There's no evidence from the pictures ive seen to worry about this type of inflammation.
Ankylosing spondylitis is associated with pretty severe autoimmune diseases like sjogren syndrome etc. You don't have anything of the sort. So don;t worry.
So to sum up, no.. i'm not talking about Ankylosing Spondy. Its just general spondy i'm talking about.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
one other question:- is spondolytis of the neck common? I know mine is mild.. I have an excellent physio who keeps all this at bay
Brief Answer:
Incredibly common, Unfortunatley
Detailed Answer:
It seems to happen to just about everyone with age XXXXXXX at least in modern day cultures. Good exercise habits, plenty of healthy fats and Vitamins in the diet can help ward it off, but for the most part, it's a part of aging.
Stick with the PT, it's more effective than any pill in the long term.
Take Care,
Vinay
Incredibly common, Unfortunatley
Detailed Answer:
It seems to happen to just about everyone with age XXXXXXX at least in modern day cultures. Good exercise habits, plenty of healthy fats and Vitamins in the diet can help ward it off, but for the most part, it's a part of aging.
Stick with the PT, it's more effective than any pill in the long term.
Take Care,
Vinay
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks XXXXXXX . are my osteophyses compressing any nerves at all.. have you seen much worse neck scans than mine? thanks for been so reassuring..
how about physical activity with all these conditions> thanks Vin
do I have Spondylolisthesis - thanks vin
Is Arcoxia a good drug for neck pain..have you any idea if spondolythis gets worse
..is it ok to hill walk..i am extremely careful overall with all that I do thanks vin
in you opinion do you think acupuncture is good for the neck. thanks
how about physical activity with all these conditions> thanks Vin
do I have Spondylolisthesis - thanks vin
Is Arcoxia a good drug for neck pain..have you any idea if spondolythis gets worse
..is it ok to hill walk..i am extremely careful overall with all that I do thanks vin
in you opinion do you think acupuncture is good for the neck. thanks
Brief Answer:
Osteophytes, Listhesis, Arcoxia and Acupuncture.
Detailed Answer:
Hey there XXXXXXX thanks for coming back. Lets try and address these issues one by 1.
In the single picture i saw of the neck. I didn't see any osteophytes. Those are generally more of a problem in the lower back to begin with. Down there, i think i saw some evidence. But i don't have the full scan, so it's tough to say.
I've seen PLENTY of REALLY bad scans. Yours isn't that bad at all.
Spondylolisthesis is a situation where the spinal column starts tipping over like the Leaning tower of Pisa due to collapse of the bone. I didn't see any evidence of this on the pictures that I saw. Again. I would really need to see the full scan to be sure though.
Arcoxia is a drug called Etoricoxib, which brings down inflammation. I think it would be a great drug to use in your case.
As for Hill walking.. I don't exactly know what that entails. Make sure you wear proper protective gear and high top boots to protect your ankles on the trails. You should be fine.
Lastly, Acupuncture. That's a toughie. Look, I have no evidence that this stuff works. But I have seen lots of patients benefit. So as long as the acupuncturist is well known and has a good track record, i don't think it would hurt to try and see if you get some relief from it.
Hope this helps,
Vinay
Osteophytes, Listhesis, Arcoxia and Acupuncture.
Detailed Answer:
Hey there XXXXXXX thanks for coming back. Lets try and address these issues one by 1.
In the single picture i saw of the neck. I didn't see any osteophytes. Those are generally more of a problem in the lower back to begin with. Down there, i think i saw some evidence. But i don't have the full scan, so it's tough to say.
I've seen PLENTY of REALLY bad scans. Yours isn't that bad at all.
Spondylolisthesis is a situation where the spinal column starts tipping over like the Leaning tower of Pisa due to collapse of the bone. I didn't see any evidence of this on the pictures that I saw. Again. I would really need to see the full scan to be sure though.
Arcoxia is a drug called Etoricoxib, which brings down inflammation. I think it would be a great drug to use in your case.
As for Hill walking.. I don't exactly know what that entails. Make sure you wear proper protective gear and high top boots to protect your ankles on the trails. You should be fine.
Lastly, Acupuncture. That's a toughie. Look, I have no evidence that this stuff works. But I have seen lots of patients benefit. So as long as the acupuncturist is well known and has a good track record, i don't think it would hurt to try and see if you get some relief from it.
Hope this helps,
Vinay
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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