MargoMemberJanuary 18, 2012 at 8:27 pmPost count: 12
Dear Dr Corenman,
Firstly I must say thank you for making yourself available for questions. I live in South Korea and cannot communicate with my doctor and even so through a friend interpreting I guess they just don’t tell the patient too much.
I had a numb pain in my left toe for a long time over two years when it got really bad I finally went to check it out. It is from a hyrniated disc pushing a nerve. Disc 5 and 6 in the lower back. I had this machine with 4 pads put on my back which vibrate on some nerves that helped a lot. After 3 months of that the radiating pain has completely gone but then about 2 weeeks ago I got this horrible numbness down the last fingers and side of palm on my left hand and a weakness down to my elbow. I was so afraid I did nerve damage, maybe by having that machine on a little too high I thought. The orthopedic said not to worry and this from a cervical disc also pushing on another nerve that he saw from xrays on the neck area. Well I tried not to worry but the numbness moved to my right hand again the last two fingers and side of the palm. The doctor seems still calm about it and did that pad machine thing on my neck area. I sleep very carefully on my back now with no pillow and a pillow under my knees. That made the numbeness go away but I’m still worried. Do you think I need to get an MRI. Wow they are so expensive but if you think I had better get one I will. Should I be worried? How serious is this? Now the pain in my toe is gone and also the numbness but I have to be so careful because it’s easy to come back if I bend my neck for reading or something for too long.
I look foward to hearing your advice.Donald Corenman, MD, DCModeratorJanuary 18, 2012 at 11:30 pmPost count: 8459
Your leg symptoms were from a herniated disc in the lower back. Without motor weakness, about 70% of patients will be able to avoid surgery with appropriate care. It sounds like you had an electrical muscle stimulator or interferential current device given to you for relief. I’m not sure if the machine itself gave you relief or just time but it seems you had a good outcome from that.
You then apparently developed a disc herniation in your neck with radiculopathy but without a thorough examination and an MRI- this is speculation. The machine did not cause this potential herniation.
You report that bending your neck will cause the toe pain and numbness to return. I am confused. Has your hand pain and numbness disappeared or is that also present?
One of the most important factors is the results of a carefully performed physical examination. Did your doctor perform a thorough physical examination? Do you have any motor weakness? Do you have any long tract signs? (See website under cervical radiculopathy and myelopathy).
Dr. CorenmanMargoMemberJanuary 20, 2012 at 12:10 amPost count: 12
Yes the numbness in my hands is gone. No bending my neck did not cause my toe pain what happened is that I started laying flat to care for my lower back but in doing that I would put two pillows under my head so I could read laying down. That is when my hand pain started. So I realized and I did not bend my neck like that again that is why the numbness stopped.
No my doctor did not give me a physical examination. The doctors here do not seem to be so concerned about being thorough. He seems convinced though that I really should not worry and I’d like to believe him because an MRI is soooo expensive.
How it stands the pain in my toe is very low now and the numbeness and weakness has gone but I am also aware the slightest wrong movement of either my neck or my lower back will bring the radiating pain back. Maybe I will cancel the MRI and if the numbness should come back then I will go ahead and proceed with the MRI. What do you think?Donald Corenman, MD, DCModeratorJanuary 20, 2012 at 12:34 amPost count: 8459
The bottom line is that if you can live with your symptoms, you have no significant weakness of any important motor group and there is nothing dangerous about the spine (instability or such)- then you don’t need surgery. Therefore, a full work-up is not necessary.
Now- if you want relief as you can’t live with the symptoms, then a work-up is necessary which includes a complete physical examination and imaging including an MRI. Treatment would be determined based upon the findings.
Dr. CorenmanMargoMemberJanuary 20, 2012 at 5:27 pmPost count: 12
thank you this is very helpful.
It sounds like I don’t need the MRI but I’m still worried about this numbness. I am sleeping the correct way on my back with a pillow underneath my knees and rolled up towel underneath my neck. However at different times I still get this numbness down my last two fingers to the side of the palm on my left hand. I don’t know what this coming from and I don’t know how to find out. This doctor has not suggested anything about a physical examination he just keeps saying not to worry. Do you know what this numbness could be coming from. Today as I was laying on a firm floor I wanted to see something on my computer so I lifted my little netbook computer to see it and held it up for some time when this numbness returned. This morning I slept on my side for an hour and it came back then too. The doctors just say it is from my neck cervical area or stress and not to worry but it feels strange to just ignore this numbness they do not make any suggestions to do a physical examination. I had to ask them to do the MRI but even after I get the results if I do it they will find nothing and just tell me not to worry but the numbness will not go away so I don’t know how to fix it.Donald Corenman, MD, DCModeratorJanuary 20, 2012 at 9:59 pmPost count: 8459
You are not being consistent reporting your symptoms. You reported that “Yes the numbness in my hands is gone” and then you just stated that you have numbness in your fingers. Numbness in the fingers could be anything from peripheral nerve compression (carpel tunnel syndrome or cubital tunnel syndrome) to cord compression (myelopathy- see website).
Again, a physical examination is needed and if you see any physician that tells you nothing is wrong without performing a physical examination- find another physician.
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