Am I done? Cervical disc herniations

Triathlon Forum
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Calling the collective ST brain trust- having a tough time getting a straight answer from the people I have talked to on this:

Problem: What I thought was a rhomboid muscle pull turned into something much worse-

Xray: minimal degenerative disc disease, minimal disc height decrease at C5/6, hypertrophy, etc

MRI: C2/3- some impingement on left neural nerve root from stenosis (no symptoms from this)
C3/4- severe left foraminal stenosis, moderate right stenosis, mild central stenosis (no symptoms from this)
C4/5- right lateral disc herniation, impingement on right nerve- some mild left foraminal stenosis
C5/6- large disc herniation to the right foramina, posterior displacement of nerve root and cord, severe right lateral recess and formaminal stenosis, and mild central stenosis
C6/7- mild central stenosis, but otherwise ok other than old age stuff
C7-T1- good!

Background: I am a 48 year old male, been training/racing short course stuff for 6 years, above average but not pointy end. Racing is not super important to me, but having a good quality of life is. The two hernias resulted in significant radiculopathy down right shoulder/arm/hand, and numbness/pain/weakening of bicep, less so writst. I have had Chiro, an epidural and medrol dose pack, just started PT. Symptoms are almost resolved after 5 weeks, but I have been doing very little/no exercise/training in the hopes of calming down the nerve pain.

Question: Am I done? Should I be done? The spine specialist said I can bike and run, but swimming is a problem. My PT said biking and running are a problem too.
Looking for thoughts on this and perhaps some perspective on what I can/can’t should/shouldn’t do… I can give up racing, but if I can’t bike and run, I’ll be…well…you get the picture…

Thanks.
–Tris

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Shoot me a PM… I am a neurosurgeon and happy to help you out.

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Had those same ones fused sept 2010. I raced 2011. I can run—bike–touch toes . Dr. Heim saint louis brain and spine . Walked in a day rode bike in feb. “trainer”.

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I’m a retired Heavy Construction Carpenter. My Super for the last ten years suffered with herniations, sciatica, back pain, what ever you want to call it for the whole time I’ve known him. He finally had the surgery this fall. When I saw him a month after the first thing he said was ‘‘I don’t know why I waited so long.’’

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Had C5-C6 fused in 1999; I am 52 now…do everything I want to do athletic wise; this year have swam over 100,000 meters (makes my neck/back feel better than anything), biked over 1500 miles and have ran almost 500…had the same symptoms as you for several years before fusion; the level of discomfort comes on goes with the irritation of the nerves…I was scared of a surgical procedure on my back just as you are, but the pain got so bad I did not care what they did; turns out best medical decision I ever made…You are NOT done.

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Thats my worry- is this just a ticking timebomb in my neck just waiting for the next irritation to go downhill…the pain I was in was the most intense I have had- literally in a ball crying like a little kid. Did not sleep for more than 2-3 hours for 2 weeks. I don’t want surgery (so many horror stories), but I also don’t want a reprise of that experience. So far, the conservative approach is working, but I am wondering about the limitations of this approach towards training/future activities…

I should add that I have probably had many of these issues for awhile: Played college lacrosse in upstate NY (no soft hits up there) in the 80s, then post college club lax until about 8 years ago, play and coach soccer as well, also coach lacrosse and regularly warm up goalies with my stinging righty cannon (not). Did lots of stupid stuff growing up, too. This is the first episode of neck/shoulder pain, and it started while typing on the computer- how lame is that!?

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Exactly ! - any conservative approach (PT or lying on a couch) will help because the nerve irritation naturally calms down. When you start back being active, at some point you will irritate the nerve again and all the symptoms return. I too ended up literally in a ball in an unbearable pain, did not sleep lying down for 17 days; that’s when i said enough…you have a neurosurgeon on this page, talk to him. I am sure he will explain the procedure in depth and relieve some of your worries; can’t say i’ve met anyone that has undergone a C fusion with bad results. Pm me if you want more details regarding my experiences.
.

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I have 3 ruptured discs since 2007… L3 to S1 and I’m still going…
Sometimes I have issues but 90% of the time I’m good

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Herniated/ruptured discs are not the end of your career unless you decide to make it so.

Me, its the physical activity like training and competing in triathlons that keeps my ruptured discs from making me into an invalid looking for a wheel chair. That is not my opinion, its my doctors own words. The worst thing you can do for you back is to allow it to take more and more of the weight from your body as your muscles atrophy. Keeping the muscles strong and fit allows them to take more of that load, relieving the strain on you back and the pressure on your discs.

