You are here:

Physical Rehabilitation Medicine/PT for pinched nerve, cervical radiculopathy

Advertisement


Question
Two months ago I sustained a cervical spine injury I believe from doing a yoga pose (shoulderstand into plow).  I am 51 and normally in excellent shape.

I had pain for 2-3 weeks through the shoulder, down the right arm and into the fingers.  Pain is gone and I am left with a weak triceps (right) and numb right index finger.  My right hand is somewhat crampy.  Some numbness along the middle finger inside. I had an MRI that showed bulging discs and narrowing of the neuroforamen at C6 (amongst other things).

Was told by a neurologist today (who I very much trust and respect) that I will  require surgery to decompress the nerve (most likely an ACDF).  He also said there is no guarantee that the weakness will improve. this is very concerning as this is my right arm.  My neurosurgery appointment is in 2 weeks.

I was hoping to recover with PT/cervical traction and have had one visit where the PT said he used manual traction with little response on my symptoms.  I'm really worried about having surgery. Have you seen people with significant muscle weakness recover without surgery?  I was told I need to have surgery sooner rather than later.

thanks!

Answer
Dear Susan,
I will give you 2 answers.  

One, I rarely see someone who has weakness due to nerve compression so I don't have a large pool of clinical experience with the motor component of nerve impingement.

Two, I often see people with the sensory component giving pain.  These patients often have the pain resolve and avoid surgery.

Have you been tried on a strong course of anti-inflammatant medication?  Here are two options both worth exploring along with continued PT.
Oral Prednisone.  Secondly one or more spinal epidurals is less involved than surgery.

If you were doing fairly well prior to the yoga overload on your neck you may be able to get back to that without surgery.  The weakness is a clear concern.  Discuss these other options with your surgeon.

Good luck.  Please feel free to write me back and let me know  what you tried and how it worked.

Rachel

Physical Rehabilitation Medicine

All Answers


Answers by Expert:


Ask Experts

Volunteer


Rachel Katz, PT, SEP

Expertise

I have expertise working with recovery from car accidents, RSD/CRPS, neck and back pain and chronic pain. I can answer questions about pain that is not responding to expected patterns of recovery. I can address pain issues that are associated with traumatic events, and veteran associated pain issues. If you have had abuse or periods of significant stress in your life, your pain issues may be more complicated. I authored A Consumer Guide for Recovery from Car Accidents which discusses many aspects of injury recovery as all as specific detail about PTSD, traumatic brain injury, and protective involuntary muscle spasm. The link is: http://mindbodyphysicaltherapy.com/car-accident/ I can't answer questions regarding pain medications, or some specifics related to surgical interventions.

Experience

I have over 30 years experience as a Physical Therapy clinician. I taught swimming in Michigan and skiing in Aspen. I have experience in analyzing movement patterns and muscle control. I treat all areas of pain in the body including headaches, neck pain, back pain, shoulder injuries, plantar fasciitis, nerve compression, and knee pain. I have had personal experience with chronic pain, RSD, car accident injuries, PTSD, and traumatic brain injury (TBI). Muscle spasm and pain is a common component of injury and response to traumatic stress. Posture patterns and habits of how your body is often used can also contribute to pain. Restoration of movement and the senses that enable you to feel it are key. Rachel developed and implemented a stress reduction program for inmates within the Boulder County jail's drug and alcohol recovery program in 2005-2006 based on trauma healing principles from Dr. Peter Levine.

Education/Credentials
Rachel holds a BS in PT from the University of Colorado Health Sciences Center. She has over 30 years experience as a clinician. She has over 1500 hours of post graduate continuing education in many Manual Therapy and Exercise approaches. She completed her training in Somatic Experiencing under Dr. Peter Levine in 2000. This 3 year program trains therapists in treating traumatic stress conditions. Rachel has developed a body of work integrating her training and unique insights into complex pain issues. She is the developer and instructor for Sensory-Motor Manual Therapy, which is a State approved 2 day work shop for Massage Therapists through the Boulder College of Massage Therapy.

©2016 About.com. All rights reserved.