Two years ago I started to experience numbness and pain in my left arm. Had no idea what it was. and just suffered through it. Not fun on long rides. Eventually went to a Chiropractor and had X-rays advising that I had a pinched nerve in my neck. I guess a combination of riding aero but lifting my neck too much, lots of trainer rides and age. I’m 58 now (Chiro mentioned onset of arthritis)
Lots of treatment and it went away till last week where it came back with a vengeance. I tried to go for a short ride and had to go back home after 3K, way too painful. I have been able to ride on the trainer, and jog a bit on the treadmill.
I am asking what might be the best type of treatment for this issue. Chiropractic, Physiotherapy, or massage. A former racer I know suggested massage, I do have VERY tight neck muscles.
Two years ago I started to experience numbness and pain in my left arm. Had no idea what it was. and just suffered through it. Not fun on long rides. Eventually went to a Chiropractor and had X-rays advising that I had a pinched nerve in my neck. I guess a combination of riding aero but lifting my neck too much, lots of trainer rides and age. I’m 58 now (Chiro mentioned onset of arthritis)
Lots of treatment and it went away till last week where it came back with a vengeance. I tried to go for a short ride and had to go back home after 3K, way too painful. I have been able to ride on the trainer, and jog a bit on the treadmill.
I am asking what might be the best type of treatment for this issue. Chiropractic, Physiotherapy, or massage. A former racer I know suggested massage, I do have VERY tight neck muscles.
Thanks
Swimming will loosen up your neck and strengthen your back and neck muscles which should help. It is no coincidence that many if not most competitive swimmers have relatively big necks for their overall size. Since you made no mention of swimming in your original post, I’m guessing you hate it but it might be worth suffering through 20 min to help your neck:)
I had a similar situation…suddenly started getting numbness in my fingers on my left hand. And I would have a very sore neck riding aero due to the “head up” position.
Went to the neck doctor and found I have congenital fused discs in my neck that were causing a pinched nerve.
The treatment was about a month of physical therapy to really get some flexibility in my neck and well as strengthening counter pulling muscles. They also put me in traction treatments to help take the pressure off of the effected discs. At 59, I’m just not that limber any more and as the muscles in my neck got tighter (made worse by riding aero and turning my head to breathe while swimming) it eventually led to a neck problem I had never before encountered.
My neck still gets pretty sore after about two hours in aero on the bike. But other than that the issues have largely disappeared.
In addition to the blood clots in my leg, I am also getting the pain in the left arm from a pinched nerve in my neck. I had x-rays on Monday and meet with the Ortho next week. The blood clots caused me to cancel all my events for 2014, as my doctor doesn’t want me doing any long running for a while. I’m now out registration fees for this year’s Boston Marathon, Raleigh 70.3 and IM Chatt (foundation slot). Whahh! I was able to defer my Rev3 entry.
Any of those could work for you. I’m a chiro for over thirty years so my opinion might be a bit bias but at some of my previous offices we also had massage therapists and chiro plus massage often worked very well together. We also sometimes used traction as well. It seems like the chiropractor already did help you once so why not go back to the same one again?
I stopped riding steep and low on a dedicted tri bike in my late 50’s because my neck was starting to bother me after long rides and converted to a more John Cobb “big slam” position on a road bike with shortie aero bars. Never had an issue after that. I’m not racing any more so sold my tri bikes and only ride a road bike now and never have any neck issues. Put me back on the tri back where you’re forced to lift your neck in more extension and I’m sure my neck woud be uncomfortable again. I also have early degenerative arthritis in my neck. Its sucks getting older, but it sure beats the alternative.
Last season, I had a severe pinched nerve in my neck that ran down into my upper back and it plagued me for 6 months. Tried all that you mentioned (chiro, PT, massage) and none worked. Wife suggested that I try acupuncture. No f—ing way. A month of pain later and I relented. The dude fixed it in 3 sessions, for about the cost of a single massage. I was a total idiot for not doing that sooner.
I went through this recently as well. The trigger was riding aero on the trainer and looking up trying to stretch my neck out. MRI showed osteophyte at C5 and my neurosurgeon recommended trial of oral steroid which didn’t help, then steroid injection which also didn’t help, and PT. My therapist is also a pilates instructor and after a month of exercise and traction, the symptoms completely resolved.
What was interesting was that she determined I also had impingement at the shoulder from a previous injury that included fracture of the clavicle. In addition to the above, I have poor posture and she had me use a “posture shirt.” I originally scoffed at this but damn if it didn’t make a difference in both my posture and symptoms.
I had to raise my position a bit on the TT bike but I"m riding without the radiculopathy pain and numbness. I just turned 59 so I know my days of riding low and steep for IM distance are numbered.
BTW, swimming may make the pain worse as you tend to extend the neck similar to riding aero. Backstroke is more neck friendly.
You need to find out what the exact cause is. Parasthesias can be caused by central injuries near the nerve root (think disc) or by peripheral lesions (think nerve entrapment). Each will present differently upon clinical examination and treatment will be different for each also. Xrays wouldn’t be conclusive for pinched nerve. Arthritic changes and bony structure sure, but nothing more. If it is a true cervical herniation you are not going to want to be too aggressive with cervical motion. You’re also going to want to avoid excessive upper extremity motion until you’re found the origin. Right now I would have to disagree with the rec to swim as you’re not sure where your symptoms are coming from and repetitive cervical rotation and flexion combined with upper limb motion might aggravate it more. My patient had to drop out of St. Anthony’s because he was too stubborn and hopped back in the pool when I advised against it.
Cervical herniation is one possibility with the left nerve root compromised. Good eval to determine which motions aggravate symptoms and which motions centralize or reduce symptoms. Then treat accordingly.
Cervical stenosis is a good possibility at your age and if your pain is worse in cervical extension and rotation to the left then you are compressing the facet joints surrounding the nerve root. This is a degenerative condition and not reversible but treatment will focus on symptom management and restoring ideal cervical motion and strength.
A peripheral entrapment (think piriformis syndrome in the leg) such as thoracic outlet syndrome in the shoulder girdle is also very common and often overlooked. As triathletes we are in a constant forward bias which can tighten the soft tissue structures and compromise the brachial plexus and neurovascular bundles causing parasthesias. Pec minor, first rib, subclavius, scalenes and trapezius are all common sites of entrapment due to tightness, poor posture and movement dysfunction.
Its hard to believe that a herniation is the root cause if you can’t remember a specific instance or event when it all started. An image may show a herniation but imaging is not conclusive and lots of people have herniations that are asymptomatic. I usually prefer my patients don’t have an image unless we are stumped because they use the findings as a crutch or excuse. I’m not saying its not possible.
A peripheral nerve entrapment from muscle contracture in an athlete who spends a lot of time in a forward tucked bike position is more likely IMO.
Whatever you decide, chiro, PT, massage etc wont be able to treat effectively until you find out what the exact cause is. Cookie cutter approach that says radicular symptom = herniation is not going to benefit you in the long run. Get a proper differential dx eval done and youll be in a better spot.
Chiro says inflammation pressing on nerve, so at present two treatments a week, Aleve twice a day, but not sure it’s getting better, though being on the trainer from 1-3 hour sessions probably not helping. Forced myself to take today off.
At least X-Rays don’t show significant deterioration from 2 years ago.
I couldn’t swim even if I wanted to. I’m in pain when walking.
When on the trainer, I have to lok down at my Garmin and only look up occasionally at my laptop running TrainerRoad, never mind the TV.
This Chiro treats athletes and it did resolve last time so hope for the best.
I really really don’t want to have to raise my position on the bike ;-(