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Hi. Thanks for your question.
I am a board certified neurologist in the U.S.
Are you available to chat?
yes i am thank you for being online!
Sure. Well to answer your question, some variation is definitely normal in people who have problems with nerve root compression.
There may be inflammation that comes and goes, or perhaps just some nerve irritation that can occur once a nerve has had some degree of injury to it.
It does not mean that the disk is being intermittently more or less herniated, necessarily.
In terms of time duration, one would have after 2 or 3 months latest, that there would be resolution of the symptoms, if they are going to resolve.
ok so it is still relatively early in the game?
If the symptoms continue after that period of time, it may have a chance of becoming a chronic problem, and surgery may be needed if conservative treatments do not help.
It is relatively early, and there is some time.
ok i understand what you are saying
Have you tried physical therapy?
And have you tried any antiinflammatories?
not yet, i will start it next week 2 spetmeber
i was on tramadol / still am sporadically
Good that will be an important step.
ok, nobody told me that before
Sure tramadol will only be a pain reliever.
understand on the tramadol, but it it normal i still have to take it some days after 6 weeks
in the beginning i took it daily
Antiinflammatories include steroids or medications like Ibuprofen which can help.
but tried to tape off
one doctor told me to not keep taking the ibuprofen, whats your take on that?
Well if you have given Ibuprofen a daily try for a week or so, then it likely has done its thing in terms of treating the inflammation.
usually only a one week course or so is needed as a trial.
yes i did
thats why i have given up on that
i try and eat extremely clean
nothing pro inflamatory
So if the symptoms have been pretty stable and not worsening, then it makes sense to give physical therapy a try.
and got back to do some cardio
not worsening no
Sure, just avoid activities that will put stress on the neck.
what can the phsyical therapy do?
Get the PT going, and let's see where you are after a few more weeks.
can it alleviate the nerve pressure?
Heat, massage, ultrasound, electrical stimulation perhaps may be helpful in relieving some irritation.
ok i will try some of that
It can buy a little more time.
time before deciding on operation or not, is that what you mean?
Yea, pretty much.
ok i see, here in Europe they often are conservative with operating early, i hear that success rates of operating cervical hernias are low?
no idea about that though
The EMG will also be useful to determine if there is any sign of muscle injury, in terms of making a decision on surgery.
Ah thank you thats very useful information!!
Well, I would expect success with most routine neck surgeries, but still we don't necessarily want to rush into it.
You are very welcome Paul.
ok... yes i heard scar tissue can be an issue
That I am not sure about, but of course any surgery can have complications.
sure, that i understand, in the end it will be my own choice to go for that or not
Yes, that is true.
but i will await the EMG, i presume that's quite key
If anything should get worse, you will need to tell the doctor immediately, though.
well, in that respect
EMG is an important test, that is true also.
the fact that tonight my arm hurts more
does that qualify as getting worse
its like there is more pressure in the tricep and little finger
Probably not, if you have cut down on the Tramadol.
but this comes and goes
yes, i take 1 a week, mostly 2 a week (50mg)
Sure, not a high dose either.
no i try not to get addicted to it
ok so i start the phsyical therapy
await the emg
and also talk to my neurosurgeon here on 10 september
Sounds like a good plan, sir. Best wishes. If this has been helpful, please remember to click on the happy face (accept), and Bonuses are always appreciated!
Can i come back to you at some point for more advice
thanks a lot
Yes you can, but I am not always immediately available. I would be happy to answer other questions in the future.
i will rate you high, and give you a bonus too, though out of work for the moment so cannot give that much sorry :)
No problem. It was my pleasure to help you today.
ok then i will ask my questions ahead of time
thanks a lot, i can sleep more peacful