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Does strength return after surgery?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Neck Pain: Cervical
I am a 39 year old active male involved in a variety of sports. On Feb 20, 2009 I sustained a cervical injury playing hockey. I have a herniated disc at the C6-C7 level as well as a bulging disc at C4-C5 level. The herniation has affected my C7 nerve root. Initially I experienced excrutiating pain in my left arm. My forearm burned and I have numbness in my thumb, index finger and inside of my middle finger. Over the past 5 weeks my pain has subsided somewhat, unless I overdue things. However, I still have very little strength in my left arm (triceps area) and my left chest (pectoral) area. I can't even come close to doing one pushup. I was scheduled to have surgery on April 1 because I was having relief from the pain and thought I should give it more of a chance to heal. However, now I am concerned I made the wrong choice based on this continued loss of strength. My question is "Do I have a better chance of strength recovery from surgery than conservative methods" and "Have I waited too long already for surgery?".

Any thoughts would be more than helpful as this decision is killing me. I can get into surgery in May if need be.



  • Hi Jems,

    Welcome to spine-health. There is noway anyone can say wether your strength will come back or if you have waited to long. I always believe in conservative treatment first. Have you been doing any type of therapy wether physical or message therapy? Your injury is still rather new and all injuries take time to heal. Did you discuss your decision with the surgeon who scheduled this surgery? What percentages did he or she give on the full use of your arm with or without surgery? Did you go for a second opinion and if so what was the advice of the second opinion? Doing spine surgery will alter the structure of the spine forever. Surgery does have it is risk as well. What type of surgery was the surgeon proposing to do initially? Welcome to spine-health look around you will find a lot of information the search function at the top of the page will lead you to some very good articles. Keep us posted on what you decide to do.
  • Thank-you for your reply. I have been to approx 10 PT visits thus far. Mostly just traction, ultrasound and a little manipulation. The surgeon did not give me any percentages other than this injury heals itself via non-surgical methods only 50% of the time. That didn't seem like good odds to me. Glass is half empty to me. I haven't had a second opinion. The surgeon was planning on doing ACDF surgery with hardware. Any other suggestions on conservative methods other than PT?

  • dilaurodilauro ConnecticutPosts: 9,825
    You realize first hand what discomfort and pain you are in, the lack of strength, etc without having surgery.
    What has been the recommendation from your doctor based on the MRI and any other tests?
    Going the conservative treatment route first is ALWAYS the best approach. There are so many treatments such as
    Physical Therapy
    Aqua Therapy
    Massage Therapy
    Heat/Ice Therapy
    Passive Traction
    Spinal Cortisone Injections (ESI)
    Trigger Point Injections (Lidocaine)
    If you have gone through this AND your doctor agrees to the treatments, there have been many cases where the original disc problem subsides.
    Much depends on the actual disc problem and what it has
    created. When a damaged disc impinging a nerve root, the sooner you correct that situation the better. Recovery from disc and fusion surgery is trackable and for many
    predictable. Nerve damage, however can take a very long time to heal.
    If you have surgery will you regain the strength? That is almost an impossible question to answer. There are so many different variables. But, assume for a second that everything is perfect, there are no complications, your recovery is perfect, will you have the same strength?
    My answer tends to lean towards NO. Does that mean you could not return to some of the activities you did before, NO, does that mean physical contact sports such as Hockey, could you play again? MAYBE. After my first two lumbar surgeries, I started to play in an over-40 Hockey league.
    My skating was definitely not as strong and even though there was no checking in this type of league falls happen and to me, I decided to stop, didnt want to risk anything.

    But all of this, talk to your doctor about it. They would be in a much better situation to give you more formal
    medical answers.

    Good luck
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Like others have said, it's impossible to say whether you should have surgery and whether it would help. But, for what it's worth, I had almost lost complete use of my left arm before surgery and was having very wicked pain in my muscles as well. I couldn't even pick up a glass of ice water.

    After surgery, my left arm was back to normal, although it's taking some strengthening exercises to get my muscles back. But I have complete faith that it will get back to normal.

