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John Abrahams, MD, FAANS
Q. What are symptoms of a pinched nerve?
A. You’ll feel a sudden pain shooting from the base of your neck, through your shoulder, down one arm and into your fingers. Or, you may feel weakness or numbness alone or in combination with pain. The pain may radiate into your chest. The pain is chronic and can severely affect your quality of life
.Q: What causes these symptoms in my arm and fingers?
A. They probably indicate a compressed – also called pinched – nerve in your cervical spine, the first seven bones of your spinal column, located in your neck. The typical cause is a herniated disc in your cervical spine. The disc is the cushion between the spine’s vertebrae. Herniation means that part of a disc is outside its normal place. If that material compresses a nearby nerve, you feel a searing pain.
Q. What caused my disc to herniate?
A. Usually, there’s no answer. You move a certain way – perhaps simply turning your head — and it happens. Less commonly, you may have disc degeneration from aging and an accident exacerbates it. In 25 percent of cases, herniation results from degeneration of the spine due to evolving arthritis.
Q. What are my non-surgical treatment options?
A. Your doctor will first use Motrin to try to reduce your pain. If pain continues, you’ll have an MRI of your cervical spine. If this shows disc herniation, you’ll go on a seven-day dose of oral steroids. If all goes well, the steroids will reduce the inflammation of the compressed nerve. Typically, as your pain diminishes, the disc reabsorbs the herniated material, which relieves pressure on the nerve. If you are among the approximately 30 percent of patients who don’t respond to systemic steroids, your doctor will inject steroids around the surface of the compressed nerve. If you respond to either systemic or injected steroids, you could be pain-free within weeks and back to normal in six to eight weeks.
Q. Is there a surgical treatment?
A. If steroids don’t reduce your pain, your primary physician will refer you to a surgeon. Surgical treatment involves making a one-inch-long incision in the neck and removing the herniated disc entirely. That immediately decompresses the nerve. We then insert a spacer where the disc was and secure it with two small metal plates to the upper and lower vertebrae. The body heals by fusing the upper and lower vertebrae. You’ll have a minimal loss of mobility of the neck, which you won’t even notice. A recent alternative to the spacer is a titanium disc replacement. No fusion is involved. Either way, surgery takes under an hour and most patients leave the hospital the same day. You’ll probably be back to work in a week. After surgery, physical therapy helps strengthen your core and expand your neck’s range of motion. More than 95 percent of patients undergoing surgery enjoy a complete resolution of their symptoms. If you stay here overnight, a physical therapist comes to your room to start your recovery. NWH also has m more than 1,000 spine surgeries a year and have developed great expertise in surgical treatment and post-sua comprehensive outpatient physical therapy facility.
Northern Westchester Hospital
Co-Director, Orthopedic & Spine Institute, Spine Section
Read Past Topics from Dr. Abrahams:
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