Thanks for coming to my aid again Genntaj. I think, when I learned about these two MRI resukts a week ago I was overwhelmed by a feeling of relief that, just possibly, surgical decompression might resolve my most disabling issues.
I guess it’s pretty natural to clutch at straws
But what I’ve started to appreciate is that it’s much more likely that the SFN is the major player for me. My pragmatic reasoning is that my issues are all bilateral whereas most of the radiculpathy is on my left side at both ends of my spine. Also my EMG/ NCS was only done 2 years ago and the young neuro physio noted the sensation of of arm weakness and leg I described, which I’ve suffered increasingly from for at least 7 years now. She made a real effort to try and measure signals in my nerves and muscles but found exceptionally healthy responses in each test she ran.
She was very surprised to find such healthy responses, having heard my account of these symptoms, and seen my discomfort for herself. I carry a soft pillow for resting my arms on during long journeys or at the cinema and hotel stays. I carry a fold out fisherman’s seat stick with me for if I need to queue or stand still or attend any functions. And yet my parasthesia predates the EMGs and has been getting steadily worse for a few years now. I am therefore forced to admit that it’s unlikely to be due to mechanical problems. But as you say I do realise that these can often co-exist and I think the spinal issues are increasingly contributing to my inflammatory poly SFN.
PS I call it inflammatory because my always elevated CRP fluctuates according to how much pain the SFN is causing. I know that a lot of the numbness and tingle is damage which has already occurred, so I would be very sceptical if a neuro surgeon told me that they thought surgical intervention was a good option for me to consider.
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Originally Posted by glenntaj
--come from compromise of nerve roots in the spine, if it is severe enough, one would expect something to show on EMG/NCS--and if that testing was done all up and down the arms and into the neck and shoulder, it may be determinable just where the compromise is coming from.
Spine problems that produce symptoms will usually produce evidence that goes all the way back to the spine, although you may notice it more peripherally. More peripheral problems will show up at and below the area of compromise.
Of course, small fiber problems don't show up on EMG/NCS at all; those nerve are just to small and narrow to be targeted by the currently available technology, which is why quantitative sensory testing, sudomotor testing, and skin biopsies are used to try to determine that.
And, remember, you could have both. I certainly do, and so do many others. In my case, though, the symptoms caused by each tend to be fairly distinct, and in the case of the spinal problems along clearly recognizable body regions--the dermatomes connected to the nerve root levels compromised. But, admittedly, it can be difficult to tease out just what is causing what, as the symptoms CAN feel exactly the same.
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