Cervical radiculopathy advice

I recently received a preliminary diagnosis of cervical radiculopathy based on a positive Sperling's test while doing PT for neck/shoulder pain.  I wasn't too worried about it since I was making good progress with the PT, but last weekend while climbing my favorite 10b I was shocked to find that I couldn't pull the key move, and quickly realized that I had lost more than half of my grip strength in one hand.  I'm waiting on MRI results now, but am assuming the worst (arthritis / spondylosis resulting in a compressed nerve root), and trying to understand my options for treatment.  Has anyone gone through some form of spinal decompression surgery for cervical radiculopathy?  I would love to hear about your experience, especially recovery time, and recover level from the perspective of a climber.

How is this going for you? I’m dealing with the same issue. 

It has been a wild ride.  MRI back in January showed "severe stenosis C6-C7 & large spinal canal" but my orthopedist was not convinced the narrowing was terribly abnormal and didn't see surgery as a good option, at least not immediately.  I followed up with a nerve conduction study that suggested some level of "posterior interosseous syndrome" (generic compression induced weakness) but nothing really out of the ordinary, which had the neurologist stumped.  I continued PT on my own (basic shoulder/neck strengthening) and after 4 weeks of <50% hand strength, the strength slowly started to come back (probably unrelated to the PT).  By May the pain in my neck & shoulders & arms was growing, and I was feeling the so-called "sock & glove" sensation in my arms and feet associated with peripheral neuropathy, so I had another nerve conduction study looking beyond the hand that turned up nothing abnormal.  Again the neurologist was stumped.  Then I asked my doc to check B12 levels...found out I was in the low normal range...and started taking supplements.  Within a week the pain dropped by ~75% and my hand strength came back to near normal.  Rechecked B12 a month later and it was in the high normal range so the supplements were doing their job.  Hand continued to improve, but shoulder/arm pain was still there so I kept up with the PT which kept the pain to a manageable range without excessive chemical assistance.  Then about a month ago I added some basic yoga to my morning routine to limber up the joints, and the pain has basically disappeared.  Like, almost completely gone.  So, I dropped the PT routine and just kept on with the yoga. At the end of the day B12 + yoga has me back to near 100%.  

Obviously the B12 is not a panacea, since clinically low levels are rare, but low-normal levels are *not* rare and there is a lot of debate about whether the lower normal cutoff should be increased. I would at least suggest having this checked out if you're suffering from a similar situation.  Alternately, you could just start supplementing and see what happens -- you'll just excrete any excess so no worries about toxicity.  2500 mcg sublingual B12 daily does the trick for me. 

I hope you can find some relief for your own situation...would be very interested to hear how it goes.

Thanks for the reply. I’ve been doing PT for the last six months and I’ve also undergone several sessions of dry needling and that’s been pretty effective at keeping the pain tolerable. I haven’t been climbing much at all which is a huge bummer but I have been able to continue cycling. Then a couple weeks ago the pain really ramped up and so I made an appointment with a specialist but he can’t fit me in until the end of the month. I’m sticking with the stretches and exercises that seem to help. Honestly I’m pretty skeptical of injections and surgery.
What clued you in to b12 supplements?

B12 was just a guess, based on low B12 resulting in myelin sheath damage and neuropathy issues, and a suspicion about some general malabsorption issues.  Given how long it takes for damaged nerves to heal, I'm planning to wait another 6 months to make sure I'm back to a good place before experimenting with dropping the supplements.

I hear you on avoiding shots + surgery.  Hang in there until you can get a proper diagnosis & treatment plan.  It sucks losing sleep week after week due to the pain, but if you can get back on top of things with conservative treatment it's worth it.

Shit. That doesn't sound fun.  I've heard too many similar stories about back surgery going sideways, and couldn't agree more with your advice to avoid surgery until it becomes the last option.

Thanks for the advice. My PT is very knowledgeable and also an avid outdoor athletic type. I’m definitely going to continue with a conservative approach. Sux not climbing though. 

ubu wrote:

B12 was just a guess, based on low B12 resulting in myelin sheath damage and neuropathy issues, and a suspicion about some general malabsorption issues.  Given how long it takes for damaged nerves to heal, I'm planning to wait another 6 months to make sure I'm back to a good place before experimenting with dropping the supplements.

I hear you on avoiding shots + surgery.  Hang in there until you can get a proper diagnosis & treatment plan.  It sucks losing sleep week after week due to the pain, but if you can get back on top of things with conservative treatment it's worth it.

Why drop the supplements? Just curious. 

Kristian Solem wrote:

Why drop the supplements? Just curious. 

Partly because it's a pain, especially for a sublingual that you can't just pop in your mouth and swallow, but mainly because I want to figure out whether a B12 deficiency is really part of the problem or just a red herring.

Spine pain doc recommends I consult a neurosurgeon based on mri images. The other dude that commented on here recommended a specialist in Boulder but those comments have been deleted.  Any recommendations would be appreciated. 

Cheers. 

Thanks. I’m absolutely not resigned to surgery. I want to be as conservative as I can. The spine pain specialist has concerns about my spinal cord and wants me to consult with the neurosurgeon before any injections. I’m sticking with the pt and needling and I like the pt I’m seeing. He’s very knowledgeable and I felt like I was on top of the pain for the last six months or so but man it’s really got the better of me for the past few weeks.
I appreciate the replies. That orthopedic place in Boulder seems like a good resource. 

Thought I'd share my experience in a nut shell. ~4 years ago my hand was going numb as well as minor nerve pain down my arm, had mri on neck which showed severe radiculopathy c4-c7 as well as central stenosis. The first 3 docs recommended c4-c7 fusion s.ooner than later. The 4th doc recommended carpal tunnel surgery as I might be experiencing "double crush" syndrome as she suspected I might have carpal tunnel. She was correct. I've been > 90% symptom free ever since.

You fused people up there, how you doing?  It's been nearly a year, I'd love to hear some progress.  (I'm going through some pinched C8 issues)

Hi! Just been diagnosed with severe cervical stenosis in several areas… among other things…I’m so scared I’m not going to be able to climb anymore…seeing a specialist next week…searching on here hoping to hear others who have had neck issues but were able to still climb…thanks for reading!

Hi Eileen,

I don't think you need to worry too much. I know plenty of people who continued to climb after surgery and did so w/o as much pain. My one recommendation is to get 2nd and 3rd opinions as there are various surgical options available! Maybe talk to some PT's that could recommend a Dr. or two. That's how I found my preferred specialist.

Good Luck!

Hi Dan! Just seeing your response.  Thank you! Been needing to hear some positivity! I’m seeing  my 3rd opinion on Monday! (My first 2 had differing opinions!)  Hope to get this figured out and out there climbing again!!!

Thanks!

Eileen

Any thoughts on ACDA vs ACDF? Disc replacement instead of fusion? Seems like a solid idea.

Hmmm thanks for the info… I’ll have to ask about disk replacement and see if I’m a candidate for that!

Thanks!!!!

Eileen

I’m “lucky” enough that I’ve only bulged a c4/5 disk and can correct it without surgery. However it’s been a couple years now and several aggravations later. I’ve had to change jobs, spend thousands on quality furniture and 8 months of PT (so far). I’ve learned a whole lot about myself though, and once the shoulder fire is gone then I’ll have some great furniture to rest on.

Who would have guessed that every couch in the world is the perfect design for torturing neck injuries?