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KarayanMD
KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 805
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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Dear Doctor, I have a c7 herniation. the acute phase started

This answer was rated:

Dear Doctor,
I have a c7 herniation. the acute phase started 6 weeks ago.
After MRI i saw a neurosurgeon, he tested my strength levels in my right arm and concluded that strength is NOT diminished. Pain in the first weeks was hell though.

I have an EMG next week, the neurosurgeon did not seem it urgent to have it sooner.

What I don't understand is that sometimes my right arm is pain free (although pink and ring finger have 20% less sensation) and sometimes like tonight the pain in my arm is there and I am taking a tramadol to be able to sleep.

My questions
Is this pain variation normal?
Does it mean I am doing something wrong that pushes the herniated disc out one day more than the other?
I read stories of people that have no more pain after 6 weeks, is that an average?
Can i still hope for more healing of the symptoms? Some people tell me 6 weeks is short.

Thank you for your answer, best wishes, Paul Schuchhard

KarayanMD :

Hi. Thanks for your question.

KarayanMD :

I am a board certified neurologist in the U.S.

KarayanMD :

Are you available to chat?

Customer:

yes i am thank you for being online!

KarayanMD :

Sure. Well to answer your question, some variation is definitely normal in people who have problems with nerve root compression.

KarayanMD :

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.

KarayanMD :

It does not mean that the disk is being intermittently more or less herniated, necessarily.

KarayanMD :

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.

Customer:

ok so it is still relatively early in the game?

KarayanMD :

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.

KarayanMD :

It is relatively early, and there is some time.

Customer:

ok i understand what you are saying

KarayanMD :

Have you tried physical therapy?

KarayanMD :

And have you tried any antiinflammatories?

Customer:

not yet, i will start it next week 2 spetmeber

Customer:

i was on tramadol / still am sporadically

KarayanMD :

Good that will be an important step.

Customer:

ok, nobody told me that before

KarayanMD :

Sure tramadol will only be a pain reliever.

Customer:

understand on the tramadol, but it it normal i still have to take it some days after 6 weeks

Customer:

?

Customer:

in the beginning i took it daily

KarayanMD :

Antiinflammatories include steroids or medications like Ibuprofen which can help.

Customer:

but tried to tape off

Customer:

one doctor told me to not keep taking the ibuprofen, whats your take on that?

KarayanMD :

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.

KarayanMD :

usually only a one week course or so is needed as a trial.

Customer:

yes i did

Customer:

thats why i have given up on that

Customer:

i try and eat extremely clean

Customer:

nothing pro inflamatory

KarayanMD :

So if the symptoms have been pretty stable and not worsening, then it makes sense to give physical therapy a try.

Customer:

and got back to do some cardio

Customer:

not worsening no

Customer:

stable yes

KarayanMD :

Sure, just avoid activities that will put stress on the neck.

Customer:

what can the phsyical therapy do?

KarayanMD :

Get the PT going, and let's see where you are after a few more weeks.

Customer:

can it alleviate the nerve pressure?

KarayanMD :

Heat, massage, ultrasound, electrical stimulation perhaps may be helpful in relieving some irritation.

Customer:

ok i will try some of that

KarayanMD :

It can buy a little more time.

Customer:

time before deciding on operation or not, is that what you mean?

KarayanMD :

Yea, pretty much.

Customer:

ok i see, here in Europe they often are conservative with operating early, i hear that success rates of operating cervical hernias are low?

Customer:

no idea about that though

KarayanMD :

The EMG will also be useful to determine if there is any sign of muscle injury, in terms of making a decision on surgery.

Customer:

Ah thank you thats very useful information!!

KarayanMD :

Well, I would expect success with most routine neck surgeries, but still we don't necessarily want to rush into it.

KarayanMD :

You are very welcome Paul.

Customer:

ok... yes i heard scar tissue can be an issue

KarayanMD :

That I am not sure about, but of course any surgery can have complications.

Customer:

sure, that i understand, in the end it will be my own choice to go for that or not

KarayanMD :

Yes, that is true.

Customer:

but i will await the EMG, i presume that's quite key

KarayanMD :

If anything should get worse, you will need to tell the doctor immediately, though.

Customer:

well, in that respect

KarayanMD :

EMG is an important test, that is true also.

Customer:

the fact that tonight my arm hurts more

Customer:

does that qualify as getting worse

Customer:

its like there is more pressure in the tricep and little finger

KarayanMD :

Probably not, if you have cut down on the Tramadol.

Customer:

but this comes and goes

Customer:

yes, i take 1 a week, mostly 2 a week (50mg)

KarayanMD :

Sure, not a high dose either.

Customer:

no i try not to get addicted to it

Customer:

ok so i start the phsyical therapy

Customer:

await the emg

Customer:

and also talk to my neurosurgeon here on 10 september

KarayanMD :

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!

Customer:

Can i come back to you at some point for more advice

Customer:

?

Customer:

thanks a lot

KarayanMD :

Yes you can, but I am not always immediately available. I would be happy to answer other questions in the future.

Customer:

i will rate you high, and give you a bonus too, though out of work for the moment so cannot give that much sorry :)

KarayanMD :

No problem. It was my pleasure to help you today.

Customer:

ok then i will ask my questions ahead of time

Customer:

thanks a lot, i can sleep more peacful

Customer:

goodbye

KarayanMD :

good night.

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