Notices
Results 1 to 15 of 15

Thread: Herniated Disc in Neck

  1. #1 Herniated Disc in Neck 
    Forum Freshman
    Join Date
    Feb 2009
    Location
    Carbondale, IL
    Posts
    28
    So back in Dec we had a bad ice storm and I slipped and fell on the ice. When I fell I had kind of a whiplash action and got a concussion. They did a CAT scan to make sure I didn't have any internal bleeding in my brain and sent me home telling me not to sleep for more than a few hours at a time.

    Now, over 3 months later, I'm starting to have pain in my neck and it shoots down my arm and into my hand. The best way I can describe it is: when you turn your head the wrong way or too fast and it catches and you get a burning sensation in that area for a few seconds. It's like that only its persistent.

    I finally made a doctor's appt after the pain didn't go away and she pushed on the vertebrae along my neck and when she got to my C3 vertebrae I got that same sensation spreading into my shoulder and down my arm. She scheduled an x-ray on my cervical spine and said everything is fine but from talking to others and my own research, I've found that x-rays really wont show a herniated disc.

    I'm due to start physical therapy on April 7th but don't know what that is really supposed to do. I was wondering if x-rays really do find herniated discs? Should I request an MRI for further information? Will physical therapy most likely heal it? I'm only 22 so I figured that physical therapy would work but my doctor isn't giving me very much information to work with. Plus, my father had a herniated disc in the same exact spot and said that, what my doc is telling me, is totally different than what he was told.

    I'm just a little confused on the whole situation and can't take this pain anymore. Any information is helpful.


    Reply With Quote  
     

  2.  
     

  3. #2  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    Physiotherapy is probably a good idea so I would definitely go to that; physical therapists would have a greater depth in knowledge about these types of injuries and dealing with them than doctors.

    It does sound like you may have caused some damage to the spine but I couldn't specify what.
    It is almost definitely not a herniated disc considering your age; this is when the substance of the disc protrudes irregularly from the round substance, it tends to be more degenerative than by injury alone.
    It may be a slipped disc or some form of compression on the C4 nerve.

    You are absolutely right; a plain film xray won't show this.
    For a proper clinical diagnosis you would probably need an MRI.
    However; this isn't really necessary unless the physical therapy failed or you were considering surgery for the problem; an MRI wont change your treatment so why do it?

    I think your best option for now is to do the physical therapy and that should work.
    If it fails according to your physio, I would go back to your doc and ask for an MRI for a proper diagnosis.


    Reply With Quote  
     

  4. #3  
    Forum Freshman
    Join Date
    Feb 2009
    Location
    Carbondale, IL
    Posts
    28
    Thanks, Robbie. That's what I thought but when I called up to get my results I ended up talking to a nurse, not the P.A. that did my initial examination and she was very adamant that an x-ray would show any herniated disc.

    I was under the impression that a herniated disc and a slipped disc were the same thing? How long does physical therapy take to fix a problem like this? My P.A. was making it sound like after 2 weeks if the pain didn't subside I would have an MRI but that doesn't seem like a long enough span to really analyze the problem.

    Thanks again for clearing that up for me.
    Reply With Quote  
     

  5. #4  
    Forum Radioactive Isotope skeptic's Avatar
    Join Date
    Nov 2008
    Location
    New Zealand
    Posts
    4,840
    There are lots of subtle injuries that can happen to the spine, and a lot cannot be diagnosed. Even when diagnosed, a lot cannot be treated. Beware of simple explanations and overconfident treatments. It is rather likely that your injury cannot be explained and that there is no simple treatment.

    The greatest thing you have in your favour is youth. Young people have great powers of recuperation,and injuries tend to heal. It can be painful in the short term, but in the long term, healing comes.

    If no expert opinion gives a clear diagnosis and a clear treatment, my advise is to be very wary of quacks, who will give ready diagnoses based on nothing and offer expensive treatments that they will continue for years to come. It is just as likely that the following will work as well as anything else that might be offered.
    1. Try to continue normal life as much as possible.
    2. Take simple pain killers like paracetamol to get through the day. The effect of different painkillers is very individual, so use what works best for you.
    3. Avoid any action that exacerbates the pain. You will quickly learn what these are.
    4. Take time. Do not expect rapid results. The body, even when young, needs time to heal.
    5. When healing has occurred and the pain has subsided, start simple exercises to build up neck muscle strength. Start slow and gradually increase till your neck muscles are strong.
    6. I would be very sceptical of physical therapy. Until the injury has healed, it is not good to put pressure on that injury. Normal movement that does not cause excess pain is OK. Anything that causes excess pain is to be avoided. Pain is the body's warning that something is wrong. Take heed!
    Reply With Quote  
     

  6. #5  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    Hi salukgirl.
    Firstly I don't know if the nurse would have known enough to make a comment on it; but a plain film xray is pretty standard, safe and reasonable for a first start as it rules out a lot of the big things.