  • Jems,
    I have the same exact problem like you did. I first had the symptoms start oct 13 2007 when a chiropractor adjusted me and caused sever pain and some weakness. After 6 weeks and 3 cortisone injections i was essentially pain free but still i see weakness and atrophy of my left tricep, left trap, and left forearm muscle. I did physical therapy and it improved my weakness by a significant amount but never to my previous form. i saw 4 surgeons and prior to physical therapy they all recommended different approaches. only one of them said i need surgery right away and he only does fusions. he said he does not like that i still have pain as the reason of why surgery is indicated (that was not a good reason for me since my pain was minimal at this time) if he said you need it to regain strength i would have done it asap. Other surgeons said try conservative approach first. After 2 month of PT i went back to see 2 surgeons and they both said pain is almost gone weakness is improving they would not recommend surgery. so i decided against it, the pain was gone for over a year and last month it came back again and after 2 epidural injections the pain is again gone, but the weakness persists. Now I am scheduled for a laminoforaminotomy on May 1 and i cant wait to get it done.
    I recommend you see a doctor who specializes in minimally invasive surgery and have him/her do a laminoforaminotomy since you have only issues with arm pain/weakness and no central spine herniation. I wish i did it the first time this happened i would not have persistent weakness. The disadvantage of laminoforaminotomy is that it could happen again. but when that happens you still have option of fusion or artificial disc. form reading research on this procedure i see recurrence numbers anywhere from 8-15% some say up to 30%. all good odds to have a "safer" less invasive outpatient procedure that would alleviate pain/numbness/weakness and leave your disc intact.
    My two cents
    Best of luck
  • I would love to hear from everyone also about this good or bad be honest, let us know...
  • I lost both, my arms that were once very toned now look horrible. My strength is no where near what it use to be and it has been 2 years since my surgery. I ask PT these questions and she was very honest in telling me that it probably will not return. I get so mad when sometimes I try and open something that should be easy and I have to ask someone to open it for me. Another thing I notice is that I drop things a lot, very frustrating.

  • Is there any arm exercises you can do without nec strain/pain?
  • The way it was explained to me was since I have the nerve damage the muscle is not getting the signal. I have tried to left small weights but each time I do the neck pain increases. I also had problems with my left shoulder about a year ago when I started lifing weights. I'm talking 5lb weights, nothings really heavy. The doctor told me to stop and I am still healing from that little exercise bout. I also had to have 5 trigger point injections in that shoulder. It seems the neck and shoulder problems go hand in hand.

  • Jems,

    No one can guarantee that you will regain the strength in your arm. I have some loss of strength but 11 weeks after surgery the arm is feeling better, but not the strength yet but I have yet to start Physical Therapy. I also waited 8 years before I had my surgery so it was a long time. I had bone spurs pushing on my nerve so that is what was causing most of my pain and weakness but the surgeon seems to think I will get at least some of it back.

    The reason I did wait so long is in the beginning I had good luck with non surgical treatments I had a series of 3 cortisone injections which the first time left me pain free for 3 years so you can try that too if that is an option for you.
  • I injured my neck in June, 2007. I had herniations at C4-5 and 5-6 and bulging at 3-4. I had terrible pain in my scapular area and lost about 50% of the strength in my left arm-I could hardly even wash my hair. My ORS offered physical therapy or epidural injections. I tried PT for 8 weeks and then saw a Neurosurgeon who secheduled surgery for the next week (this was in early September). I agreed but cancelled the next day. In January, as a very last ditch effort, I agreed to see a Chiropractor. I told him I did NOT believe in chiropractic and if he used any force whatsoever, I would leave and never come back. To make a long story short, I have seen the Chiro for 30 sessions. The past 2 weeks, I have had absolutely NO pain in my neck or back, NO weakness or pain in my arm and have slept without a heating pad for the first time in 9 months! Up until the past month, I had looked at my calendar almost every day to see when I could fit my surgery in. Now I no longer contemplate surgery and am planning a 6 week boat trip this summer. Obviously this is just one person's experience but I am very glad that I waited. I may still need surgery at some point, but I have avoided it for this week-this month-this year.
  • what type of stuff does your chiropractic do? thats good news he keeping you out of surgery.
  • I would caution you to think about putting surgery off too long especially if your losing strength.It took me a long time to get to a surgeon and then i was on a waiting list.By the time i had my surgery i had lost muscle strength everywhere.I'm just under a year out of surgery and am still building back my strength.Its a very slow process to regain muscle strength once you've lost it.Good luck making your decision.
  • Thank-you all for your replies. They were very informative and I appreciate the feedback. It seems to be a prevalent viewpoint that waiting on surgery decreases your chances of muscle strength recovery and avoiding permanent nerve damage. My question is "How long is too long?" Are we talking weeks, months, etc. If I have surgery it will be in May and that will be approx 2 months after my injury. Does that seem too long?

