Intro / ADR for Numbness Rather Than Pain?

[LisaW]

Hi all! Thank you Harrison for allowing me to join and for all the great information I've already found on this site!

My big question: Has anyone had ADR to relieve numbness rather than pain?

I started having pain in my neck/shoulder area in September 2021. By October, it was severe pain radiating down my left arm and hand, into my shoulder blade, and occasional pins and needles.

I started conservative treatment in November, including steroids, PT, acupuncture, and stretches which eventually actually reduced the pain dramatically.

November MRI showed C5-C6 large bulge, severe canal and foraminal stenosis and C6-C7 diffuse bulge touching cord, mild canal stenosis, severe foraminal stenosis.

In December, I saw Justin Keadle PA at Dr. Yeh’s neurosurgery clinic in San Luis Obispo, California and he recommended moving forward with Dr. Yeh for evaluation for ADR.

By January 2022, my pain was manageable, but numbness/pins & needles began increasing. For two months, I've had constant left hand numbness in middle and pointer fingers and thumb, and persistent pins & needles in entire left arm, which is increasing in severity. Pain flares but is not interfering with my life like it was in the fall.

My insurance changed, so Dr. Yeh referred me see Dr. James Carr, an orthopedic surgeon who specializes in spine conditions and ADR, also in San Luis Obispo. I see him next week and want to be as informed as possible going into the conversation.

At this point, I am not considering surgery for the pain, just the numbness because of my history: In March 2020, I had to have emergency L5-S1 microdiscetomy. The pain was alleviated, but I still have permanent saddle anesthesia due to compression of the Cuada Equina nerves.

So I am extremely concerned about the possibility of more permanent numbness, especially since I am left handed and am already seeing decreased function (dropping, handwriting and typing issues).

Anyone else have surgery due to numbness from a cervical disc? I would love to have pain relief as well, but it is not severe enough anymore for to consider such a big operation. Thoughts?

Thank you!
Lisa

[annapurna]

If you reword your question to, "Should I have surgery to improve my quality of life?" it's a lot easier to answer. That's always a reason to consider the next step up in intervention; surgery in your case.

Numbness and muscle weakness would definitely drive one to pursue surgery and have done so for many posters on this board. Laura sought surgery for her second cervical ADR once she began seeing signs of muscle weakness and numbness. We didn't wait for the pain to ramp up because we knew what the situation was. She'd already been evaluated for the need for the 2nd cervical ADR when the first cervical surgery was done. We just hoped the second would stabilize where it was at that time and not need surgery. In your case, it sounds like the nerve impingement is causing you enough trouble that surgery should be on the list of potential options and Carr should, hopefully, engage with you about whether it's the path you want to take.

[LisaW]

Thank you, this is a very helpful perspective! I do worry about the 2nd disc deteriorating to the level of the worse one, so hopefully this would prevent that.

[Harrison]

Lisa, what are your next steps?

[LisaW]

Hi Harrison. I had a transforaminal steroid epidural injection to see if that would help, and unsurprisingly it has not. We can try an interlaminar injection next, but I'm not optimistic that would do anything either.

So I have a follow up in 2 weeks with the surgeon. He thinks I have a bit more time to decide but in the next few months I will have to pull the trigger or risk permanent numbness. I'm starting to get numbness on my face now so if that continues I will be more aggressive with getting surgery soon. I'll keep you posted, thanks for checking!

[annapurna]

While it's not my spine, I'd hesitate to regard the steroid injections as anything more than a way to control pain and numbness while you looked for a more permanent solution. Too many injections can actually weaken the connective tissue in the area and cause more problems down the road. I don't mean to keep pushing you to surgery but I'm afraid that the temporary care options you're being offered are buying time now at the expense of more problems in the future.

[LisaW]

Thank you, I think that's a really valid point and one that I can considering heavily right now. Meeting with surgeon next week.