    I'm a medical student myself, I don't know a huge amount about physical therapy but I would discuss a plan as soon as you meet your physical therapist so you both know what you're aiming for in terms of results.
    The overall aim of the therapy should be to return you functionally to where you were before & this will involve doing exercises around the area to maintain joint flexibility & strength as well as dealing with the injury: this is one of the reasons you should ignore sceptic.

    Physical therapy is an evidence based discipline; you do not need to be skeptical of it.

    Yeah, sorry herniated and slipped discs are the same I was thinking a slipped vertebrae but this is would have shown on the xray.

    Sceptic; I find it ironic you say to beware of quackery and then dish out some very poor advise off the cuff; medically a lot more can be offered than damage control!
    Reply With Quote  
     

  7. #6  
    Forum Radioactive Isotope skeptic's Avatar
    Join Date
    Nov 2008
    Location
    New Zealand
    Posts
    4,840
    To Robbie

    The difficulty in this case is that the exact cause of the trauma is undiagnosed. To go offering therapies when we do not know what the nature of the damage is, can be most irresponsible.

    I agree that physical therapy is evidence based. The problem is mainly centred around physical therapists, who are not trained doctors, and often have no good understanding of the science. They are targets for, and very vulnerable to, the blandishments of those promulgating quackery.

    A few years ago, I went to a physical therapist for a severely sprained ankle, at the urgings of my doctor. This physical therapist began by telling me that acupuncture was the way to go (wrong!). Then used a pad that pulsed electric fields (wrong!). Then massaged the sprain. I since learned from a specialist doctor that the proper clinical evidence shows that massaging a sprain increases pain and slows healing. So this professional physical therapist tried to apply three treatments which were all incorrect.

    My observations since have not improved my confidence in physical therapists. If they used only treatments which met the normal standards of evidence for medical research, I would be happier. But they do not. No doubt there are many conditions that are helped by their work. But care is needed.

    A neck injury is especially vulnerable. It should NOT be massaged, or treated in any way that leads to increased pain. Pain and discomfort are the best guides to what is good, and what is bad. The primary concern is healing. If the cause of the trauma is not known, then it is even more important that nothing be done that might increase the damage. The best way of avoiding damage is to avoid pain and discomfort.

    Once the worst of the pain is gone, THEN is the time to begin building up strength and flexibility.
    Reply With Quote  
     

  8. #7  
    Forum Freshman
    Join Date
    Feb 2009
    Location
    Carbondale, IL
    Posts
    28
    Yeah I went in thinking that an x-ray would show a slipped disc but then I found out that they were mostly looking for congenital things. The doc that looked them over said that my spine is less curved than it should be but that wouldn't cause the type of pain I've been having.

    I go in on Tues April 7th to discuss PT. The P.A. said that usually insurance needs to see a preliminary test like an x-ray or PT before going to the MRI. She said that I'll most likely have one but that to make it easier for me dealing with insurance she wanted to do an x-ray and PT first so they don't come around asking "why would you have an MRI with no testing first?"

    Thanks again. I was mostly just scared with reading up on herniated discs and, only being 22, I don't want to go through all that while being so close to graduation etc... So you've made me a lot more confident that this will be taken care of more easy than I expected.
    Reply With Quote  
     

  9. #8  
    Forum Freshman
    Join Date
    Feb 2009
    Location
    Carbondale, IL
    Posts
    28
    I got the results of my MRI back and they didn't say anything about a herniated disc but they said that I have narrowing in my 5th and 6th vertebrae? I guess the nurse said it's degenerative and something that just happens with time. But I'm only 21.....

    So they are scheduling me for a Nerve Conduction Study (whatever that is). Does anyone know what that is? Does this sound like something a 21 yr old should be dealing with?
    Reply With Quote  
     

  10. #9  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    To skeptic.

