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Advice/Support for back and neck problems

Started by bmdb on 11/23/2010 3:18pm

New to the community. Hello to all. I am a 41yr old obese male with non-insulin diabetes with sugar under control with oral med only. Have had back problems for about 20 years (long before my weight gain). Tried some adjustments years ago but they just made my back feel work and didn't relieve any pain. About 15 years ago my back got much worse ...extreme pain when standing or walking for more than 10 minutes. Sometimes pain and numbness/burning go into right groin. Noticed left thigh going numb frequently then was numb 100% of time. Have had 2 falls on back and neck about 2 years ago. Early this year started having major problems with back, neck and shoulder. Pins/needles, burning and more numbness in thigh frequently setting, standing or walking just worse when standing or walking. Doctor told me diabetic neuropathy. About 6 months ago started having issues with more tingling throughout all extremities. Constant slight numbness in finger tips, left arm weeknes, fatigue, coordination etc. Dr finally referred me to neurologist who did an EMG/NCS on left side only as that is what bothered me the most. She then ordered a C-SPine and L-Spine MRI. Upon those results she referred me to a neurosurgeon. I see him tomorrow morning. She is hard to understand as she speaks with a heavy oriental accent so there is a bit of a barrier there. I am not really sure what to expect tomorrow. She said she doesn't know if he can do anything since there is already impingement so I don't know if she means anything at all or if she means he may not be able to do anything non-surgical. Tried to get clarification but still had trouble understanding. Below are my EMG/NCS and MRI reports. I know you all aren't doctors but any input, insight or support you can give would be appreciated.

EMG/NCS Results (11/5/2010):

1. There was a slightly prolonged distal latency and slowing of the conduction velocity of sural sensory responses.

3. Left ulnar sensory nerve action potentials had reduction of amplitude.

5. Left ulnar motor response showed amplitude reduction at below elbow stimulation, and amplitude slowly recovered at above elbow stimulation.

6. EMG study showed evidence of acute denervation and reinnervation of the left extensor digitorum communis with only acute denervation on the left biceps, deltoid, anterior tibialis, medial gastrocnemius, and extensor hallucis longus.

IMPRESSION: This is an abnormal study. The above findings are suggestive of:
1. Left C5-C6 and to a lesser extent C7 radiculopathy and left L4-L5 and L5-S1 acute radiculopathy.
2. Left sural entrapment neuropathy and left ulnar axonal sensory neuropathy. Clinical and neural image correlation such as MRI is highly suggested.

C-Spine Results (11/15/2010):

Mild disc degeneration is present at C5-C6 with mild disc/spur complex protrusion impinging on the spinal canal mainly right paracentral and
lateral resulting in mild right foraminal narrowing.

The only significant finding is very mild disc/spur complex protrusion right paracentral and lateral at C5-C6 producing mild foraminal narrowing.
L-Spine Results (11/15/2010):

There is some mild to moderate right inferior L4-L5 and L5-S1 foraminal narrowing and moderately severe left L5-S1 foraminal narrowing due mainly to disc/spur complex protrusion on the right at L4-L5 and disc degeneration with disc/spur complex protrusion at L5-S1 bilaterally. The greatest impingement is on the left at L5-S1 and is exacerbated by some hypertrophic facet arthropathy.

There is disc degeneration at L5-S1with disc/spur complex protrusion as described. This is most prominent on the left and produces moderately severe left foraminal impingement exacerbated by some hypertrophic facet disease with mild to moderate right foraminal narrowing.
Mild to moderate right foraminal narrowing is also present at L4-L5 as described due to disc/spur complex protrusion.

How bad is this? Do you think at this point I am looking at definite surgery?

Do you find this discussion helpful?

4 Responses


WOW! Not 1 response to my post. Maybe it was too long or not interesting enough or ??? Well I know I was asking a lot anyway so I do apologize for that. Shorter version:

Family doctor said diabetic neuropathy in left thigh...
Had more recent symptoms of more pain and burning/lightning type pains in left thigh and started getting quick "flashes" of same type of pain in various other parts of the body. Sent to Neurologist who did EMG/NCS after finding left knee reflex showed hyperreflex plus other exams. After EMG was sent for C-Spine and L-Spine MRI. Neurologist said MRI supported EMG/NCS showing problem NOT diabetic neuropathy...showed spine issues in neck and lumbar area...sent to Neurosurgeon.
Neurosurgeon said no pinching so the nerve issues can't be cause by back or neck issues and nothing to operate on...sending me to PT for eval and PT for back and neck pain. Said need to go back to Neurologist for nerve issues? I am confused. Any advice?


