Sore neck, numb fingers upon waking, tingling hands throughout the day,

Tagged: cervical radiculopathy vs thoracic outlet syndrome

Viewing 6 posts - 1 through 6 (of 6 total)

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departed
Participant

January 13, 2018 at 1:18 pm

Post count: 3

#27296

I am a healthy 33 year old male, who is very active. I exercise weights multiple times a week, and keep myself in good shape.

So far I’ve been told “sprained neck, and nerve root impingement”, what I don’t want to hear is surgery.

About a month ago I was going through some defensive tactics training and that night I woke up with neck pain, numb rink and pinky fingers on both hands, as well as some numb toes on my right side.

During the next week I noticed that my arm would fall asleep easily if held up on the wall.

I am currently on a 12 day course prednisone to “help reduce swelling.”
Since then I’ve been getting tingling and pins and needle feelings in my hands (fingers/palm) during the day, but my fingers have not been numb upon waking. It feels like the bottoms of my feet are tingling but I keep being told the systems are not connected.

Also I dont know if its related but my neck has began clicking from time to time (almost like the sound of fingernail clippers if I look to far to the side.

I have an MRI scheduled and here are the results of my X-ray:

IMPRESSION:

Degenerative disc disease and spondylosis at C5-6 and C6-7 with
moderate/severe left and mild/moderate right foraminal narrowing at
C5-6 and C6-7.

__________________________________________

Narrative
[HST]: Teaches high impact self defense class without specific trauma, but multiple neck jerking maneuvers, with three weeks of bilateral upper and lower extremity tingling affecting 4th/5th fingers, soles of feet and shins.

Examination: CERV 5 VIEW AP, LAT, ODON,2 OBL

History: three weeks of bilateral upper and lower extremity tingling affecting 4th/5th
fingers, soles of feet and shins.; R20.0-Anesthesia of skin,
R20.2-Paresthesia of skin, R29.898-Other symptoms and signs involving
the musculoskeletal system

Comparisons: None

Findings:
There is straightening of the normal cervical lordosis. Mild disc
space narrowing at C5-6 and C6-7 with degenerative endplate changes
and small marginal osteophytes, most pronounced at C5-6. No acute
fracture or subluxation. There is moderate/severe left and
mild/moderate right foraminal narrowing at C5-6 and C6-7.

Donald Corenman, MD, DC
Moderator

January 14, 2018 at 9:58 am

Post count: 8660

#27297

Your symptoms could be from cervical radiculopathy or thoracic outlet syndrome or both.”About a month ago I was going through some defensive tactics training and that night I woke up with neck pain, numb rink and pinky fingers on both hands, as well as some numb toes on my right side”.

You have foraminal stenosis of C5-6 and C6-7 which would affect the C6 and C7 nerves. (see https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/). This would cause symptoms into the thumb and middle fingers. Pinky sided symptoms would be more related to thoracic outlet syndrome. See
https://neckandback.com/conditions/thoracic-outlet-syndrome/.

During the next week I noticed that my arm would fall asleep easily if held up on the wall”. This also fits with thoracic outlet syndrome.

“Also I don’t know if its related but my neck has began clicking from time to time”. This fits with degenerative changes of the facets associated with degenerative disc disease of C5-7 (“Degenerative disc disease and spondylosis at C5-6 and C6-7 with moderate/severe left and mild/moderate right foraminal narrowing at C5-6 and C6-7”).

Also read https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/.

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.

departed
Participant

January 14, 2018 at 11:15 am

Post count: 3

#27301

Thank you for the response Dr.

So assuming all goes well with my treatment/recovery will jiu-jitsu, and heavy weight lifting still be an option in my future or has that ship sailed?

Donald Corenman, MD, DC
Moderator

January 14, 2018 at 8:34 pm

Post count: 8660

#27312

Whether you do or do not have surgery (as long as we are talking two levels only), you should be able to participate in Karate and wt lifting but I would reduce weights and do more reps to reduce neck stress.

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.

departed
Participant

January 29, 2018 at 7:25 pm

Post count: 3

#27426

Hello, I got my MRI results and my Dr. Said does not believe my symptoms are due to my stenosis but is referring my results to neurology for further evaluation. Does this still seem like cervical radiculopathy and or thoracic outlet?

Study Result
Impression
Impression:
Degenerative disc changes and trace degenerative retrolisthesis at
the C5-6 and C6-7 levels.

Moderate to severe bilateral foraminal stenosis at the C5-6 and C6-7
levels.

No significant central canal stenosis.

No acute bone, joint or soft tissue abnormality.

__________________________________________

Narrative
[HST]: NECK INJURY WITH UPPER EXTREMITY PARESTHESIAS PERSISTENT
neck trauma 12/5

Exam: MR cervical spine without contrast

History: NECK INJURY WITH UPPER EXTREMITY PARESTHESIAS PERSISTENT::
neck trauma 12/5

Comparison: X-ray 12/29/2017

Technique: The following MR sequences of the cervical spine were
performed without contrast:
Sagittal T1, T2, STIR, axial T2, GRE

Findings:

Straightening of the cervical lordosis and trace degenerative
retrolisthesis at the C5-6 and C6-7 levels again noted. No abnormal
bone marrow signal.

No Chiari malformation. Visualized posterior fossa is normal. No
cord signal abnormality. No significant facet joint arthropathy is
identified.

Axial morphology:
C2-C3: No disc herniation. No thecal sac or neural foraminal
narrowing.
C3-C4: No disc herniation. No thecal sac or neural foraminal
narrowing.
C4-C5: No disc herniation. No thecal sac or neural foraminal
narrowing.
C5-C6: Broad-based noncompressive disc protrusion. The central canal
is patent. Moderate to severe bilateral foraminal stenosis due to
disc and uncovertebral osteophyte.
C6-C7: Broad-based noncompressive disc protrusion. Central canal is
patent. Moderate to severe bilateral foraminal stenosis due to disc
and uncovertebral osteophyte.
C7-T1: No disc herniation. No thecal sac or neural foraminal
narrowing.

Donald Corenman, MD, DC
Moderator

February 2, 2018 at 7:52 am

Post count: 8660

#27448

Severe bilateral foraminal stenosis at C5-7 certainly can cause your current symptoms as well as thoracic outlet syndrome. If there is any question, the physical examination can help differentiate between the two. If there was still confusion, selective nerve root blocks at C5-6 and C6-7 with good temporary relief of pain will confirm the suspicion of radiculopathy.

The neurologist will perform an EMG to look for severe root compression which is fine but the physical examination generally will help to discern the disorder with just as much accuracy for radiculopathy. The EMG generally will not help to diagnose thoracic outlet syndrome.

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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