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I have pain in upper back, tingling/numbness in index and…

I have pain in...

I have pain in upper back, tingling/numbness in index and middle finger on right side, and weakness on that side in pec, triceps and lat. Thinking c6-c7 impingement. How long do I have to try to recover conservatively? Meaning without surgery. Don't want to wait too long and risk permanent damage.

Doctor's Assistant: Have you had any recent injuries? What seems to make the pain better or worse?

Pain started after 3 days of hard weightlifting workouts. Pain improves if I put right arm up over my head.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Nothing significant

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Answered in 24 minutes by:
3/22/2018
drphophalia
Category: Neurology
Satisfied Customers: 37,807
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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It may take around 2-3 weeks for recovery.

Following measure would help you:

1) Neck care in the activities of daily living.

a) No working on computer for more than half an hour in a single stretch. Same for TV.

b) Monitors and televisions exactly in front (180 degrees).

c) Contour pillow: Should fill the hollow when lying on back or straight. Available over the counter.

2) Cervical Collar or Brace

3) Cervical traction

4) Anti-inflammatory analgesics like Ibuprofen

5) Some physicians do give oral steroids in severe radiculopathy cases, in whom weakness, pain / numbness / tingling is quite significant.

6) Physical therapy: gradually increasing exercises from passive stretching to active against resistance regime.

7) Electrotherapy in the form of TENS, interferential and laser and ultrasound.

8) Hot fomentation

9) Local analgesic patch / ointment / spray

You can consult following specialists;

a) Orthopedist

b) Neurologist

c) MD in Physical medicine and rehabilitation

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 1 month ago
It has been 10 days so far, pain has been lessening but weakness in pec triceps and lat on right side still weak. I would like to know how long to try conservative non surgical treatment before nerve damage becomes permanent without surgery

Nerve damage takes almost 12 weeks or more depending on the severity of pinching of the nerves (and degree of disc herniation or pressure on nerves due to osteophytes / degenerative disc changes).

It is privilege assisting you.

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Customer reply replied 1 month ago
Thank you for your help. So should I see symptom improvement gradually? At what point or sign should I consider surgical intervention? Will function of effected muscles return without surgery?

You are very welcome.

Yes, symptoms would improved gradually.

Irreversible damage is rare, so after surgery, majority of the time, functions come completely.

The surgical indications are;

1) Conservative treatment not responding even after 12 weeks.

2) Progressive pain, numbness, tingling, weakness.

Wishing you a speedy recovery.

" I sincerely hope that I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you!”.

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Customer reply replied 1 month ago
At what point can I return to strength training, boxing or swimming? Should I train through pain or rest? Have started stretching rehab program as well as ice, heat, NSAIDs and trigger point release using foam roller and tennis ball.

Once you are better by 90%, you may return to strength training.

Swimming can be done earlier, when you are better by 60-70%.

Pain is our protective phenomenon so avoid train till your pain is substantially better.

It is privilege assisting you.

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Customer reply replied 1 month ago
Thank you for your help.
Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 49,181
Experience: Experienced physician in Neurology
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This is Dr. David

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Customer reply replied 1 month ago
Hello and thank you. I'm very worried about the lack of sensation in my fingertips and the lack of function in my right pec, lat and triceps. I would like as many opinions as possible deciding on a course. Athletics is a big part of my life and I want to be certain that I won't delay a treatment that will leave me permanently lame.

how old are you?

are you male or female?

what is your height and weight?

do you have bad anxiety symptoms?

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Customer reply replied 1 month ago
41 year old male, 5-11, 180 Negative on abnormal anxiety. Just looking for a solid prognosis on c6, c7 impingement with reduced motor function and strength. Diagnosis seems to be dialed in, just want to take best option for remedy

the most common cause would be a slipped disk causing disk impingement on nerves exiting the neuroforamen at C6-7

every patient recovers at different rates

disks that slip out of position can slip back into position at any point. have you seen a doctor about this or gotten an MRI scan of your cervical neck spine?

did you diagnose yourself or see a doctor

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Customer reply replied 1 month ago
Initially went to ER 1st day pain was so intense. Diagnosed cervical radiculopathy given muscle relaxer and prescription NSAID. Pain has steadily decreased ocer 10 days but numbness and weakness continue. X rays of upper back and shoulder were unremarkable. No MRI yet. Started seeing physical therapist who did various tests and agreed with diagnosis and c6-7 impingement. Impingement onset on rest day following 3 days of crossfit style workouts with lots of overhead movement but no immediate acute injury.

I see.

I'm glad your symptoms are getting better

crossfit can be tough with the overheads.

since you are still having some numbness, I would see a neurologist and ask for a neck cervical spine MRI scan closed MRI with 1.5 or 3.0 tesla MRI magnet to look at the area of pinched nerve

you may need to help strenghten your neck muscles with yoga stretching and better body position to help improve your tendons and muscles to help keep your disks in place.

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Customer reply replied 1 month ago
Thank you. I will look into MRI as well as functional stretching. The other doc said 12 week window to see if symptoms improve before resorting to surgery. Do you concur? I know surgery has complications as well, would prefer to allow body to heal itself. Will the motor nerve be able to heal itself and restore function to enervated muscles?

yes, you can also rest as well for 12 weeks

I would not do any overhead presses at cross fit for 12 weeks.

you can do other exercises

if the disk pressure is off of the nerves, then yes, the nerves will heal.

only time will tell if the pressure comes off of the nerves.

Let me know if you have other questions.
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Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 49,181
Experience: Experienced physician in Neurology
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Customer reply replied 1 month ago
Thanks a bunch doc.
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