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@jtstarr

I was just diagnosed with cervical radiculopathy about 4 months ago and I'm seeking advice on where to turn for treatment. I started having tingling numbness in my right upper arm. It would come an go and then the numbness extended to my right forearm as well. After 2-3 weeks of this on and off tingling and numbness I began having some issues like putting on my seatbelt, opening and closing a sliding glass door, and carrying a 23 lb bag of dog food or flats of water. My primary ordered an MRI and referred me to a Neurosurgeon. The neurosurgeon ordered a nerve study and EMG and also referred me to a orthopedic surgeon. By the time I had the EMG and nerve study, my strength had returned about 90% and the episodes of numbness had mostly subsided also. The EMG results showed, "large motor units and reduced recruitment in C5-C7 muscles on the right and C6 muscles on the left." Also, "evidence oof chronic right C5-C7, and left C6 radiculopathies without active denervation." The orthopedic surgeon read the MRI and saw no issue to the spinal cord but identified the problem in C-5-C6 at the nerve root. He also said this type of thing often just goes away on it's own. When the neurosurgeon's PA called me with the EMG results, I was told surgery wasn't recommended. Having regained about 90% of my strength over several weeks and the numbness becoming less intense and shorter duration, I thought all was getting better. Then one evening, after 3-4 weeks of little to no symptoms, I got a sharp burning pain in my deltoid; so intense I thought I would throw up. I ended up taking 1000 mg of Ibuprofen just to be able to drive the 1 hour home. Over the next 10 days I had upper arm and upper back pain almost constantly along with a rapid loss in right bicep strength; I had to use two hands to brush my teeth and sometimes couldn't get a utensil to my mouth to eat. I went back to my primary and told him the neurosurgeon and orthopedic surgeon had no further recommendations, however, that was when the symptoms had improved after the first episode and now I was in the second episode and this time it included periods of significant pain that didn't accompany the first round. He decided to refer me to "sports medicine". His office called me a couple days later asking who I wanted to be referred to. I now have an appt with a different neurosurgeon but I'm not confident that is the best way to proceed. I'm 57 and retired Air Force pilot. Many hours of flying while wearing an extra 20-50 lbs of gear, and pulling G's, probably is a primary factor leading to this condition and the previously diagnosed lumbar stenosis also. I'm doing physical therapy and it seems to help. But I'd like to avoid the loss of strength and range of motion get even worse or become permanent. It being being a nerve root pinched by vertebra, I question whether that fits ortho or neuro. It seems a surgeon in either of those don't have options that aren't surgical. Any suggestions on a type of specialist to see for additional treatment options?

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Replies to "I was just diagnosed with cervical radiculopathy about 4 months ago and I'm seeking advice on..."

I can relate. My pain and numbness started about a year ago. After battling with insurance to get an MRI, they found degenerative discs in c4-C7

I had spinal fusion surgery last week and the pain is 100% better. In fact I feel stronger all over, including my legs.

A neurosurgeon was the type of physician I was sent to.

Hope you can get some relief!

I recommend getting different Orthopedic opinions. But since you were 100% relieved with pt, it sounds like something is impinged. I have two recommendations: MFR therapy for sure. (there's a section on it here) Pay out of pocket and try a couple therapists before you ever consider surgery! (I had the surgery - TWO of them because the hardware moved); try botox if you find a muscle is impinged. It doesn't sound like you are sure you do have an impinged muscle/nerve and it doesn't sound like you know yet where it originates @jtstarr . I had a lifetime of getting to my cervical spine surgery, trying many things. When I saw that manual manipulation ( MFR) could resolve my problem -- but it could only last for a couple of days with the bones sitting properly on top of each other, I knew I was ready for surgery. But it was only a partial answer. I am still in a lot of pain (this summer 2 years out!) The second surgery putting a rod down my neck/spine has been less than great. My bones were too soft to hold the hardware from the front (an AMAZING surgery if it would have stopped there). You are correct - the ortho doesn't have nonsurgical measures but they SHOULD and can direct you. I don't think neuro is your answer without an EMT test.
Go to the MFR guy for a bit and get relief, see about trigger points, acupuncture, botox, epidurals, cortisone injections and RFI/RFA. Most of all, keep up that exercise. Most of the time, the Ortho has to see a specific thing in order to recommend surgery. If he doesn't see it then you are LUCKY he/she is being conservative - as frustrating as it may be. You have to isolate the pain to treat it, probably. Yes, see a sports med doctor (Kinesiologist) too. A diagnosis of radiculopathy means it is originating from "somewhere else" but you need to locate the source. Any noticeable loss of muscle mass needs evaluation by Rehab or PT professional. They too can help you. In a way, you must become the doctor in all of this managing yourself. If you do need surgery, you need to build up your body because the muscles waste afterwards when you must live in the brace to heal. good luck. In my case, part of it is hereditery. My dad had some scoliosis and I inherited it. We were both left handed artists. I have a lifetime of my trapezius, rhomboid, levator scapula fascia gluing together. They act as a unit and would bear down impinging all kinds of things. Eventually they pulled my neck out of whack. Look at your lifetime of pulling heavy gear. You might have glued fascia. MFR!!!