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  • Q&A with Australian Health Practitioners

    Can I be causing permanent damage by avoiding surgery for my pinched nerve?

    Related Topics
    Back & Neck Pain Pain
    I have been diagnosed with cervical Radicularpathy and on further examinations with imaging have been told I have a number of nerve impingements. I have done some research and found out if I don't deal with the problem it will get worse eventually leading to permanent damage that I won't be able to be treated for, is this true?
    In need of some help to decide wether or not to proceed with surgery
    Thank you.
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  • 5

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    Dr Don Williams

    Chiropractor

    Don WilIiams has worked and studied internationally in rehabilitation and sports injury management. His career started out in the late 80s with a move toward … View Profile

    This is an interesting question. Some more background information is required before a specific answer can be given, however. Cervical radiculopathy tends to indicate that there is true compression of the spinal cord or nerve root/s which will cause a pain or sensory disturbance in the related nerve roots. (Whereas a referral pattern does not always indicate specifically nerve or spinal cord compression). This path of disturbance is relatively easy to trace and identify. Hypothetically, an MRI or CT Scan should have been, or should be, performed to confirm compression of the spinal cord or nerve roots from either a disc injury, degenerative compression or other definitive pathology to explain the radiculopathy.
    Essentially, if the compression is significant and there is a notable decrease in strength with muscle wasting (size decrease) or a definitive decrease in sensation then a decision needs to be made relatively quickly. If true significant compression is present and is not addressed, then the loss in strength &/or sensation can be permanent. However, if there is still good strength and there is normal sensation then there is still time to trial conservative management. Remember, surgery should always be a last resort and is not always successful.
    Hopefully you have access to good practitioners who can give you an unbiased opinion in relation to the severity of your presentation and your likelihood of success from conservative intervention or surgical options.

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    Abs

    HealthShare Member

    I want to thank Dr Don Williams for replying to my question in regards to Nerve Impingement and I would like to give you updated information and further seek your opinion please.
    I recently took your advise and got a CT Scan done which reports the following findings: c3/4 presents mild osteoarthritis of facet joints and a mild anterolisthesis of c3 on c4 with pseudo disc buldge,c4 nerve roots impinged, c5/c6 moderate sized disc- osteophytic complex with severe narrowing of right neural exit foremen and the c6 nerve root is impinged, c7/T1 again broad based disc- osteophytic complex with spinal canal stenosis of neural exit foramina.
    On reading that what does this all mean? And should I be trying to contact my Neurosugeon asap?
    Please would love a reply as I am still in sure of what to do.

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    Dr Don Williams

    Chiropractor

    Don WilIiams has worked and studied internationally in rehabilitation and sports injury management. His career started out in the late 80s with a move toward … View Profile

    Hello Abs,
    I would think from reading the details included that you are likely to be in the 55-65 year age group (hopefully I have not insulted you). Certainly, the results suggest that the condition has probably been manifesting for a period of time. Degenerative changes like that occur over many years, rather than being a new injury or incident. So hypothetically, progression of symptoms is not rapid in these cases. The interesting thing with stenotic degenerative conditions are the difficulty to predict the response to conservative treatment. We sometimes see some really terrible looking scans and the clinical presentation is not that severe and essentially the patient responds well. Often it is a case of managing the presentation to prevent further deterioration and symptoms. On the flip side, sometimes cases don't appear that significant and they really don't settle well conservatively (multimodal approach), leaving few options other than agressive intervention (surgery).
    I think a neurosurgeon consult is a good idea. I am not sure what city you are located in, so am unsure of whether I can suggest someone to you, however, the clinical presentation and the potential correlation with the ct scan is still very important. Maybe getting an assessment and trial intervention with a conservative practitioner is still an option.
    Mind, an opinion given without comprehensive history and examination is always somewhat ignorant and is always with reservation.
    Hope this helps.
    regards

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  • Abs

    HealthShare Member

    Dr Don Williams
    Thanks for again replying to me quickly I wasen't very clear on my condition and how it came about so I just wanted to give more detail.
    I am infact a 36 yr old female who was diagnosed with cervical degenerative disc disease since the age of 21, I suffered and am continuing to suffer from chronic neck and shoulder pain up til this day. By the age of 29 I was experiencing worsening symptoms that were unbearable and decided to finally seek some help which led me to my Neurosurgeon, after physical examination and imaging they told me I had Cervical Myelopathy and needed an operation immediately, I then had a Anterior Cervical Distectomy and Fusion on the c4/c5 level at the age of 30 I was fine for a couple of years still experiencing bad neck pain but I wad told they could not help me with that and the main purpose of my surgery was to prevent paralasis. Moving on 2 yrs after I started experiencing shooting pains in my arms and severe neck and shoulder pain accompanied with numbness I went back to my surgeon and that's when I found out I had Cervical Radiculopathy and most likely needed another Fusion in which I have been ignoring for 4yrs now and trying to manage with more conservative treatment but unfortunately have been unsuccessful. I hope I have made it more clear to why its hard for me to make a decision and to why I am seeking much needed advise as I don't want to do anything I will later regret.
    I am from Sydney and would love to know of any nuerosugeons whom you recommend so I can get a few opinions.
    Thank you kindly.

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    Dr Don Williams

    Chiropractor

    Don WilIiams has worked and studied internationally in rehabilitation and sports injury management. His career started out in the late 80s with a move toward … View Profile

    Hey Abs,
    Certainly a less than usual and complex sounding case. You are very young to have the history you have described.
    I don't know too many of the neuros and orthos in Sydney. I do know a couple of rehab practitioners though who may be worth a look for conservative management and should know the best neuros and orthos in Sydney.
    If I was in your position, I would seek the advice of Dr David De La Harpe. He is in Melbourne. However, he is the busiest spinal orthopaedic surgeon in Australia, pioneered a lot of microscopic disc surgery, started as a chiropractor then did medicine, fellowship in plastic surgery before going on to spinal orthopaedics. Very well educated and very well respected. I have had several spinal surgeries myself and if I was going to look to further surgery I would make the trip there for his opinion.
    Send me an enquiry via my profile and I will send you a list of contacts to speak with.
    regards

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