Pinched nerve in neck. Anyone else?

[Clancy]

A pinched nerve in my neck has kept me off the bike since January 1. Not fun, longest spell I’ve been off since I was 20, now 65.

Diagnosis is cervical radicuitis whatever that means. My understanding is that basically my discs are all shot and a bone spur is pressing on a nerve causing neck pain and numbness down the right arm. Only when I tilt my head back from vertical or tilt my head to the right.

Other symptoms were repeated migraines lasting 24-48 hours, 2-3 a week. That has been by far the worse. I can suffer on a bike, actually enjoy it. Migraines? Retreat to a darken room, curl up in a ball and retch uncontrollably. Not fun.

Nerve tests shows no nerve damage.

Epidural steroid injection gave me relief for 3-4 weeks but has worn off and now the pain is as severe as before. Thankfully the migraines have not returned. That may be the result of the epidural or a major change in my diet; I eliminated all forms of sugar, white flour, and heavily processed foods a month ago and have seen amazing improvements in my health - sleep, digestion, energy, etc.

Been religiously doing PT and traction daily. Sitting in a sauna or steam room and doing my neck stretches and strengthening exercises. The irony here is that other than my pinched nerve, with my daily exercises and new diet I’m in the best condition I’ve been in probably in the last 5 years. With that said, although the PT has greatly increased the flexibility and strength in my neck it has done nothing to calm down the pinched nerve. Tilting my head slightly back from vertical and wham.

Except for being off the bike. That has caused some major depression.

So now I’m looking at probable surgery, currently trying to get in to see a neck surgeon for a consultation. My family doc sent a referral to a surgeon that he trusts, surgeon reviewed my MRI and said I wasn’t a candidate (?) That put me in a dark depression for a day.

So now I’m sitting here wondering what to do. How does one find a surgeon these days? Seems as if it takes 6 weeks to get into see anyone but that’s only with a referral.

Orthopedic or a Neurosurgeon?

3 months of PT/traction, symptoms still persist. Do I give PT more time before looking at surgery?

Anyone been down this road? Suggestions/advice?

[Ken Robb]

I've had an arthritic neck for years so my position on a bike has become more upright. I think I will have to use pull-back bars like moustache or the like on any bikes I keep. If that would let you ride pain-free could you skip neck surgery? If one qualified surgeon said he thought surgery was a bad idea is the risk/reward ratio worth chancing surgery?

If you avoid tilting your head back whether on or off the bike would the migraines go away?

[Clancy]

I've had an arthritic neck for years so my position on a bike has become more upright. I think I will have to use pull-back bars like moustache or the like on any bikes I keep. If that would let you ride pain-free could you skip neck surgery? If one qualified surgeon said he thought surgery was a bad idea is the risk/reward ratio worth chancing surgery?

If you avoid tilting your head back whether on or off the bike would the migraines go away?

Surgeon said (via office staff) that I wasn’t a candidate for his type of surgery and recommended pain management unaware of the PT and pain management I had already completed.

Migraines were triggered by the pinched nerve. The level that is effected is known to cause migraines. Migraines were not triggered by my head movements.

I can’t ride a bike but I also cannot do many other daily functions such as look over my right shoulder when driving, reach up high with my right arm (such as an upper shelf ) etc., etc.

I would gladly ride a Jones handlebar as an option, but not being able to turn my head to the right makes even a flat bar or swept back bar not an option.

I’m currently also on medical leave. Unable to work due to limitations.

[ripvanrando]

Have you been checked for Thoracic outlet syndrome? Be careful, EMG testing is not conclusive. You have not listed all of your symptoms, so, just throwing that out there. The nerves from cervical spine snake down under your shoulder and clavicle where they can be pinched and radiate down your arm, give you a painful shoulder, and cause intractable radiating pain thru the occipital area up over your head into your eyes giving you double vision, vomiting, ringing eyes, and all sorts of fun.

In the USA, I would go to The Texas Back Institute. Dr. Blumenthal. But do your own due diligence. If you need more than 2 ADRs, you can't get that in the USA. I would confer with either Dr. Bertagnoli in Bogen Germany or Dr. Clavle in Barcelona.

To be a candidate (meaning insurance will pay usually), you have had to fail conservative treatment and have suffered for at least 6 months. If the MRI does not show foramenal narrowing or canal narrowing; then, what is causing it???? TOS is other possible. A rare lung tumor can do it too but rare. Don't be afraid of getting a lot of opinions espcially since it usually takes 2-3 months to get into some specialists and then when you get there, you find out the guy doesn't know jack. I had one say he could do two discs although I had three bad ones. I asked which ones would he do. He told me to pick the two worst ones. He was an Orthopedic. I would use a Neurosurgeon but in my state, none of the neuros take my insurance.

This can all be very complex and you will get the runaround. Go to the pain lady. Go to PT. Back to pain lady. try accupuncture. In the meantime, you lose all of your income. You must learn and must be your own advocate. I was at a specialist getting another opinion the other day and he told me there weren't nerves in the shoulder. ***...am I wireless? How do the fingers move if the the nerves don't go from the neck to the fingers. The other thing is to write your symtoms down and trim it to 30 seconds because that is about all a specialist will let you speak before they are tuning out.

[ripvanrando]

Tilting my head slightly back from vertical and wham.

I missed that on the first read.

If your insurance would cover you at TBI, send them your MRI images and get them reviewed online. Might only take 2-3 weeks. Out of pocket is $40-80K depending where and what.

The problem with surgery is having realistic expectations. What is success to the installer is not the same as your criteria.

Do you know what your NDI is? Could be why he said you are not a candidate. I think it has to be at least 25. I'm generally 35-40 on it. If you are low on that score and "only" suffering for 3 months, they won't pay for your surgery if I recall

Typcally, the neck disability index is lowered like 15 points.....not down to zero.....This is Mobi-C clinical trial data and 7 year followup.

[makoti]

I'd stay with PT, but if you are so inclined I'd try Acupuncture. Been having low back issues and the combination of PT, acupuncture, and massage has worked wonders. That said, Acupuncture isn't a true fix. That may only come with surgery.

[ripvanrando]

PT helped me some, accupuncture helped less. If you have time and money, try both.

Make sure Docs know you are not working and that this is serious.

[2LeftCleats]

You may not be a surgical candidate, but you might benefit from an epidural. That’s often what is done in pain management.

[ripvanrando]

Also....one ESI might not be enough. Try another.

[OtayBW]

A pinched nerve in my neck has kept me off the bike since January 1. Not fun, longest spell I’ve been off since I was 20, now 65.

Anyone been down this road? Suggestions/advice?
Two words for you, my friend: TRACTION....

[jimcav]

i have had this since 20Dec 2016. my spine guy said 3 epidural steroids 1 week apart is the best--it helped me 40%, the key for me was it was NOT the stuff on MRI (being over age 40 there is going to be something--osteophyte, disc protrusion, etc), what it was for me was exactly what i suspected, muscle irritation/damage creating traction on the nerve transiting through there--that is a pseudo thoracic outlet syndrome. Dry needling helped me a lot, but it took months to get to that and I keep up PT mainly for the manipulation to help my muscles relax--i have developed spasms and trigger points there that I didn't have before the injury. I still have numbness and weakness in my left thumb, and my neck muscles go into fits when I overdo it--mostly anything involving overhead work where i look up (so road bike position is no-go, but upright on mtb is fine)--that type of thing causes my muscles to tighten up which then starts the pain again. When it was bad, the 1st 2-3 months, my "spurling's sign" was super positive, I couldn't turn my head, lay prone, or truly flat supine (no pillow). Now that range of motion and those positions are fine, but i can't seem to break the over-reaction cycle in the muscles, so just don't do certain things. I wish you luck, it sucked, and I miss being who I was before it appended, I was in the best shape of my life, which oddly is what let me over do it and injure the muscles in the first place. I've also noticed it i worse when i am dehydrated

[Clancy]

Great advice from everyone....

RE: traction, doing it 2X a day

MRI shows narrowing of canal hence pinching of nerve. Moderate to severe stenosis

I live outside San Antonio so Texas Back Institute might be an option.

3 months into PT and so far I’ve gained strength and flexibility but pain level is the same and restriction of head movements is the same.

One Epidural with minimal effect.

Looks like months more of PT and possibly 1-2 more injections. My goal is back on the bike by October.

[ripvanrando]

Canal narrowing is a little different than pinched nerves as they come out thru the foramen either due to degenerative disc disease or osteophytes or both. If your MRI does not mention degenerative disc disease or narrowing at the foramen AND only references, canal narrowing...? Your symptoms sound like DD and foramen stenosis. But. I am pretty sure 6 months of conservative treatment is the norm before surgery is considered.

My Neuro told me NOT to see a Chiro.

I started seeing a Chiro who specializes in TOS and nerve impingement and he is doing specialiezed PT and this is helping.....last night was the first time I made it thru the night without waking many,many times in pain. This is the best I have been in 18 months and can drive a little bit. He uses computerized traction on my neck and e-stim, too

I feel for you. Hang in there. Finding relief is a bit of hit and miss. Try it all. Accupture helped certain radiating pain (shoulder) but did little for anything else. Was it worth $100 a couple times a week......maybe.

[glepore]

Had it for years, eventually fell off a motorcycle, severely contused my cord at c4, and ended up with a c4-7 laminoplasty after telling the neurosurgeon that I really didn't want to be fused despite the fact that I was, for the moment, a quad.

All good now. Sorta. Still have spasms at night and neuropathic pain in both arms, but can control the later with Lyrica and still ride a bike.

I don't suggest bruising your central cord to get approved for surgery, but hey, it worked for me.:eek:

[Ozz]

....

Orthopedic or a Neurosurgeon?

3 months of PT/traction, symptoms still persist. Do I give PT more time before looking at surgery?

Anyone been down this road? Suggestions/advice?

Went down this road with lower back...epidural cortisone worked for awhile, PT gave a little relief, for awhile but eventually surgery was only option.

My advice is to find a Neurosurgeon to do it...I was lucky and my Physiatrist was a good friend at a good institute. Orthos can do it, but when you are dealing with nerves and such...

Most important, make sure they have done the procedure a couple hundred times before...beware of anyone younger than 40. :cool: