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Cervical radiculopathy/protruding disc in neck (Read 7031 times)

slab_happy

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Well, fuck.

As of about a fortnight ago, I have what's been diagnosed as cervical radiculopathy, caused by a bulging disc in my neck at C5/6. It came on very suddenly and I hadn't had any symptoms before.

Lots of pain in my left shoulder, especially at night, left thumb's gone pins and needles.

Currently on "wait and see", maybe a corticosteroid injection in a couple of weeks depending on how it's doing, doctor's orders not to even think about climbing in the immediate future.

Anyone had this sort of thing? Any tips/recommendations? Reassurance that it'll get better and I'll be able to get back to climbing again?

petekitso

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NNFN.

How far down the diagnosis route are you?

I developed exactly the same symptoms as you around the same time. It came on overnight, central site of pain is left shoulder,, numbness and pretty intense shooting pains in left arm and hand. Codeine having limited effect, cannot take anti-inflammatories for other reasons.

 My initial diagnosis was exactly the same as yours. I have since seen a physio and had more detailed consultation with the sports specialist doctor at my local GP. The current diagnosis is that my neck is fine and it is a badly strained rotator cuff which has compressed the nerve rather than a bulging disc. The strain happened a couple of weeks before (trying fast offset pullups) but was basically OK (a bit stiff) for a couple of weeks before it really went south . . .

Still a few weeks from doing anything strenuous and the pain is painful but it was reassuring to rule out any bulging disc issue. If you haven't already, may be worth seeing a good physio (I can recommend one in London).

slab_happy

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Already had an MRI (I lucked out and they had a last-minute cancellation, so I got fitted in early) and it's definitely a bulging disc; I got to see some mildly terrifying pictures of where stuff is getting squished.

(And my climbing was going really well! Fuuuuuuck.)

Sounds like physio may still be useful for it at some point, though, and I'm currently in London, so I'll gladly take your recommendation.

Hope you're on the mend soon!

petekitso

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Ah - sorry. I was hoping to be the bearer of good news there . . .

Hope it improves soon.

I will send you the physio details

Hydraulic Man

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Had the same a few years ago. Came on overnight and was very uncomfortable affecting my sleep amongst other things.

Did the Physio/Osteo thing but in hindsight and although it did give slight relief that was a waste of time.

Had MRI, saw Sports Doctor and Epidiural injection and was back climbing 6 weeks later.

Hope it works out for you as it can be a debilitating injury.

webbo

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I was diagnosed with a bulging disc in my neck 25 years ago. I had physio, osteopathy, mri scan and saw the Neurologist who said the only thing that might work would be surgery. However he thought it was a bit too risky, so it was a case of just see how it goes.
My right traps used to go into spasm and standing at the bottom of the crag belaying was incredibly painful. In the end after several periods of rest from climbing, the building back up only for the pain to reoccur, I gave up climbing. Started cycling again with no problems, then after about 5 years started bouldering again with no real issues.
Nowadays I get a bit of stiffness and pain occasionally  but nothing that stops me climbing.

sheavi

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I've treated enough of these symptoms to advise that it's usually a case of it will get better in 6-12 weeks with advice and exercises with appropriate pain medication.  Just monitor your symptoms for any worsening neurological issues - weakness, numbness etc.  Be aware of MRI shortcomings.  Disc bulges/protrusions are very common in the asymptomatic population above the age of 25.   Seems a bit early to be discussing injections I'd say.

Move as much as is comfortable.  Try not to get freaked out by the MRI. Nerve pain is usually worse at night. If your sleep is disturbed amitriptyline can certainly help.  Where are you based?
« Last Edit: October 02, 2019, 01:38:08 pm by sheavi »

slab_happy

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Where are you based?

About half the time in London, half near Hathersage (long story).

I'm already on a fun cocktail of psychiatric meds, and have a track record of freak bad reactions to meds (to the point where my doctors are highly averse to using any medication I've not been on before), so amitriptyline's out.

With a lot of strategic propping with pillows, it seems to be possible to find a minimal-pain position to go to sleep, but I get woken early with really bad pain.

So I'm now getting a decent amount of sleep overall, but could do without the searing pain at 5am -- if anyone's got any tips on that, I'd be eternally grateful.

