Other/Mixed Neck, cervical spine, Expert

[william bad butt]

A friend is having neck issues. He has seen a specialist and surgery is recommended. He is uncomfortable with it, mostly because he has been improving over the last 2 months.

I have had a lot of success using Stu Mcgills Back Mechanic book and practices for my lower back issues. Is there an equivalent guru out there for the neck, as McGill is to the lumbar back? Is their a book out their that is the equivalent of Back Mechanic, for the layman, but for the neck?

Thanks,

Eric

 

[Tarzan]

Have him investigate the McKenzie neck retraction exercises.

https://www.youtube.com/watch?v=ZQes2ijwcKY
There's a better vid floating around on youtube by Robin McKenzie himself somewhere, if I track it down I'll post a link.

Depending on his problem, they may be of some help. The exercises saved me from the knife and also helped a lot of people I've steered in that direction.

 

[Tarzan]

Here's the other vid I was talking about.

 

[william bad butt]

Thanks, we will check it out.

 

[rickyw]

He has seen a specialist and surgery is recommended. He is uncomfortable with it, mostly because he has been improving over the last 2 months.

I'm not sure what part of "improving over the last 2 months" some surgeons don't understand, but a second opinion from another specialist may be helpful.

 

[william bad butt]

If I recall, he said the MRI showed severe foraminal bilateral stenosis in either C6/C7 or C7/T1 (I might be butchering these medical terms, hopefully this makes sense). In November he was in pain and had severe weakness and tingling sensations in his right hand.

Anyway, the part that seemed odd to me was that after 2 months, he currently does not feel any pain. But still has weakness and hand tingling. I am just relating this to my back issues, I don't think I would get surgery if I was improving.

 

[North Coast Miller]

I have degenerative disks at C5/C6 and C6/C7.
When I went in for an MRI, I was in so much pain I had a tough time staying still in the tube - excruciating would be the word.

Symptoms were constant pain between shoulder blade and spine, shooting pain along middle delt, back of forearm, numbness in index and ring finger.

As my back Dr explained to me, DD and other related issues aren't exactly like a rubbery bulge pressing on the nerve, sometimes bits of the disk actually come off and impinge on the nerve. Smaller bits will be reabsorbed, leading to a lessening of symptoms for most.

Surgery to remove larger bits or open the passageway the nerve takes can be done in severe cases, stenosis being on the list.

However I am not a surgical candidate at this stage - I'm not showing any lack of muscle tone on the affected side, and strength difference is less than 10% by his estimate. "I wouldn't even consider surgery in your case".

In the year since it was at its worst, I've actually recovered quite a bit. Still have pretty much zero sensation in my index finger - feels like it always has a band-aid wrapped too tight at the base and I have to be careful not to burn it. Other than that almost all the acute stuff has subsided and strength has returned to equal the opposite side. I still cannot do TGU with my right arm without nerve pain across the middle delt...

If I were your friend I'd get a second opinion. Surgery is warranted in plenty of these situations, but the improvement rate is not the best, so is IMHO a last resort. Visible changes in muscle tone and strength from one side to the other and persistent pain would be the minimum threshold for me.

 

[Tarzan]

Ok then. Maybe his condition is beyond internet self help vids.

I'd suggest that his condition would be best treated by a specialist and as @rickyw suggested a second opinion could be a wise decision for your friend.

 

[rickyw]

Anyway, the part that seemed odd to me was that after 2 months, he currently does not feel any pain. But still has weakness and hand tingling.

To be honest, pain is not the main issue here. The weakness and hand tingling are. A compressed nerve can be inflammed and cause pain to target tissues because it is short on oxygen to a degree, but it is not short enough on oxygen to die. The more compressed the nerve, the more weakness and numbness to the tissues it innervates. Too much compression leads to nerve death. Surgeons are more concerned with function than pain-they want to see strength and sensation returning. If your friend's pain is gone but his numbness and weakness is progressing or is interfering with his activities of daily living, that is a serious issue, and can justify surgery. If his numbness and weakness is improving, then that is different-but he needs to have this managed appropriately by a doc, not online.

If I recall, he said the MRI showed severe foraminal bilateral stenosis in either C6/C7 or C7/T1

This is different than degenerative discs. It means there is likely arthritis of the facet joints, arthritis of the joints of luschka, degenerative disc disease, and possibly hypertrophy and buckling of the ligamentum flavum. In short, the nerve is being crowded from multiple angles as it exits the intervertebral foramen.

He needs management by a really good doctor, in person, in that doctor's office.

 

[Steve Freides]

As I was recovering from my back injury, I bought a dozen copies of McKenzie's book and would give one away every time someone told me they had low back pain.

-S-

 

[william bad butt]

Thanks guys. He told me yesterday that he is scheduling an appointment with another doctor for a second opinion (the first doc may be absolutely correct and the surgery may be necessary). I forwarded him the McKenzie book info and we ordered it today, so we can learn a bit more. He does not want surgery. He insists that he can tolerate this.

After 2 months his pain went away, his weakness has decreased some, but the tingling has not decreased at all. To me that sounded like improvement, and he says he feels better. But Ricky, you may be right.

FYI, to make things tougher for the poor guy, English is not his first language and there is a lot of confusion, I was trying to help him understand the report his doctor wrote out for him.

Steve, I have let several folks borrow my Stu McGill book and all have been gratefull and learned a thing or 2 to help them.

Thx for the comments, all of you. I've passed them all on to him. Tough decisions need to be made, his doctors opinion, a second doctors opinion, and some educational reading material to understand the basics is where I am trying to lead him so he can make make an informed decision. Ultimately everyone must own their own health issues. Concerning my own past back issues, If I would have followed the literal advice of the first, or even the second expert I sought out, my life would have probably turned out very different than it has.

 

[rickyw]

After 2 months his pain went away, his weakness has decreased some, but the tingling has not decreased at all. To me that sounded like improvement, and he says he feels better. But Ricky, you may be right.

I hope he does better and does not need surgery. Conservative methods can do wonders with neurological symptoms. If his strength is returning that is a good sign too! I urge seeing a doc because, when it's all said and done, you just can't compare a Google search or a forum plea to a medical degree Especially when you're throwing out the diagnosis of severe bilateral foraminal stenosis with weakness and tingling, etc

Best of luck to you both!

 

[william bad butt]

Ricky, much obliged. Thx for the response.