I have also found that chiropractic adjustments help in keeping me from having the awful pain that you described. I take glucosomine, chondroitin and msm to assist in keeping the joints and my back from eroding, and a suppliment called Joint Support from the Pathway to Healing website to keep my spinal cord from becoming inflamed. Those all work for me, that plus losing 40 lbs from where I was when I initially injured my back.

Be careful with fusion surgery recommendations, only about 50% of those surgeries work out in the long run, and often result in problems at other locations in your back when the fused areas no longer can move freely. I am not a doctor, but I did a bit of research on the subject myself when I ruptured 2 discs in my lower back and concluded that I would avoid that surgery unless I had absolutely no other choice.

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In 2010 I was hit by a car while riding. Fell on my fat head crushed my neck up a bit. Caused me to have some major issues similar to yours. Within two weeks my left triceps, chest and lat started to atrophy. Fingers numb and crazy pain and numbness on my left side. That’s the short version.

MRI showed :
C2/3- impingement on left neural nerve
C3/4- impingement on left neural nerve
C4/5- disc herniation, impingement on left neural nerve
C5/6- disc herniation on the left side nerve and other finding (can’t remember the exact terminology)
C6/7- Same as C5/6

Results permanent nerve damage and a ton of pain for awhile. Had two epidurals and I have been doing rather well since.

My biggest issue is swimming. After 2000 meters I get really sore and tender and sometimes it causes me some tingling and numbness of the fingers. I still have some mild twitching on my left side but no pain for the most part.

End result - I stick to the shorter stuff that does not require a long swim. Just did my first Sprint race of this year and was 6th place in my class (I’m 47).

Your not done.

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Been going through some of this lately as well. Stay encouraged.

I have cervical and lumbar issues. A few weeks ago I tweaked my lower back and had trouble standing up straight with both a sharp pin point pain and discomfort radiating through my hips. I have been able to continue to train in cycling and also recover at the same time.

At 48 I know I will continue to have these periodic bouts and they seem to be occurring more often, but until I am at the last point I will continue to do my own therapy to delay anytype of surgery. With the lumbar issues I can use stretches and an inversion table to help expedite recovery. My chiropractor has also used a decompression table.

Keep the faith

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ST never fails to amaze with the wealth of information online - so I too will join in on the search for information:

I finally figured out that my “shoulder blade issue” is really a neck/disc issue, and I’m in a similar (but sounds like less severe) situation as you.

MRI results:
C4-C5 “mild right lateral disc bulging”
C5-C6 “mild central and right paracentral disc bulging”
C6-C7 “small to moderate sized central and right paracentral herniation”
C7-T1 " may be some slight central disc bulge"

But my main symptom is right mid back pain right at the shoulder blade. (Which from what I heard from Drs is classic C7 referred pain). When waking up it’s the worst - getting out of bed, etc.
I did have a two week period of time right at the beginning where my right side neck was stiff, irritated, and had very little range of motion. But that was fixed between chiropractic adjustments, lots of massage, advil and ice.
No tingling, no numbness, no weakness ever which probably means I caught my issue early… and I’d like to keep it that way and not aggravate it, but at the same time, MUST be active.

So my question to all you who have had similar issues in the past… what did you do while healing and what wouldn’t you recommend while healing. We all have our own injury knowledge and what we did that we wished we hadn’t, or what we wished that we had done right away.

I’m seeing/ have seen a chiropractor, massage, PT and spine/sports doctor. MRI results are only known to spine doctor as of now. But the spine doctor focused more on what I shouldn’t do. My fault for not turning the conversation around, but when I’m at the Drs office and I get that kind of news/info, I can’t seem to process quickly enough to ask the right questions.

He said I shouldn’t swim (unless I’m using a snorkle), and shouldn’t bike but can spin as long as I sit upright.
Running? on dirt ?
Aquajogging - probably a given - done this lots in the past for PF
Yoga? don’t do it currently, but wondering if now is a good/bad time to try it
Weights? again, don’t do it currently, but it’s always been there as a ‘I should do this’

Thanks in advance for any advice you can throw my way.

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Sounds like a degenerative condition. Since no numbness and tingling appears there is no cord compression which is good. Did the md mention esi’s? Injections to the spine. I don’t quite comprehend the logic of not doing anything. You’d be amazed at what your spine looks like with a MRI, most have some level,of degeneration, but just don’t know it. I’d see another md for a consult.

