cybermarc

To me the double crush wrist-neck hypothesis made sense because I was first symptomatic 3 years ago in my wrists, I assumed from intensive computer use on job and at home. That then migrated up into my arms while working a farm job (and also sustained computer use.) And finally settled in neck as well.

When I said “pain going from my neck down into my hands” I didn’t mean it always goes in that direction. It can also start in my hands/wrist/forearms and travel up. It seems to go both ways.

I’m a bit daunted by the number of tests possible for something like this. The nerve conductivity tests seem only to check one nerve pathway (median nerve at wrist is what I have ordered, I believe.) What about ulnar at wrist, cubital, orbital, etc?

If this is an issue of double crush/multiple nerve impingements, I want to catch that before going into another surgery (partially because if I do need carpal tunnel release, I could have done that at the same time as my ACDF instead of now looking at waiting for another 2-3 surgeries to happen [both hands separately and possibly 2nd ACDF on adjacent level] before getting relief and being able to work/function.) Any advice on best route of diagnostic testing for nerve impingements? My surgeon says he trusts EMG for wrists but doesnt put much stock in it for neck because the muscles are so dense and so much is going on there.

Ext/Flex Xrays showed fusion progressing and no problems with the graft.

I am now again experiencing the full pain and tingling/numbness of my worst symptoms from before surgery, extending from neck down both arms and into hands. My doctor has suggested the possibility of carpal tunnel and double crush syndrome. This would make sense, as my symptoms started 3 years ago in the wrist from computer use, before progressing up forearm, bicep, and then to neck last.

I have an EMG scheduled for both wrists in a couple weeks, but I am wondering if that may, again, be trying to isolate the problem at one location and then miss the bigger picture. Just watched a video on double crush that pointed out it can come from a combination of a number of locations, including ulnar nerve entrapment sites, thoracic outlet, etc. My surgeon has already told me he doesn’t believe thoracic outlet syndrome is a real thing…which scares me that diagnostic testing might be just paying attention to the most popular sites like the median nerve at carpal tunnel.

He also suggested the possibility that it’s my C6-C7. My previous MRIs showed some disc degeneration there, but nothing like the C5-6 that I had removed/fused. We will look into diagnostic steroid or nerve block to investigate if that level is causing the pain/weakness. Would you recommend nerve block over the steroids for that?

I suppose I should also note that the surgery is on my right side, and so is the shoulderblade pain I’m having.