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Has a cervical epidural helped anyone's arm pain/weakness?

cybrmarc21ccybrmarc21 Posts: 6
edited 12/29/2018 - 6:52 PM in Spinal Injections

Hi,

After a year of thinking I first hand carpal tunnel, then tendinitis of elbow/bicep (as pain and weakness moved up my arm), and then finally getting an MRI with confirmed stenosis/radiculopathy (in C6-C7 area,) I got an epidural. Trying to put off surgery if possible, although the suffering I have is acute, what with my arm pain/weakness (both arms) as well as pain and my neck, upper back, and shoulder blade area. Could be congenital or as a result of falling 100' out of a tree ten years ago (which healed fine, but kept spasming every so often when I overdid it or was stressed.)

The good news: not even 48 hours after the epidural, pretty much all my neck/shoulderblade/upper back pain is gone. I'm surprised that happened so fast, since the doctor said medicine would take 2 weeks to go into full effect. That neck/shoulderblade pain was the worst pain I was having, and it's a huge relief to not be haunted by it all day.

The bad news: my arm pain/weakness is not gone, and seems to have gotten a little bit worse. It is usually triggered by strenuous activity, although today I'm having a huge flare up just from doing a bit of sweeping. I'm thinking maybe the steroids haven't worked their way into the nerves coming off my main spine? Or maybe I have concommitant tennis/golfer's elbow and radiculopathy? I'm really hoping this injection will make a difference in my arm pain, as it's currently limiting my employment options quite a lot. I'm also using this epidural as a test to decide what kind of relief I can reasonably expect from a full-blown ADSL surgery.

Any experience with a "lag" on arm symptoms after a cervical epidural?

Thanks and best,
Marcus

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1

Comments

  • dilaurodilauro ConnecticutPosts: 13,587

    I've never heard of an ADSL cervical surgery.  I cant find any information about it.

    Regarding the epidural. Relief can be almost with in 48 hours up to 2 weeks, IF it does help.   Not everyone gets relief from ESIs.

    The major objective of an ESI is to reduce the inflammation to hopefully allow time for the condition to subside and possibly heal.  ESIs generally do not fix nerve related pain, but by reducing the inflammation in the targeted area, hopefully, the nerve pain will subside.

    Have you had a mri of the cervical area?  Some of you symptoms sound like it could be coming from a cervical disc

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • By ADSL I mean going in the front (by throat) and removing C6 and C7 discs. Cervical MRI showed slight bulging in those discs leading to stenosis and radiculopathy.

    I can't tell yet, but it seems the relaxing effect on my neck is starting to go away. Pain is coming back. Arg.

    Thanks for the info though dilauro.

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  • Sorry I meant ACDF. Discectomy with fusion.

  • Another question - is it unrealistic to expect the ESI to be a gauge of whether surgery would give me relief? Are their effects relatively unrelated?

  • Ask pain management doctor. I was told ESI’s can be diagnostic in nature. 

    I won’t get them without fluoroscope guidance.

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  • Just by my own experience, I never received any relief after cervical injections, Injections can work as Ron described but are usually a band aid to the main root of the problem. Secondly and most important, the longer you wait on further diagnosis, the percentage of permanent nerve damage also increases......David.  ( unsuccessful C-5 - C-7 with permanent radiculapathy )

    DavidG

    Veritas-Health Forum Moderator

  • Oh wow...that's not what I wanted to hear. 

    What do you mean by "further diagnosis?" Where is there further to go in a case such as the one I described (which sounds similar to yours C5-C7 stenosis & radiculopathy?)  Isn't it just get surgery or not? Or do you mean alternative treatments like nerve blocks, the sonic thing, etc?

  • I have had a many esis, with a lot of relief. Although they are temporary for me. I have had a previous neck surgery in 2010. A fusion from c4-c7. The esi does help me a lot to bring down inflammation. 

    I also have had to make many lifestyle adjustments too; as a result of radiculopathy. I have to accept a “new normal” in regards to my physical abilities.

    Us spinies can learn how to deal with our condition.  Read “ the Blend” on this site. There is much for us to learn here.

    Try to keep an open mind- it will help you to deal with this stuff.

  • I have had very good luck with the injunctions. I had a set of 3 over a year ago that lasted until just recently. I had to get a fore and five about 2 months ago. It takes more than one shoot for me. But the pain went from a nightly 8 to a generally a 1. It didn't help with the numbness,  but I can live with that. 

    For those considering them, I would say the procedure is about the same pain level as a blood draw. I would actually use the word pleasant because I could feel the pain leave my arm. I went in at a 6 and sat up from the table at a 1.

  • Hi Cybrmarc - I just read your post and I literally thought it could have been written by me!  My MRIs, taken over the past 4 years, show a bulging disc at C6-C7 that barely impinges on the spinal cord and "mild" bilateral foraminal stenosis.  My symptoms are nearly a mirror image of yours: neck pain, pain in both arms (upper deltoid/triceps area, top of forearms and hands). I've had 6 radiofrequency procedures covering C2-C7 that have produced decreasing results and four ESIs which were ineffective.  I've also had two EMG/NCV tests in the past couple years that have been normal and don't indicate carpal tunnel or cubital tunnel syndromes.  

    Like you, my arm pain increases pretty dramatically whenever I do things like raking leaves, shoveling snow, holding binoculars for an extended time, etc.  While these activities undoubtedly stress the cervical area, my arms ache for such long periods afterwards that I began to wonder if I had something else going on independent of the neck issues.  I even went so far as to visit a rheumatologist to see if I had some kind of muscle myopathy that was responsible for the arm pain and fatigue.  Many blood tests later (all normal) he said it would be very unlikely that there was some underlying myopathy responsible for the arm pain since I don't have similar symptoms in my lower extremities, which is characteristic of myopathies.  So, I have been left wondering what my next step should be.

    Fast forward to this January (2019).  After a final failed ESI (interlaminar C7-T1) last December, I finally received a referral to an orthopedic neck surgeon to discuss a disc replacement using the Mobi-C device.  Much to my surprise, I found out that I was contraindicated for disc replacement due to the presence of facet arthropathy (arthritis).  However, the surgeon says we can entertain the idea of a single-level ACDF at C6-C7, but only after getting a lidocaine diagnostic injection at C6-C7 to see if the arm pain improves.  That procedure is now scheduled for 3/11.  If it does reduce the arm pain, then I will have to make a decision about moving forward with ACDF.  So, I would recommend that you ask your doctor about doing a quick lidocaine diagnostic injection to specifically target the arm pain and see if that works.      

    Finally, I should share a misconception that I had regarding neck pain and ACDF surgery.  If your neck pain is originating from the facets via arthritic processes, then ACDF may not resolve that pain.  For example, let's say you have pain and stiffness in your neck stemming from facet arthritis at C3-C7 as well as arm pain due to a bulging disc that compresses the neural foramens at C6-C7.  An ACDF at C6-C7 is the gold-standard for relieving the arm pain, but you may still experience neck pain from coming from the arthritic facets  depending on how much of a reduction in motion they incur as a result of the procedure.  I was unaware of this until having a lengthy discussion with the surgeon.

    Best of luck to you,

    -Matt  

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