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Neuropathy and Cervical Stenosis?

Neuropathy | Last Active: Jun 2 5:09pm | Replies (24)

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@ray666

Good morning, Jennifer (@jenniferhunter)

Thank you for such a careful reply! I have tried going over all of the points you make with equal care.

I believe it is so true for many of us with idiopathic PN, and especially those of us with additional conditions, either related or unrelated, to know which therapies may help relieve some if not all of our symptoms. That's undoubtedly the conundrum I'm facing with my PN and cervical stenosis. You do refer to pain throughout your post. Here's where we encounter one of my situation's oddities, the source of considerable frustration when I speak with my clinicians, notably when I'm presenting for the first time: I have no pain. I have neither pain that I can associate with my stenosis nor pain linked to my PN. I only learned that I have cervical stenosis due to the MRI my neurologist's MA sent me to get in an attempt to decode my balance and gait issues. That led to my being referred to the neurosurgeon who further diagnosed my cervical malformity, offered surgery, but at the same time called my condition "borderline" and, as I had no cervical symptoms (at least none of the typical symptoms that might cry for urgent cervical surgery), we take a wait-and-see approach. I got that diagnosis a little under two years ago, and I've still no pain that I (as a person who has no pretensions of being a doctor) think of as stenosis-related pain; no dizziness or vertigo-like symptoms, either. An EMG a year ago pinpointed (bad pun!) sensation-loss in my feet. Even that sensation loss – if it hadn't been for the EMG – is yet another condition of which I might not be aware if it hadn't been for the EMG. I tell my clinicians: "It's a weirdness. I've no pain, but my balance is poor, my walking is wonky, and I don't know why." I should add that I've not been injured. One curious note: a brain MRI, which was otherwise A-Okay, did reveal my having been a heavy drinker, although my drinking days ended more than 30 years ago and I've had nothing alcoholic since. You ask toward the end of your wonderful message, regarding the wait-and-see approach, "Will the neuropathy obscure worsening of the symptoms that are coming from the spine?" That is a question weighing heavily on my mind. Should I get a fresh cervical MRI and return to meet with the neurosurgeon? I trust he'll not pressure me into surgery. He'll expect me to consider seriously what he has to tell me, but he'll also expect me to make that surgery decision. That the decision is ultimately mine? Therein lies the crux of my conundrum.

Again, Jennifer, thank you a millionfold for your thought-provoking reply!

Ray (@ray666)

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Replies to "Good morning, Jennifer (@jenniferhunter) Thank you for such a careful reply! I have tried going over..."

@ray666 Ray, the decision is yours. Some spine patients never feel pain at all and are shocked to learn of spinal cord compression. That confuses this even more doesn't it?

When you say that your walking is "wonky" I imagine weakness and a limp. I also had a limp when there was enough pressure on my spinal cord and there was nothing I could do to stop that when it happened. My condition was at a borderline point too- not bad enough to cause debilitating symptoms, and sometimes pretty normal depending on my neck position. It was intermittent because my physical therapist would realign the vertebrae taking the pressure off, and I walked normally again. I had muscle spasms moving the vertebrae around and altering the normal neck curve and effectively that made the spinal canal smaller when that happened. The vertebrae also had a degree of slipping forward and back slightly. The other evidence I had was the epidural injection that took the pain away completely. That works by reducing inflammation in the spine which buys a little bit of space. Epidural injections carry some risks. My surgeon at the time did this as a diagnostic test although ultimately he did not offer surgery because he missed the diagnosis. He had no answer as to why this injection took away ALL my pain, so he ignored that result, but this is a clue to the correct diagnosis of funicular pain (all over the body) which is what I had. If you can cause symptoms of pain or jumping muscles by changing the position of your head (Flexion and extension or head turning), that may be happening because those movements would increase pressure on the nerves in the spine. The spinal cord has to float and move within the spinal canal when you change position and stenosis can interfere with that normal movement. Another symptom of spinal cord compression are changes to normal functioning of the bladder or bowels. I had trouble emptying my bladder unless I consciously did it because it would stop half way. That also stopped and was normal again when my therapist realigned my neck. That can progress to incontinence caused by spinal cord compression which can become permanent without intervention.

Have you had physical therapy? Physical therapists, particularly if they also do myofascial release can help figure some of this out. Myofascial release works on the overly tight tissue in the body and releases that tension and gets the body moving better and with better ergonomics. I have done a lot of MFR with an expert level certified therapist which helped me a lot. That may be something to try to see if you can improve your condition or pinpoint where the problem may be. There are some conditions where pelvic tightness causes symptoms similar to a lumbar spine problem and can compress nerves to the legs. Some neuropathy is helped by MFR if it has a physical component. You can search for a provider a t https://www.mfrtherapists.com/

Here is our MFR discussion where you can learn more.

Neuropathy - Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
Ray, I just found this discussion from a patient who did have spine surgery and has neuropathy. You may want to look at this discussion where you can connect with @domiha https://connect.mayoclinic.org/discussion/neuropathy-in-feet-post-laminectomy/

Jennifer