    Anyways, I realize there are no guarantees of anything. I just really need to find a way to get this strength back as activities and sports are a HUGE part of my life.

    Thanks again all for taking the time to reply.

  • dilaurodilauro ConnecticutPosts: 9,825
    Bkorry, I know everyone wants to help out here, but it is so very important that members AVOID telling other members what doctors to see and what kind of surgery they should have based on what they see is the issue.

    No one here is a medical professional and as such, no one should be direct in their medical statements. One of our forum rules states that no member should be providing medical advice.

    Any information we give to other members, is based on our own personal experiences and is NOT formal medical advice.
    We try to include that on every one of our posts.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Jarrett,
    You ask a very reasonable question and I ask myself the same. However from my experience i could never find a doctor to give me a timeline. My physiatrist said 6 months to me, but I heard stories from patients who had recovered strengths after years. So there seems not to be any data that i could find to support this because situations are different with every one. My latest doctor said that it is hard to say because there is never any study that evaluates every scenario and try to scientifically determine that. I myself am worried I may have waited too long my injury was caused by a Chiropractor who adjusted me and caused severe herniation. However I am optimistic that i will be one of those cases of people who recover strength after surgery, or other means. If you run across any research please do share.
  • I don't know how long it takes for nerves to be damaged beyond repair but my arm hurt for 2 years before a doctor found my neck problem. I know I waited too long but I had an idiot for a doctor and not until I went to a new doctor did I find out the entire time my arm pain was from my neck. My surgeon told me it takes a long time for nerves to heal, anywhere from 1-2yrs. Since my surgery is 2 years old I feel that I am healed to where I will always be.

  • My Chiropractor is very gentle with me because of the herniations. I have 15 minutes of heat and then he uses an activator (a little device that he holds as if he were giving me an injection). It gently "nudges" the vertebrae back into alignment. Once a week I have a deep tissue massage to loosen the muscles in my back (especially around the scapular area) that tightened up while trying to compensate for the disc issues. This has been a slow process and I tell my Chiro every week that I'm still not convinced he isn't a quack but I am 100% better than I was 2 months ago, so I hope it continues.
  • intresting ive found some help almost the same way, your story makes me smile.
  • I was into bodybuilding 4 years prior to my ACDF c5-c7. My surgery took place a year ago this month and prior to surgey I had muscle atrophy in my left forearm, bicep and hand (thumb). I initially lost probably 40-50% of my strength in the affected arm. After 9 months back in the gym I have regained around 80-85% of my strength back in my arm. The arm is still an inch smaller in the forearm and you can see a big descrepancy between the bottom of my left bicep and my right bicep. I have a feeling that I probably will never get back all of the strength I lost but for now I am pleased with my progress.
  • Do you still bodybuild or lift weights after surgery?
  • Welcome to spine-health. In my case after my surgeries I have had PT. I will say that I have not recovered to my pre-surgery levels, but I have recovered to the point that I can do most things that I used to do, just not at that high competitive level anymore. I PT'd for 8 months before my last surgery(monday) and it prepared me well for it, I have not had much pain or complications at this point. I also know that my NS has told me to expect a 8 month to a year recovery again, but I am supposed to take my time and not force the issue. Just allow my body to do as it needs to. I am still hoping to swing a golf club before October and to get back to bowling by January, simple things but ones that I miss the most. Nerves can take a long time to heal, it has been a year and a half for me, it is not as bad as it was, will it get any better? Only time will tell. Good luck in your choice and I am sure you will do well.

  • JKDE302 said:
    Do you still bodybuild or lift weights after surgery?
    Yes. I can't lift the same amount that I used to but I am fairly close. Maybe 85% or so of what I use to lift. I avoid all overhead movements such as military press etc and squats. Had a little bit of a flare up recently and have backed down on the weight and switched to high reps for awhile. No pain but increased numbness at times.
  • Hey Jems,
    You sound a lot like me, right arm and all. Searing pain, ice cold hands, burning down my spine and inbetween my shoulders, headaches, the whole 9. I could not pick things up in my right hand that were small and could not do things like golf or even excercise really.