Hydraulic Man

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I know I had terrible pain in the night and had no way of getting comfortable.....Before I had the injection I was prescribed Tramadol...That certainly got rid of the pain but made me feel wired to the Moon and I dont mean the pub.

Needless to say I didn't take them for long.....

sheavi

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It's probably a sensible idea to see a good physio or osteopath.  I can recommend someone around Hathersage or Sheffield if you're interested. Best wishes

Where are you based?

About half the time in London, half near Hathersage (long story).

I'm already on a fun cocktail of psychiatric meds, and have a track record of freak bad reactions to meds (to the point where my doctors are highly averse to using any medication I've not been on before), so amitriptyline's out.

With a lot of strategic propping with pillows, it seems to be possible to find a minimal-pain position to go to sleep, but I get woken early with really bad pain.

So I'm now getting a decent amount of sleep overall, but could do without the searing pain at 5am -- if anyone's got any tips on that, I'd be eternally grateful.

duncan

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I’ve had lots of professional experience with people with neck radiculopathy and distant personal experience of low back radiculopathy. It’s quite worrying and very frustrating.
Like sheavi, I’m not always convinced that MR! scans are totally helpful but you've had one and the good news is it has not shown any really nasty pathology like a tumour or spinal cord compression.

The usual course of radiculopathy, as sheavi says and in my direct experience, is it slowly improves but with ups and downs on the way. My back and leg was so painful that I was crawling to the toilet for the first couple of days. I was back to work after three weeks, gradually recovered, and am now no more prone to back ache than anyone else my age. It had no long-term impact on my climbing. 

The night or early morning pain you describe is very common: when you’re not moving and your circulation slows discs swell a little, a bit like ankles swelling during a long flight. As well as experimenting with pillows, as you have done, you could try a deliberate break in your sleep, getting up and pottering around for a little while before going back to sleep again.

Nerve pain is notoriously hard to help with prescription medicines and it sounds like this is something to be discussed with your GP/consultant. Some people find heat or cold helpful.

Factors known to make recovery slower are: resting completely, being depressed, withdrawing socially or from work, being very scared by what is happening, and expecting someone else to provide a complete fix. It is completely normal and rational to feel, think, or behave like this to some extent, but an excessive amount is unhelpful. I realise some of these factors are not within your power, like being depressed or being excluded by your work, but being aware they could be an issue and watching out for them can be helpful. Try to look after yourself as a whole person, not just your neck.  Some people can do this by themselves, many people find a supportive (physio)therapist helpful.   

Good luck.

slab_happy

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As well as experimenting with pillows, as you have done, you could try a deliberate break in your sleep, getting up and pottering around for a little while before going back to sleep again.

Good tip, thanks.  That seems to be helping (along with taking slow-release ibuprofen before bed).

slab_happy

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I'd also appreciate any tips anyone's got on forms of training/exercise that are unlikely to aggravate the radiculopathy.

The consultant says no pressure on my neck (obviously), nothing with impact/jarring (obviously), otherwise anything that doesn't hurt is okay.

At the moment, though, finding out what's going to hurt is purely trial-and-error, so if anyone's got any leads, I would be super-grateful.

petekitso

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[shameless bid for free advice coming up]

Having been around the houses with medical advice on this, I seem to be back where I started and am finding it pretty hard going.  I was struck by Duncan's advice above that expecting someone else to have the answers is unhelpful so am trying to understand what's going on. It is perhaps ironic then that I am asking for advice on an internet forum but . . .

I think that a diagnosis of cervical radiculopathy means just that the nerve root is inflamed or impeded existing the spine but does not offer a diagnosis of the cause of that inflammation or impediment.

I think possible underlying causes include a bulging disc or degenerative changes in the spine. In my case, I am working with the hypothesis (possibly optimistic) that because there was an immediate 'pop' in my neck it's likely to be a disc issue.

I think a scan is the only way of confirming that hypothesis and ruling out the potential other causes.

Free advice welcome . . .



largeruk

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I’ve had lots of professional experience with people with neck radiculopathy and distant personal experience of low back radiculopathy. It’s quite worrying and very frustrating.
Like sheavi, I’m not always convinced that MR! scans are totally helpful but you've had one and the good news is it has not shown any really nasty pathology like a tumour or spinal cord compression.

