[ozzyleven]

I posted on here awhile back looking for advice on how to deal with hand tingling/numbness/pain caused by a cervical herniation caused by a car wreck in March. After being bounced around between several doctors and a terrible neurologist (not terrible knowledge, just zero people skills), I have finally landed in the hands of a spine specialist that I like. She brought my MRI to a surgeon who said I'm very borderline on the nerve impingement and its a hard call for surgery. The spine lady says she hates the surgeries personally and for my age, 24, she thinks it might cause more harm in the long run.

The herniations are at C5/6 and to a lesser degree C4/5. I've been in physical therapy since May, so 2+ months. All muscle tension and surface neck pain is gone. I've gotten some strength back in my right hand, but my thumb and pointer still have little. The PT is ending soon and I really feel like we have hit a wall there. I know the stretches/exercises, etc. and do those at home. The pain/tingling just hasn't changed much at all, most days its a 7 for pain and some mornings I wake up and it feels like a 10 until the meds kick in. The spine lady put me on Gabapentrin about 4 weeks ago and some days it seems like it helps a handful of days, but usually not. Mostly it just kind of keeps me in a fog. I also got a TENS unit a few weeks ago and that helps while using it, but the relief is extremely short lived. I was told to mull over the thought of spinal injections.

I was wondering what others experiences were with injections? The spine lady scared the crap out of me when explaining the potential risks and it didn't help when she jabbed her pen into the spine model, yikes! I'm getting desperate for some relief, but don't want to go through with them if they don't help at all.

[Dr. Smith]

Hi Ozzy,

Unfortunately, regardless of others' experiences, it's like investing -- "past performance is no guarantee of future results".

IMO, you've got two doctors, one of whom you like, that seem to be (my impression) hinting as strongly as they can against surgery. There are some good reasons for this.

PT doesn't have to end when the visits do. I'm still doing exercises I learned there years ago, because they still help some. There are also still other therapies to investigate/try. I got/get a lot out of myofascial trigger point therapy. Other folks have gotten results from biofeedback/self-hypnosis, accupuncture, changes in lifestyle, and other therapies -- in and/or out of pain management, which may be where you're headed. Even diet can have some effect.

Since each patient and their spine is different, it can take some time to find the right combination of therapies for you. Keeping a journal helps; the memory can cloud (especially under some of the meds we get put on) when it comes to recalling what helped and what didn't, and the details/impressions at the time.

I think what's most important is to keep trying, keep learning researching, and keep communicating with your support network -- doctors, family, friends, here, elsewhere.

Doc

[redframes]

Hi there Ozzy,
I'm also sorry you are experiencing so much pain. I'll fill you in on what happened and is still happening for me, although you need to remember that what has or hasn't worked for me is me specific.
About a month or so ago I woke up, sat up and then turned back to get something off the bedside table. I felt a spasm/pain in my neck and then that was it. Very rapidly I developed radicular pain all down my right shoulder, arm, hand and tingling in my fingers. Initially I tried to stick it out and just rest for three days. It didn't help. I went to the chiro who x-rayed my neck and commenced treatment. The second day into my treatment I drove in excruciating pain to work (a one hour drive). I got there only to lose it and break into tears in front of the deputy principal (I'm a teacher). I went straight back to my chiro and got him to write a letter to explain my need for pain medication and I finally got an appointment to see a new gp on Friday. I was lucky... This gp happened to be keenly interested in spinal and sports injuries. He read the letter after talking to me and sent me to have an urgent ct scan. I was given pain medication and my results were degenerative damage, a bulging discs at c5/6 and nerve impingements at 6 with at smaller bulge just below. Her referred me to a pain management specialist who he trusted and I saw this doctor on tuesday. He scheduled me in on the same day for a cortisone epidural. The procedure didn't hurt at all as I was put out to it and immediately afterwards I still felt a lot of pain. Over theft couple of weeks the radiating pain subsided, but aching in my shoulder and arm persisted. Every time I sat down to drive pain would shoot up my arm. Every time I do anything I felt pain and got pins and needles in my thumb and fingers. I'm now on lyrica to help with the aching (reflective pain), which has helped. I still get some pain and definitely get just as many pins and needles when I sit, bend or reach. I had a MRI on Friday and saw the pain specialist on Tuesday. I've been referred to see a surgeon, who I'll see in two weeks. Next week I'll have a 2nd epidural to try and help with the pain and pins and needles from the impingement, until I get the surgeons opinion and possible surgery. My gp insists on me getting a second opinion re surgery if that is what is suggested.
So there you go. I'm sick of lying down... I now also have lower back pain, which isn't uncommon from c5/6 issues, apparently. Living in constant pain is draining, as I'm sure you know. Having to sleep on my back is challenging. Thankfully the lyrica can cause drowsiness so some nights I get some decent sleep now. But only some.
Hope you're feeling much better by now,
Wendy

[Leesa]

Personally I HATE the Gabapentin, and I don't think it works as well as it should. My doc took me off it because of the brain fog and because of the water retention and the weight I gained because of the water retention.

He put me on Topamax, 200mg twice a day, and it works GREAT! The burning & tingling are GONE completely, there are NO zaps, there is no feeling of "water running down my legs" like there used to be, there's NO symptoms at all!!! In fact I've not had to have my dosage changed in several years! Now I KNOW I still have the nerve problem because I ran out of the Topamax a while back, and without it, I had the burning/tingling, etc., so the problem is still there. This medication is just great! Also, I LOST weight on it -- I lost ALL the water retention weight, plus an additional 10lbs which I needed to lose anyway. LOL And I have NO brain fog at all, and everyone I've talked to who is on it, says they have no brain fog either. So why not ask your doc about putting you on this? I think it's 3 times better than Gabapentin!!! I don't know why they keep using it.

Just thought I'd suggest it. I hope your doc agrees. God bless and take care. Hugs, Lee

[Dr. Smith]

Originally Posted by Leesa

I think [Topamax is] 3 times better than Gabapentin!!! I don't know why they keep using it.

My SWAG would be the numbers of people for whom the side effects of Topamax are intolerable. I learned from my experiences with IBD that very often any particular medication/treatment only works for a portion of patients, and since there's no way to tell in advance, we're stuck with being guinea pigs to find out which one(s) will work (best) for each of us.

For some gabapentin works fine. For others like you, gabapentin is horrible, but Lyrica or Topamax may work. For some, like me, none of them work, or the side effects of each/all are intolerable.

It'd be nice if one medication worked well for eveyone without intolerable side effects, but it'd be even nicer if we all had our health, no pain, and were all rich...

Doc