I am being steered towards injections despite progressive symptoms…

@laura1970
Thank you — I appreciate this perspective. That’s exactly how it feels, like things have crossed into a different territory now. I agree it’s time for a more comprehensive exam, I have not seen a neurologist. I would like an actual discussion about definitive treatment instead of continuing to chase symptoms. Yes, I have urinary incontinence.

Hello,
I have Cervical Radiculopathy with canal narrowing that I was born with, as well as foraminal stenosis in C-5 through C-7, which maybe has progressed to other areas since my last MRI. I was diagnosed 8 years ago. Since then, I have tried physical therapy to no avail, been prescribed meds that I discovered I was allergic to, such as gabapentin, pregabalin and NSAIDs, none of which I am able to take. I now take Tramadol, which really only helps me sleep. I suffer from insomnia on a nightly basis without the medication. Physical therapy has been ceased due to having no effect towards improvement. I have had 2 cervical epidural injections. The first greatly intensified my pain, which I had 3 years ago. I had the second one 2 months ago, and there was little to no difference in my pain. At this point, surgery is being considered. I have had 2 different medical opinions offered to me. One doctor says the surgery should be a last ditch effort when all else has failed, since the other areas of my neck are not yet deteriorated, they fear that surgery could have more of a damaging effect than a healing one. The second doctor says that this is difficult to determine at this time, and that it isn't fair to say that it would absolutely damage me further, especially since nothing else has proven effective, and that surgery is the correct next step. I have been made aware of the spinal cord stimulator option, but this isn't something I'm interested in trying. So, for me, it's either surgery or continuing as I am on the Tramadol. My symptoms are worsening, I'm right-handed and my right arm has significant weakness and pain. I am at the point of dropping objects if they are too heavy or painful to carry with that arm. My newest symptom is migraine headaches. I plan to get a new MRI in the next few weeks to determine whether I will go through with the surgery. Please let me know if you have any other questions for me. It sounds like my condition has progressed further than yours. I'll be happy to keep you updated on what happens for me.

I had a series of injections over a course of 4 months, but none of them worked for me. But at the same time, I told my doctor(pain and management) that my legs and feet started to feel slightly numb, which he ignored. To make a long story short. I had a pinched nerve, besides lower back pain. If it wasn't for my primary care doctor, I might have lost all feeling below the waist. I had an emergency operation to relieve the pinched nerve. So, stand up for yourself, do research, and if needed, get a second opinion.

@steelme43

Heather,

Thank you for your response. I just wanted to add that you are starting off with the right mindset; researching and seeking advice from others. Whichever route you end up taking, at least you’ll have the peace of mind knowing that you did your scholarly research. Prayers for more healing, so hopefully you can avoid surgeries.

@steelme43 if the urinaray incontinence is NEW the is the possibility that your case is now urgent. I would call and speak with your doctors office right away. If you are unable to do this, there is a case to to be made for a ER visit

“ Synapse Spine
Spinal cord narrowing (spinal stenosis) can cause new urinary incontinence because the compressed nerves in your spine, especially those controlling the bladder (sacral nerves), can't signal properly, leading to urgency, leakage, or difficulty emptying. This is a serious symptom, potentially indicating Cauda Equina Syndrome (CES) if accompanied by weakness, numbness, or bowel issues, which needs immediate medical attention, often requiring urgent surgery to prevent permanent damage. ”

Your imagining doesn’t mention low back imaging. Have you had a lumbar MRI?

@alwaystriving770 I don’t think a stimulator is right for you; it is my understanding that it only manages pain ( someone correct me if I’m wrong about this). Your worsening motor status indicates that nerves exiting the spinal cord, or the spinal cord itself is undergoing active damage. It is this writer’s opinion ( I am not a neurosurgeon or neurologist and have been retired a long time) that surgery to remove obstruction needs to be revisited. It was my training (a very long time ago) that only removing the obstruction will prevent further deterioration and possibly allow present deficits to reverse themselves.

I would do lots of research on the doc who recommended surgery. Search google scholar to read his published articles. Examine them to see if his area of expertise is in line with your needs. At your next appointment or through his portal ask about his personal complication rate, success rate, failure rate. Ask the same questions about the hospital neurosurgery program. He will likely say your statistics are different as you are a complicated case. But get the overall information so you can try to compare with national averages.

Don’t rely on the hospital being a “ center of excellence “ these names just mean they meet Medicare guidelines re: vaccine rates, some nursing protocols and other rudimentary guidelines that have nothing to do with surgical outcomes.

@witzend
Thank you for sharing this. That’s exactly what concerns me—progressive symptoms being brushed off while trying injections that don’t address the underlying issue. I’m definitely advocating for myself and seeking other opinions. I appreciate you reinforcing how important that can be.

@laura1970
Thank you for pointing this out—I appreciate you taking the time to explain the urgency. The urinary symptoms are new, which is part of what’s been so concerning for me. I have had lumbar imaging in the past, but nothing recent. I’ll be attaching that prior report and the NCS report from April 2022 for reference if you’d like to look over. I truly appreciate you flagging this and reinforcing the importance of not ignoring these changes. The doctors I’ve see recently haven’t mentioned new MRIs of my lower back despite my mentioning the urinary issues. I don’t understand why.

@steelme43 your lumbar report doesn’t have ny abnormalities that would point to an urgent need for surgery, though it was done in 2022. I don’t have the expertise to say if they bear repeating or not.

Your emg from 2022 is clearly abnormal.

When I read your previous post, I was worried about cauda equina syndrome which originates from lower back issues. Now I am more worried that your neck issue is causing a different type of urinary incontinence.

My recommendation hasn’t changed. I think you need urgent evaluation to rule out need for urgent surgery as untreated impingement risks permanent deficits

Keep us informed of your progress, if you don’t mind.

All the best,

Laura

@marialyce the FDA has never given approval for steroid injections into the spine, the information below is old, but still stands.
https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-requires-label-changes-warn-rare-serious-neurologic-problems-after,;%20severe%20headache;%20or%20seizures.