My issues are cervical spine, and I know nothing about lumbar, sorry. But I have had lots of experience with non surgical treatments.

In my experience, you have a lot of time to chit chat while doing therapy, and physical therapists are a wealth of information. They are very well educated. Ask questions, take notes or ask the PT to write things down for you. Ask for recommendations, things to do and what NOT to do.

good luck!


I am an American living in Doha, Qatar. I moved here from The Netherlands, where we lived for 8 years. I have suffered with back pain along with nerve pain going down my right leg. Also, my Sacroiliac Joint has been dysfunctional for the last 10 years. I have tried every non-surgical therapy in the book, both in Europe and America. My family practitioner in Den Haag sent me to Munich, Germany to have a proper evaluation. The Netherlands does not have any private practice, which is why I was sent to Germany.

Artificial Disc Replacement (ADR) is nothing new in Germany. My Surgeon, Dr. Zeegers has been replacing discs for over 20 years. OK, enough history about me.

I am not a doctor BUT ... Yes, I definitely think that you are looking at having some kind of surgery. Your problem is NOT diabetic neuropathy!

I think that you have degenerative disc disease (DDD) in addition to a nerve impingement. If you choose to let this problem go, you will on continue to get worse than you are now. I expect that you have "black" discs at L4/5 and L5/S1. (A black disc is a disc that shows up black on an MRI and means that the disc no longer has any gel on the inside. It's the gel that gives you the cushioning effect.) A lot of people have this without any symptoms at all.

My main concern is C5/6 because it is impinging the spinal canal. That is not good, and can lead to other serious problems. It could be your main problem. Pain can travel down your spine, but usually does not travel from down to up.

I had my C4/5 replaced by Dr. Zeegers in 2007. Dr. Baumbach, Neurologist in Munich, Germany is the best Neurologist I have ever encountered. I went to doctors across America before I decided that the "real" expertise is in Germany. The price for treatment and surgery is 1/4 of what it is in America. Plus, you get an inexperienced surgeon. There are many clinical studies going on in the US these days, but do you want to be a guinea pig?

I recently spent 7 hours with Dr. Baumbach because of nerve pain in my right leg. He did the most in depth evaluation I have ever seen done. He also did my evaluation before my cervical surgery. This recent evaluation was for my L5/S1, which had been compressing a nerve for a few years. After meeting with Dr. Baumbach we had a conference with Dr. Zeegers, surgeon and all three of us discussed what the options are. I had a nerve lesion at L5/S1, and L4/5 was a black disc and was also pressing on the nerve. I had nerve pain down to my toes on both sides. Dr. Baumbach's fee was 1,200 euros. Also, notable is that both of these doctors met with me on a Sunday! I guarantee you cannot find any neurologist in America at that price.

Believe me, If you continue to "put it off" your pain and body will only get worse than it is now. You do need to be dieting to lose weight. It will make your recovery a lot quicker.

If you have any other questions, please ask. Do you own homework. Don't go on just what I am telling you.

Good Luck!


Hello B, Wow, and I thought I had been through a lot...My prayers go out to you. From the report above I would say that the doctor will most likely focus on the areas that are mod-sever. Doing the least is always best. Then there is your weight factor. First please don't let people tell you that it's your weight causing this porblem. It could be a part of, but I am 43 years old, 5 ft "6" and weigh 147 lbs and I have DDD at C 2/3 6/7 T1 and some at my lower lumbar. It's like they assume patients with fibromyalgia need to lose weight and it will help their symptoms. I agree that everyone should try to keep a healthy weight but it is not the reason for every condition. But because of your weight with respect to spine surgery there is more tissue to go through for the proceedure. I would highly recommend you look into true Minimally Invasive so that you have less tissue damage. there are many spine institutes nation wide that do these types. It may be a better option for you to traditional methods. Kind regards, Cheryl