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I have had similar issues this year. 51 and had radiculopathy in left arm pretty bad and lost muscle strength and had tingling fingers and neck pain for months. I tried the McKenzie method for relieving neck and back pain after spending months looking for relief with PT, doctors, and back specialists. Fortunately for me it has worked! I had doctors recommend stopping swimming, biking, and running and I got an orthopedic surgeon who specialized in neck and back that recommended a double fusion on C5/6 and C7 since I had herniations on both discs.

Well after 2 months of doing the McKenzie exercises I now have no pain and my muscle strength is coming back and I am running, riding, and swimming again.

Worked for me – you might want to try the McKenzie method before you go the surgery route. When I first started I was not swimming since my arm strength on the left side was noticeably affecting my stroke – I have gradually built my swim back after spending about 6-8 weeks doing the McKenzie method before starting my swimming again and I never stopped doing light biking and running (even though my arm bothered me on longer runs). Been about two months now with no or little pain – still do some McKenzie method exercises but mainly watch my posture at work (I work at a desk with a computer monitor and my desk setup really aggravated my neck issues).

Good Luck!

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I have several herniated cervical disks. My experience sounds very similar to yours. 3 weeks of intense pain, no sleep. I was left with severe left side muscle weakness. I could not do a single pushup. The motor nerves recovered somewhat after about 50 weeks or so. 3 years later and I still have some stiffness and weakness but it is not too bad. I can manage 20 or so pullups and can bench press just over 200lbs again. but it took 3 years to get there and I had that kind of strength untrained prior to the injury. I simply cannot ride the bike much any more. The riding position really aggravates the nerve and I get muscle twitching and discomfort for hours afterward (same symptom I had prior to the disk rupture). I can swim, run, lift weights (including overhead presses and deadlifts), surf, paddleboard, lots of things, but riding a road or triathlon bike are out due to head/neck position. It is hard to swallow at first. I was in the best bike shape of my life when it happened and had finally figured out how to get fast on the bike. I sold 3 1/2 bikes and LOTS of gear. Now I lift weights regularly, run, surf, and paddleboard. I am as active as ever but had to give up triathlons. It was difficult at first, but now it is absolutely no big deal and I do not miss triathlons. Recently did a couple of the Spartan Races with no issues. Turns out I am better at those anyway! I am 44 and did not get treatment of any kind, other than rest. My neurosurgeon gave me the option of surgery but since the pain had resolved, there was no compelling reason to get surgery. I opted for some lifestyle changes instead. I don’t regret it.

Running is absolutely no problem at all. There is no compelling evidence to suggest that running will further stress your cervical spine. Ask the PT to prove it. I went through all of this with my surgeon and a chiropractor. Lifting weights is doable, but with some precautions. Start slowly and be VERY mindful of neck alignment. I can deadlift heavy, but have to “pack” my neck while doing so. While running, I just run, no issues. I’m not interested in swimming or biking anymore. Surfing and stand up paddleboarding are no problem though and are much more fun than triathlon anyway! There is life after triathlon.

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Sounds like a degenerative condition. Since no numbness and tingling appears there is no cord compression which is good. Did the md mention esi’s? Injections to the spine. I don’t quite comprehend the logic of not doing anything. You’d be amazed at what your spine looks like with a MRI, most have some level,of degeneration, but just don’t know it. I’d see another md for a consult.

Thanks for your reply. I guess I didn’t explain fully… Doctor didn’t say “do nothing” forever… but he definitely gave me the impression that in order to heal (and no time frame given) that I needed to be very cautious about what I did.
And yes, injections were mentioned… and left at 'come back in 3 weeks and if it’s not getting better, then we’ll discuss injections"

But I am going to get another consultation with someone else. It would be nice to know (if possible), how long these things take to start healing… 2 weeks, 2 months, etc.

So for now… spinning spinning spinning…

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Saw your response to regarding radiculopathy and running. Could you PM me?

Thanks

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Saw your response to regarding radiculopathy and running. Could you PM me?

Thanks

PM sent…

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You are a good guy, Don.

Thanks again

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Herniated discs are absorbed back into the body in 6-12 months. If you’re getting pain, chances are it’s a chemical reaction and not because of the discs touching the nerve. Most people walking around have herniatioa FYI.

Find a Doc like this and wait to get cut on. My doc hit me with a small amount of steroids and ozone twice which arrested my pain and helped the healing begin.

After you’re healed, find a good PT and strengthen your back. Good luck!

http://www.charmaustin.com