    I had an accident at age 15, 20 years ago, that caused some issues with my neck. They took xrays, put me in a soft collar and I did PT. Things went fine for a while but once I left a very active management job(restaurant and retail) to a desk job I started having all kinds of issues. Over the last 7 years I did chiropractic, drug therapy, PT, had a breast reduction and just had surgery on March 26. I ended up having an anterior cervical diskectomy with fusion of C4-C7. I am quite happy with the results and I am so looking forward to getting back into PT. In my case, I really wish I had not waited as long as I did however at the same time, I felt it important to take progressive steps to treat the issue. Traction was the devil for me. I hated it and it only caused me more pain. While my symptoms were controlled with PT, I still had flare ups and spasms that would stop me in my tracks.

    I have gained almost 70 pounds since all this started and I am so looking forward to becoming active again. While my surgeon does not refer to therapy after surgery, in the state I live, I don't need him to.

    When discussing with my surgeon he told me to put it off as long as I could. As we discussed the impact to my life over the last 7 years, he then said, ok, call me when you are ready.

    I hope that you can find a surgeon who will take the time to explain your options and give you choices. It took me 3 different ones to find the right one. Never let your family or spouse dictate where you should go, that was my big mistake.

    Hopefully this helps and I hope that you have a physician who will take the time to listen to you, discuss options and provide answers to all your questions.
  • Thanks for your comments and for posting a picture of your neck post-op. Now I know what to expect. I am scheduled for the ACDF on April 30th. Fortunately my strength loss has been severe only for the past six weeks (I was really not aware how bad it was until the surgeon demonstrated how weak my left arm was compared to my right arm).

    He tells me I may not regain any strength (I can only lift 8 pounds now), but the surgery may prevent further strength loss. Rather grim if you ask me.

    I had posted on another thread about an alternative to the ACDF (endoscopic surgery) but the folks in Tampa offering the procedure seem to be more interested in a large cash deposit ($30,000) than caring about a good outcome. They claim they bill insurance companies $60-80,000!!

    I am rather resigned to the ACDF and hoping for the best. These posts on Spine-Health have helped me to understand what to expect, and what the possible complications might be afterwards.

    I feel like a wimp listing my medical 'issues' when I look at all the problems others have experienced. I just have bone spurs with buldging disks at c4-c5, c5-c6, and c6-c7, pain in left arm to fingers with numbness, tingling, and of course weakness in left arm.
  • Ron,

    Thanks for listing all the possible treatments to consider before surgery. Over the past six years I had the lidocaine injections in my back, then PT, then corizone injection into the disk area. The injection stopped the paid from 2005 to March 2009. After the MRI and discovery of the problems at c4 through c7 with resulting arm strength loss, the surgeon determined the ACDF was the best way to prevent further loss of strength. All I really need to be able to do is type and perform normal activities. I can refrain from heavy lifting and contact sports and not feel I am missing out on anything.

    I will keep the Forum updated on my outcome so others can learn from the experience. The difficult part of the decision is not knowing what to expect, or if it is the right choice.

    Time will tell.

  • Jems I had ACDF c5-c7 just twelve days ago. I had wicked left arm pain and weakness and numbness in fingers also. The thing that drove my decision for surgery was that the doctors indicated a delay could result in permanent damage. Dude, I'm a guitarist so losing my left arm was huge, just like not playing sports is to you. After speaking with my neurosurgeon post-op, he indicated that the spine and nerve root were severly pinched, so I made the right decision. Not trying to sway you cause every one case is different, but thats what drove my decision. I'm now on home recovery and on the bright side I was able to hammer out a few notes on the accoustic last night. On the down side its a real pain in the butt while wearing an Aspen Vista cervical collar. :) Good Luck brau!

    p.s. by the way, my pain started on 2/20/09 of this year also.
  • Disco,
    Glad your surgery went well and you're playing again depsite collar. Did your doc happen to mention any time-frame before anything turns permanent?
  • Jems

    I had a 2 level partial corpectomy C5 & C6 16 months ago. I had a neck injury about 40 years earlier and eventually developed weakness and all the symptoms of nerve damage. The surgeon would not guaruntee me anything but that if I did not do the surgery, I would get worse. Short story, when I woke up from surgery, all symptoms are gone. I am so glad I did it. I like the advicce about listening to the doctor. Each case is different. Good luck
  • bkory,

    I will be in collar for 8-12 weeks. I will see him at the 4 week mark where he will review new xray/mri for evidence of fusion. It will take up to 3-4 months for any significant bone healing and from what I understand may continue healing up to a year afterwards.

    As of right now I'm really not in any significant pain other than this collar itches like crazy cause I shaved today. ~X(

    I noticed you just 12 days out from your surgery, how did it go for you?
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