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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Lower Back Pain And Neck Stiffness

I am a young man, just turned 31 years old. About a year and a half ago, I started to develop a slight tremor in my left forearm/hand. Over time, the tremor has gotten more exaggerated. Just recently I have noticed that my left lower leg/foot has felt heavy and stiff and I cannot move or rotate my foot as well as my right one. I have jogged a couple of times recently and although, while running I was okay, afterwards, this caused lower back ankle/foot pain. When I stand or walk for an extended period of time, I have pain in my lower back and ankle/foot. Sometimes when turning my head quickly, I get a pinching type pain in my neck on both sides of my neck. When I sleep, the tremor goes away. When I wake up with the sensation of pins-and-needles in my arm from sleeping on it, although it is numb, as it normally would be, I have complete use of my hand and fingers, normal dexterity, without the tremor, until normal feeling comes back, usually up to about 5 minutes. The more relaxed I am, it seems, the less the tremor. But the stiffness or lack of dexterity of my fingers stays the same. Also, a drink or two of alcohol suppresses the tremor. As a twelve year old, I had scoliosis surgery, placing rods in my back, from “T-4 to the end plate of T-10 and T-11 through L-3’. Also, about 10 years ago, from a target shooting gun accident, I have a .22 caliber bullet fragments remaining in my upper left arm. At first, we thought the bullet fragments were the cause since only my lower left arm was affected but since the EMG shows normal nerve conductivity and now that my left leg seems to be affected we don’t think this is a factor.. I was told, when I had the scoliosis surgery that possibly, down the road, I could experience problems from my neck. Currently, as stated earlier, I get some neck pain and stiffness and lower back pain. Earlier, in the summer, after doing some strenuous yard work, I had acute lower back pain that lasted for several weeks. I took Skelaxin, a muscle relaxer, which helped. This is the first time I have ever had that extensive pain in my back. We have been to several different neurologists, without much success. I have had a brain MRI done, a neck MRI, 2 different EMG’s, extensive blood work and an EEG done as well. All reports are included. You will see that the Brain MRI shows normal. The EMG shows that the nerves and muscles of my lower arm are normal. The blood work and EEG are normal as well. The Neck MRI is, we believe now is the area of focus, as the report says that I have “significant reversal of the cervical lordosis and a moderate to large, right sided disc herniation at C6-C7. The neck problems seems to have been overlooked to date by doctors as originally, the diagnosis was that I had an anxiety related tremor because when I concentrated on something else, the tremor went away, briefly. Also, there was some concern from just one of the doctors that it may be Parkinson’s disease. However, most of the doctors felt that the frequency of the tremor, 10 Hz doesn’t suggest it. Also, in trying Cararbidopa-levodopa, 25-100MG tablet, which should have stopped the tremor, if it was Parkinson’s, did nothing but made me nauseous. It had no affect on the tremor. Speaking of medicines, to date, I have been prescribed the following medications with literally no results. Starting from earliest date to most recent…      Trihexyphenidyl – 2MG, taken twice daily – (this made me dizzy, headachy,weak.)      Pramipexole Dihydrochloride, (Mirapex) - .5MG, taken 1 tab, 3 times daily – (this caused       diarrhea)      Lorazepam - .5MG, taken one tab, twice daily. (this lessened the tremor slightly for just a day or two but it kept me awake).      Carbidopa-Levodopa – 25-100MG, taken 1 tab, three times daily, (Made me very       Nauseous, with no affect).      Clonazepam - .5MG tab, taken 1 tab, twice daily. (no affect) Amantadine – 100MG, taken 1 tab twice daily. (Lessened tremor for just a day or tow but then made me nauseous, headachy).      Propranolol – 20MB tabs, taken 1 tab daily. Since there was no affect, this was       Increased to 3 tabs, 3 times daily. (No affect at either dosage).      Prednizone – Tried a metered dose pack to see if it would reduce inflammation hoping       to reduce the tremor some. (There was no significant affect).       I am currently not taking any medications other than occasional Advil for pain in my lower back and neck stiffness. Additionally, I tried acupuncture for 8 appointments. While on the table, relaxing, the tremor went away, then, after getting up, the tremor came back. my newest mri of my neck is:c2-c3: unremarkable c4-c5: posterior disc bulge. Mild left uncovertebral hypertrophy. No significant central or foraminal narrowing. c5-c6: Mild posterior disc bulge. Mild right neuroforaminal narrowing. central canal is patent. c6-c7: Small right foraminal disc herniation and eccentric right uncovertebral hypertrophy causing moderate right neuroforaminal narrowing. this effaces the ventral thesal sac. there is no significant central spinal stenosis
Mon, 28 Sep 2015
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Orthopaedic Surgeon 's  Response
hi
You may cosult spine surgeon/neurosurgeon and ask if surgery on neck for mri findings could help in relieving tremors?neck isometric exercises, cervical collar and physical therapy may also help .Fibromyalgia and multiple sclerosis should also be ruled out
best wishes
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Suggest Remedy For Lower Back Pain And Neck Stiffness

hi You may cosult spine surgeon/neurosurgeon and ask if surgery on neck for mri findings could help in relieving tremors?neck isometric exercises, cervical collar and physical therapy may also help .Fibromyalgia and multiple sclerosis should also be ruled out best wishes