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Cervical Herniation C5/C6 nerve root impingement - my progress

yatesy1983yyatesy1983 Posts: 2
edited 02/04/2015 - 7:41 AM in Neck Pain: Cervical

SOorry for the length of this post. I wanted to document my progress with my injury, give my thoughts and maybe share some ideas with those in a similar situation.

First of all let me introudce myself - my name is Paul, I'm 31 years old and live in London, UK.

Before my injury I've been fairly active - I'm a very keen kayaker (white-water), did a little mountain biking, hill walking and in the past some indoor climbing.

Last year I took up triathlon with the aim at some point of attempting an iron distance race.

I work in IT, hours can be long, my vision isn't amazing due to having Nystagmus, stigmatism andf ptossis - I'm certainly not blind but I can strain to read my screens at times, especially when tired. I credit this, and poor sleeping posture as the main protagnists for my injury along with a dose of genetics and the odd bike fall, rock bash to the head whilst kayaking.

I'd had some niggling shoulder issues for a month or so leading into December - this was nothing unusual for me with swimming and kayaking being great activities to cause the other impingement. One Friday in mid December I woke up with a particularly sore shoulder and arm. That Saturday I was due to go on a kayaking trip but knew if my arm and shoulder were in the same state then there would be know way I could make it. I booked a sports massage in the hope of loosening up. My left lat was spasming - I figured some deep tissue work would have me back to normal. It did indeed help - but as soon as I got back to work the pain returned.

I left work early that day, walked to the train station then walked at the other end of my journey - I saw some improvement. I cooked dinner for a friend we had visiting that evening and whilst I was standing and working away in the kitchen things we're OIK. Later that evening once we sat down things got worse - a lot worse. That night I didn't sleep - I was taking Ibuprofen and paracetamol as often as I could and certainly more than the OTC dose of Ibuprofen up to the max theraputic dose of 800mg every 8 hours. The following day and night were intolerable - I've never felt pain like that before, I ended up in A&E (UK ER) at 4:00am in the morning after trying to get an out of hours GP for pain relief. I had full spasms in my neck, shoulder, whole arm and numbness in my hand and lower arm. Waiting time in A&E was unbearable - I had to go home again as it was going to be 6 hours before anyone could see me. Luckily for me my friend is a GP, after chatting to her she said it sounded like a trapped nerve, she kindly wrote me a private prescription for DIclofenac and co-codamol until I could see another GP the next day.

That gave me a little relief - I got some much needed sleep a couple of hours moving from the bed to the hard floor and vice-versa. Luckily I had signed up to my wife's work private health care and was able to see a GP through that the next morning, in the meantime I'd also booked into see my physio for later that day. The private GP agreed with the trapped nerve diagnosis and suggested referral to a NS. they also increased the strength of the co-codamol to 30/5000 tablets, switched the anti-inflamm to Naproxen and also put me on Amitriptyline. In hidnsight I think valium might have been beneficial at this stage to help relax the muscles but the prescribed cocktail definitley helped regardsless. Especially the co-codamol! I asked the GP to write a referral for an MRI - knowing that approaching Christmas getting a referral to a consultant, even privately could take time.

I visited my physio straight after the GP, I'd been seeing the physio for a completely unrelated ankle issue but she also had a background in spinal trauma - working at a sports related practice she also had a decent network of consultants for onward referral, recommended a name to me and passed me on details of their secretary. Armed with this name I was able to get Bupa to agree an MRI, I also got an appointment with the consultant for Thursday of the same week.

As a side note, I'm massively pro-NHS, I only signed up to private health care when I ramped up my training for the ironman, thinking I might need access to physio or even orthapaedic care at some point in the future - little did I know! At this stage I was certainly glad I did!

I had the MRI the next day, the results were ready when I got to the consultant on the Thursday. Diagnosis - C5-C6 disc protrusion causing moderate indentation of the left side of the spinal cord, as well as obliterating the left foramen resultting in left C6 nerve root compression.

Thankfully the spinal cord compression didin't appear to be generating any symptomns - with this is mind the surgeon suggested we try pregablin for pain management along with conservative treatement (PT, light exercise).

I kept up with some easy swimming, using a snorkel to avoid neck rotation, I'd gone from swimming 3km in a session to struggling to do a couple of lengths. I also did a little light work on the indoor bike, doing ten mins max - again I'd gone from doing 6 hour plus rides to a fraction of that.

I started attending physio 2-3 times each week, stayed on medication and saw a little improvement. Come the new year however I was still struggling to sleep and unable to work, I'm self employed so not working means no income. I'd also noticed loss of strength in the arm - I couldn't do a single push-up, something that I could certainly do before. At my follow-up the consultant was quite matter of fact, options were surgery (ACDF) or spinal injections. I still had numbness. From here my consultant gave me two options, ACDF or spinal injections. We're expeciting our first child any day now so being out of action with an ACDF didn't appeal. Nor the the amount of rehab, posssible complications with further degeneration of surrounding discs in the future and the loss of movement in the neck. At this time surgery wasn't the right choice for me.

I opted for the conservative option of a C6 epidrual, I had to wait a few weeks for this. In the interim I was seeing improvements through intensive physio, light traction and using the McKenzie method. I kept up swimming, managing to get up to 400m in the pool and started doing longer sessions on the bike. The pain was still there but I found this exercise didn't aggravate it, if anything it helped. Whether that's phsycological or not I don't know but I certainly saw some benefit. It got to a point where I was spending 5 hours a week on the indoor bike (this is 5 weeks after the intial injury) and swimming for 20 mins 5 days a week ableit very slowly and carefully. My symptoms improved further although I did begin to notice some whole torso pins and needles when lying down.

Injection day soon arrived, that was last Tuesday 27/01, immediately I felt no pain - the local anaestetic was having quite the affect. Later that evening was scary - I lost complete use of my arm. The next day it had recovered. I had a few days of discomfort where the nerve had been agitated by the injection prcess once the local anaestetic had worn off.

Now, a week on I'm seeing the effects. On Saturday I was able to attend a club swimming session, managing an hour in the pool. I was able to ride my bike outside for the first time yesterday (only a short distance but it's a start). I seem to have the strength back in my upper arm. I managed to stop all medication but stopping the co-codamol has been tough. I went cold turkey not realising my body would need time to adjust - sweats, restless legs, anxiousness and irritablility were the order of the day when trying to sleep. I'm back on the co-codamol, but only a single tablet at bed time to help sleep, I'll be cutting down to half a tablet in a few days then stopping that once I'm feeling normal with only half.

I've still got no feeling in my thumb and some numbness in lower arm, I've still got pain but it's manageable - I can work fine. I've had a sit-stand desk installed and that is helping massively. I'm keeping up the swimming and hoping to start non-impact training properly soon. Most importantly I feel I can be useful once baby comes along.

I know I've been really lucky and others don't see this kind of recovery. I also know that this could be a blip and I see some further regression, my mri shows DDD in self of my cervical discs, C$-C% is protruding slightly also but so far is giving me know issues. My approach from here is to get fully fit again and strengthen my core. I'm planning to start Pilates once my physio gives me the OK. I want to do anything I can to delay the need for surgery, and once the time comes if it does I want ot look at disc replacement rather than fusion, hopefully that's a hypothetical consideration but it's still something I've thought about.

I still plan to race ironman this year, the race I'm targetting is in September - hopefully long enough off to get myself sorted. Who knows?

I hope to keep this thread updated. If anyone is just beginning on this journey then my advice is to make sure you take control of your treatment, stay active where possible (and with the guidance of medical staff) and stay positive.



  • LizLiz Posts: 7,832
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    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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