The usual course of radiculopathy, as sheavi says and in my direct experience, is it slowly improves but with ups and downs on the way. My back and leg was so painful that I was crawling to the toilet for the first couple of days. I was back to work after three weeks, gradually recovered, and am now no more prone to back ache than anyone else my age. It had no long-term impact on my climbing. 

The night or early morning pain you describe is very common: when you’re not moving and your circulation slows discs swell a little, a bit like ankles swelling during a long flight. As well as experimenting with pillows, as you have done, you could try a deliberate break in your sleep, getting up and pottering around for a little while before going back to sleep again.

Nerve pain is notoriously hard to help with prescription medicines and it sounds like this is something to be discussed with your GP/consultant. Some people find heat or cold helpful.

Factors known to make recovery slower are: resting completely, being depressed, withdrawing socially or from work, being very scared by what is happening, and expecting someone else to provide a complete fix. It is completely normal and rational to feel, think, or behave like this to some extent, but an excessive amount is unhelpful. I realise some of these factors are not within your power, like being depressed or being excluded by your work, but being aware they could be an issue and watching out for them can be helpful. Try to look after yourself as a whole person, not just your neck.  Some people can do this by themselves, many people find a supportive (physio)therapist helpful.   

Good luck.
As someone who's suffered from pretty gruesome nerve pain due to an inflamed nerve exiting from C5/6 for nearly 9 months, I'd agree with pretty much everything Duncan has said & suggested in his post.

I've had drugs, physio, osteo and acupuncture with varying degrees of success, have avoided most activity that hurt - to little discernible effect, and have done exercise that hurts on advice that it would eventually help.

It has - slowly - got better over time and, in my case, I think doing exercises that activate and engage the muscles around and along the C6 nerve to strengthen and mobilise the muscles groups around the affected areas has helped. But it may have got progressively better anyway just with the passing of time and, as always, YMMV.

Persevere, take advice from a decent physio, don't give up and try not to become too despondent - I don't need to tell anyone here how debilitating, dispiriting and exhausting constant nerve pain can be.

Great and good luck.

petekitso

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Thanks for the reply.

Nine months sounds pretty terrible but I am going to try and focus on the ‘gradual improvement’ bit. The main issues for me at the moment are weakness and numbness in the arm and not sleeping more than a couple of hours at a time. For you, was that nine months a gradual improvement in those other symptoms alongside reducing pain?

largeruk

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Thanks for the reply.

Nine months sounds pretty terrible but I am going to try and focus on the ‘gradual improvement’ bit. The main issues for me at the moment are weakness and numbness in the arm and not sleeping more than a couple of hours at a time. For you, was that nine months a gradual improvement in those other symptoms alongside reducing pain?
To be honest, it was not linear. At all! For the first 4-5 months, the weakness, numbness and pain in the neck, shoulder and arm etc was fairly constant and pretty severe - that's when I did most drugs and physical therapies. For the last 4-5 months, for a variety of reasons, I've done hardly any treatments - either pharmacological or physical - and have just continued with variants of exercises given to me by the physio.

Slowly - often almost imperceptibly - there's been a gradual improvement in feeling, strength & mobility with a slow reduction in pain (really only measurable over a long period of time) but, as Duncan said, it's not always an easy gig with some periods where you feel yourself regressing, treading water or even getting much worse again. Currently going through a 'treading water' phase.

Having said all that, I've seen enough professionals and learnt enough to know that my case is def. not the norm. For most people, it seems that it shouldn't be more than a few weeks before things improve - sometimes just by themselves, sometimes requiring some intervention. Sometimes a combination of both help.

An MRI scan seems to me like a sensible investigatory/diagnostic first step (with all the caveats about the limitations of such scans). From reading your earlier posts, it seems you already know a good physio - perhaps think about using her/him to help you determine what works best for you to effect a recovery. You WILL get there!

slab_happy

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You getting pain when you lie down, then getting woken up after a few hours because the pain's got even worse?

FWIW, what's currently working for me is an elaborate and ridiculous system involving two armchair cushions and a rolled up duvet so I'm sleeping with my back propped on a flat incline (and my neck in line, chin slightly tucked), with pillows to either side so my shoulders get a bit of side support (don't know why this makes a difference but it does). And a bolster under my knees because otherwise sleeping on my back gives me lower back ache.

Took a lot of trial and error to figure out what works for me but I can now sleep through the night and wake up not in pain, woohoo. Just getting enough sleep is making a huge difference to my wellbeing.

petekitso

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Thanks again - really much appreciated

I am still at the experimenting with pillows stage but haven't strung more than a couple of hours together as yet . . . I will try and think more creatively (and have a scan).

ianabbot

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Sorry, bit late to this thread.

I had similar (can’t remember if it was C5/6, but that rings a bell). I suspect mine was DIY triggered; fitting a suspended ceiling in our shower room - confined space and lots of craning my neck back. Initially the symptoms (pain down left arm, numb fingers) actually got worse over a fortnight or so. I was warned that my scan might not show anything, but (caveat: uninformed layperson’s perspective) there was a really obvious bulge in the disc. However, I do appreciate the comments from professional practitioners above that thousands of people have similar bulging discs which are completely asymptomatic.

You all have my sympathies regarding the sleep disruption. I put a dining chair by the bed, with a pillow on it – that way I could rest my (straight) arm at right angles to my body, which helped at night. When it was at its worst, I had a night time routine of 30 mins ‘sleep’ followed by 15 mins sitting upright on aforementioned chair by bed, then 15 mins walking around the house, repeat. Thankfully that improved! Another thing that helped during the day was lying on the floor (on my back) with head propped on pillow and arm out to side, rather than sitting on the sofa (which immediately prompted the arm pain/tingling/numbness).

The consultant I saw also considered surgery, but said it was hit and miss and carried some risks. I ended up just waiting it out on Gabapentin (which I think probably helped, but made me feel horribly fuzzy and uncomfortable mentally). Physio was initially frustrating – I had three abortive appointments which required a huge effort to get there, only to be told the arm/shouder/neck were too sensitive to do anything. Ultimately I did get some exercises to do (lie on back on floor, rotate onto side and extend arm to reach progressively further in front of body) which seemed to help. A couple of times out of frustration I tried things that were probably ill-advised (hangs from fingerboard, toe-touch stretches) which resulted in a jolt a bit like an electric fence.

It took about 4 months before things felt back to normal, and it’s now completely better. The only thing that still triggers twinges is craning my head backwards too far– I get numbness and pins and needles. I just boulder (which is completely unaffected), but I would guess head position in prolonged belaying might cause problems.

slab_happy

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I can confirm duncan's suggestion that if you get woken up by pain, it can help to get up and stand or sit for a bit, before trying lying down again. Also it's less soul-destroying than continuing to lie there in pain.

I bought a cheap cervical traction head harness thing-y and attached it to the pulley system under my fingerboard. 20 mins of gentle traction definitely makes my neck feel better.

A friend's wife had a herniation at C5/C6 that eventually required surgery, but she says she got a lot of benefit out of using a TENS unit in the evening, then falling asleep with an icepack under the painful bit (use your own judgement and don't get frostbite, disclaimer disclaimer).

slab_happy

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I just boulder (which is completely unaffected), but I would guess head position in prolonged belaying might cause problems.

Yeah, I've already invested in a pair of belay specs for whenever I get to return to climbing.

slab_happy

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I found this a really useful review of the literature and have been stealing physio exercises from it:

https://www.raynersmale.com/blog/2016/6/29/cervical-radiculopathy-part-3-physiotherapy-treatment

slab_happy

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Thanks again - really much appreciated

I am still at the experimenting with pillows stage but haven't strung more than a couple of hours together as yet . . . I will try and think more creatively (and have a scan).

Since we seem to be injury twins -- how's yours going?

petekitso

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Not great - I am definitely at the despair / withdrawal stage which Duncan warned about above . . .

Had a scan, shows 'large extrusion' at C6-7 impeding C7 root. Stopped doing physio exercises on GP advice but doing nothing with it doesn't seem to have helped either. There is probably a very limited improvement but left arm  feels very weak and is visibly withered. Am occasionally cycling to and from train station (about 15 mins each way) mainly through necessity but it does seem to make it worse. otherwise sitting up straight and 'brisk' walking is my limit. Currently wondering whether to spend £900 on a month's spinal decompression therapy which an Osteopath has recommended.

Moan moan moan basically. How are you getting on?

 

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