Numb Hands

Tagged: bilateral tingling arms (paresthesias)

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derekc
Participant

September 19, 2016 at 1:10 pm

Post count: 6

#23008

Hello Dr. Corenman,

Has been a while since I last queried you, but here I am. Two things have happened since last we spoke. An MRI of my cervical spine shows no major issues, and a nerve test shows CTS which accounts for the hands symptoms. I am scheduled to have the CTS procedure later in the week.

But other persistent/worsening symptoms are increasing the misery index. When I look down (let my head hang forward) I get electric shock all over my torso from the waist up. It runs down the inside of my arms, makes my hands hurt. So I don’t look down, stay rigid. Part of this pain is clenching of my gut as if sucking in my stomach. My HMO sent me to a pain specialist who sent me to neurologist who did painful nerve test to diagnose CTS, all good. I was also sent to a physiatry? specialist who looked worried and referred me to my neurosurgeon who is a busy man and will not be able to see me for a month.

In the interim the waist-up shocks are more painful and now my abdomen is clenching like I’ve done a 100 crunches, over and over again. One last bit: part of my blood work showed hypothyroid so I’m taking a generic thyroid med. Part of me is freaking from the chronic pain, and part of me is aware that the doctors always ask if I suffered a bowel incident. That this is causing abdominal pain for over a week is preying on my mind. Lastly is fatigue and pain/nausea upon waking. Most days I need a nap by 1pm and most mornings I wake with my feet and leg joints aching, and sick to my stomach. Part of me thinks maybe the med is twisting up my guts. There’s also the hot flashes and waking in the middle of the night.

Feel like I’m losing my mind. Wondering if I should complain about the gut-wrenching abdominal pain?

Donald Corenman, MD, DC
Moderator

September 26, 2016 at 12:03 pm

Post count: 8660

#23077

Shocks in the upper extremities as well as the torso could be from cord compression (Lhermitte’s sign) but also could be from another problem unrelated to your neck. If the MRI noted no evidence of cord compression (or cord draping due to increased kyphosis) then the spinal cord is not the source of the electrical shocks.

Hypothyroidism interestingly can cause CTS (but this is unusual). Fatigue and nausea upon waking is not related to spinal problems (reactive depression can however triggered by spinal problems). I am unaware of hypothyroid meds causing GI upset.

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.

derekc
Participant

September 26, 2016 at 12:58 pm

Post count: 6

#23079

Thank you for the response. My neurosurgeon has ordered a CT scan and a bone scan. One of the many specialists I’ve seen suggested that there might be structural integrity issues that only appear when I allow my head to droop forward. I will keep you posted when I find out more. Was asked to submit to an xray with my head in the pain inducing posture, the symptoms persisted for days, really took it out of me.

On the issue of my abdomen, the pain is from the muscle spasms which arrive with the shocks, like a leftover switch left on, the muscles just tighten and tighten, as if with a mind of their own. Went to an urgent care, got an ultrasound, nothing wrong with me, disheartening, but nice to know no gall bladder or such. Bowels work fine, nothing wrong there.

Lastly, went to the CTS specialist, so minor that all I need is small cortisone shot in the wrist. Again, no big deal, no way it’s the cause of the distress I’m under. Sorry to spew at you, but it seems to help.

Hope you have a great day.

Donald Corenman, MD, DC
Moderator

September 27, 2016 at 7:50 am

Post count: 8660

#23083

The simple way to understand structural issues with motion (instability) is to take simple standing X-rays with flexion/extension views. I am unclear what a bone scan can reveal but the CT might be helpful.

An injection for CTS is a good way to start but if the symptoms continue, you might need a surgical release of the carpel tunnel.

I am unclear as to what the source of your abdominal muscle spasms are from.

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.

derekc
Participant

October 13, 2016 at 1:22 pm

Post count: 6

#23198

Thought I’d check in to say my surgeon says my symptoms are Lhermitte’s sign and that a ridge of bone has developed between the fusion and my spinal cord, when I lower my head it pokes into the cord. His recommendation (after noting he’d not seen anything like it before) is to remove the PEAK piece and then replace the fusion and the cage after removing the bone spur/ridge. He mentioned a dorsal laminectomy as an option but said it was more invasive. Wondered what you thought of this? Anyway, I am again glad you are out there as a sounding board.

Donald Corenman, MD, DC
Moderator

October 14, 2016 at 5:52 am

Post count: 8660

#23199

If you have a kyphosis (forward angulation) and a significant spur projection from the fusion, this can certainly cause cord compression with neck flexion. Your symptoms could then be related to this condition and an osteotomy (removal of the prior fusion, removal of this spur and re fusion) would be the path to take. A posterior decompression will not decompress the cord as the spur is anterior

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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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