    NO physical therapists are trained doctors. The job of a physician is different. A physical therapist is an allied healthcare professional; they work independently and both practise and diagnose.

    Physical therapy IS evidence based and used in a huge variety of settings. They are highly trained professionals and know what they are doing.
    Acupuncture is NOT evidence based and I would not trust it as a serious form of treatment. I would not trust an acupuncturist.

    Again, I stick by what I said at the time.
    Reply With Quote  
     

  11. #10  
    Forum Radioactive Isotope skeptic's Avatar
    Join Date
    Nov 2008
    Location
    New Zealand
    Posts
    4,840
    Robbie
    I agree with what you just said. Mostly. With the proviso that some physical therapists are not smart enough to avoid quackery. (Actually, some fully trained doctors get sucked in by quackery too, but in the main they are intelligent enough, and educated enough to avoid that trap.)

    However, an undiagnosed condition should always be treated with caution. Massaging and pummelling a trauma, when you do not actually know what the trauma is, is not responsible. Better to err on the cautious side, and allow it to heal in a normal way, without that kind of intervention.

    You will be familiar with the principle "first, do no harm."
    If you do not know what you are doing, then avoid anything that might cause harm.
    Reply With Quote  
     

  12. #11  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    that's ridiculous; you've basically justified not doing anything for any patient; ever. There always remains a risk that you will do harm; but you use evidence and best practise to do what is most likely to have favorable outcome.

    Physical therapy as a treatment is all I am referring to. Nobody would avoid seeing their doctor if they were ill because they might recommend alternative therapies; thats a counterintuitive argument.

    Similarly; it may not be best to allow the injury heal; however that would be the decision of someone trained to deal with such injuries; primarily a physical therapist.
    I would follow the advice of one such therapist as a form of erring on the side of caution.
    They would know if indeed pummelling and massaging an injury would be therapeutic.
    Doing nothing is the reason many people present with late disease states which cannot be treated when fibrosis of the injury is already settled.

    Finally; no patient "knows what they are doing", that is why we need trained professionals.
    Reply With Quote  
     

  13. #12  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    salukigirl

    A nerve conduction test checks the conduction of nerves to and from your spine/brain to your muscles and skin. The idea is it can map and abnormalities and detect the source of any such abnormalities.
    It should be able to reason whether the source of your pain is the spinal narrowing as this can just occur and be nonsymptomatic.

    I wouldnt worry about the test its simple and safe and done fairly often in this setting.
    Reply With Quote  
     

  14. #13  
    Forum Freshman
    Join Date
    Feb 2009
    Location
    Carbondale, IL
    Posts
    28
    thanks. im not too worried about the test, mostly about the implications of it. my faculty advisor in school said that his wife has the same thing and, for the surgery she needs, she can only lay down or stand for 3 months straight. no sitting, no driving a car....nothing. thats mostly what im worried about - a lifetime of continuing immobility starting at the age of 21.

    thanks for your advice/information, robbie. youve made this situation a lot more clear for me (even more clear than my own doctor!)
    Reply With Quote  
     

  15. #14  
    Forum Radioactive Isotope skeptic's Avatar
    Join Date
    Nov 2008
    Location
    New Zealand
    Posts
    4,840
    Robbie

    My point is that carrying out a treatment that may involve vigorous massage etc, without knowing what the cause of the trauma is, is unwise. Clear cut diagnosis has to be the first step. The nerve conduction test being carried out right now is important, giving a better idea of what is going on.

    There are many examples in the literature of chiropractors - quacks - who do not accurately diagnose problems, applying vigorous massage, and causing more damage than existed in the beginning. This is what should be avoided.

    A doctor or other therapist should be prepared to 'do nothing' if he or she does not understand what is going on. Diagnose first, and then prescribe treatment based on knowledge. If treatment is given anyway, in spite of no clear diagnosis, it must be treatment than cannot worsen a complaint. Sometimes a trial treatment may be prescribed as a part of the attempt to diagnose, and this is acceptable - but not if it can worsen the complaint.
    Reply With Quote  
     

  16. #15  
    Forum Ph.D.
    Join Date
    Aug 2006
    Posts
    792
    I've said all that; I only said to see one.
    I dont know what they would prescribe; that's their business and decision on whatever evidence they see/need.
    Reply With Quote  
     

Bookmarks
Bookmarks
Posting Permissions
  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •