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  • joeyl328
    Member
    Post count: 2

    Hello, I have an acute disc herniation at C6/7 (moderate in the MRI report) with left paracentral and left lateral disc protrusion that impinges on the descending left sided nerve root and cause moderate left sided neural formaen stenosis and exiting left nerve root impingement. It has been 8 weeks since the injury. I am taking Gabapentin for nerve pain 3x a day, and Percocet as needed. The pain is now constant but 4/10 sometimes up to 7/10. It began as constant 8/10. I have noticed atrophy in my left forearm and tricep. When I compare to my right, I notice a 1″ difference in circumference in the left forearm compared to the right and a 1.5″ difference in the tricep. I also have noticed some left shoulder instability, when I bring my arms together and push my shoulders back, I feel a “clunking” in the posterior left shoulder. I have tingling in my left index finger and occasionally in my middle finger. I have pain that moves around from posterior shoulder, to the outside elbow to the back of the hand. The worst pain when it is present is just to the middle of the tip of the shoulderblade, in fact that is where the pain began, I can’t sleep on my back and not at all in my bed, so I have been sleeping on my right side on the couch (my wife and I are getting tired of that for sure). I am getting a cortisone injection in a few days and am going to schedule surgery. I am concerned with the atrophy in such a short time and the instability of my shoulder. But when I look up C6/7 (and c7 nerve root), it doesn’t innervate the posterior shoulder, so I am worried about maybe having 2 injuries? The problem started while doing pull-ups 8 weeks ago. So a few questions:
    1) what do you think of ADR (I am 36 and healty, 176lbs, no illnesses, don’t smoke)
    2)can c6/7 cause these symptoms (shoulder atrophy, tricep atrophy, etc)
    3) I have read surgery won’t increase my strength any faster than waiting, but wouldn’t surgery help decrease the atrophy that is currently happening?
    4) THANK YOU!!!

    joeyl328
    Member
    Post count: 2

    one more quick question: If I wasn’t taking gabapentin, would it be safe to assume the “tingles” that I feel in my arm would be more painful than tingles?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You have a left disc hernation at C6-7 that is compressing the exiting nerve root (C7 nerve). You have all the typical symptoms (pain, paresthesias, numbness) and also weakness. The weakness is the one symptom that really concerns me.

    The other symptoms can resolve over time but the weakness can be permanent. It is true that cervical nerves recover from weakness better than lumbar nerves and the C7 nerve has a good record of recovery. Nonetheless, if the weakness is significant or atrophy occurs, I give my patients only 6 weeks to see if the nerve will recover without surgery.

    If in this 6 week period there is no significant recovery, surgery is recommended to give the nerve the best chance of recovery. Atrophy is a sign of significant compression and would prompt me to consider surgery sooner than later.

    If this is a typical disc herniation with good disc height preservation (the disc is not significantly narrowed from years of degeneration), then you would be a candidate for an artificial disc replacement (ADR).

    WIthout Gabapentin (Neurontin), generally you would have greater nerve symptoms. This medication sometimes does not help symptoms but there is no way to know unless you stop taking it. For this medication, you cannot stop cold turkey but need to wean down slowly off.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Seth82
    Member
    Post count: 1

    Please tell me more abt your situation. I have those exact same symptoms except pain. I don’t hurt very much at all. I’ve had an MRI 7 weeks ago. Have been doing pt and 2 weeks ago my arm shrunk an inch. My doctor has scheduled another MRI for this coming week. I’m very nervous b/c my tricep has shrunk and my left pec is affected too. Any advice you have from your experience would be appreciated. I’m afraid surgery will be in my future and I really don’t want that.
    Thank you for your time

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Painless atrophy of the upper extremity can originate from a pinch nerve in the cervical spine but there are other syndromes that can also affect this. You cannot put your head in the sand and hope this will go away. You need to seek some medical advice soon. Atrophy is a serious sign and you need to address this.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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