8 Steps to Beating Cervical Radiculopathy: Correctly Diagnosing Cervical Radiculopathy
CERVICAL RADICULOPATHY: MY JOURNEY TO GETTING A PROPER DIAGNOSIS
Here are the health professionals that I consulted with to diagnose my cervical radiculopathy. A proper and correct diagnosis is obviously important to ensure that you get the correct treatment for your condition. I'll share my experiences with you and then I'll summarize how I would do it again (as if I were you suffering from the same symptoms). Remember, this is only what I experienced and you should not take this as medical advice, seek medical help for these symptoms.
Chiropractor: To his credit my chiropractor gave me a thorough exam including x-rays. Ironically, neither his exam nor the x-rays showed any signs of cervical radiculopathy. My chiropractor's suggestion was to continue seeing him two to three times per week, do some light stretching, and isometric exercises (which I promise I'll share with you in an upcoming blog post). I followed his advice for about a month, and then I continued only with the light stretching and the isometric exercises. I didn't feel that visiting him was helping me at all (actually his adjustments definitely aggravated my condition) so I discontinued with the visits.
Doctor (M.D.): After a few more months of only some very minor relief, I met with my M.D. Personally, I never really enjoyed visiting with my doctor. He always seems so rushed and in such a hurry, but this time, to his credit he seemed to listen as I got through mostly all of my symptoms and ultimately it was my M.D. who gave me the diagnosis that I had cervical radiculopathy. Unfortunately he didn't take any x-rays or MRIs. His thoughts were that some anti-inflammatories and pain management should clear it up. He also suggested some traction devices, which I 'll cover in another blog post, since they really did help and I still use them today. After a month with hardly any improvement he gave me a prescription to see a physical therapist. Again, I was not impressed with my office visit with my doctor, but at least I had a diagnosis to go on. Now I could do exactly what you are doing, going to the web and doing research on my own.
Physical Therapist: This was the most disappointing and biggest waste of money during my entire experience with cervical radiculopathy. The best thing my PT did for me was some localized massage therapy and when she found the inflamed muscle along my spine she massaged it which finally gave me some immediate relief, but then she stopped after about 5 seconds. I exclaimed, you found it! You found it! Ironically she told me, "we don't want to aggravate your condition and we don't want to go too fast." Between her lack of urgency and her fees (which I started calculating by the minute) I discontinued my visits with her after five visits. Even though I was very disappointed I was starting to grow hopeful as she had literally hit a nerve with my condition. Yet one more thing I could sleuth out on the net.
Massage Therapist: I was visiting with a massage therapist on a weekly basis and getting some temporary relief. After my experiences with the physical therapist I grew hopeful that my massage therapist and I could find the exact spot the physical therapist did. The massage was helpful and always left me feeling good. I continued with the massage therapy and my own research on the Internet until one day I was talking to my neighbor about my problem when she recommended....
Craniosacral Massage Therapy: I'm still not exactly sure which discipline of massage "craniosacral massage therapy" covers, so I simply call it "Bill and Sally Foster". When I first met Bill and Sally I would have sworn they were both former surgeons. They knew everything about the human anatomy, nerves, muscles, everything. I mean Everything. I worked mostly with Bill who explained it to me like this: He said, you're a software guy, right? When you get an error in your software you go through it step by step until you find the problem. That's exactly what we'll do with you. And then he went to work on me. This was definitely not your ordinary massage, this was bodywork. Bill started at the end of each of my five fingers, worked through my hand, through my wrist, up the forearm, through my elbow, around my tricep and through my shoulder. Through a variety of tests Bill was able to determine that the problem was not in my arm. Now he really went to work on me. Delicately and thoroughly he worked his way through the muscles of my upper back, through to my spine. What Bill had discovered (debugged, if you will) was that one of the longissimus muscles on the front of my spine was in spasm, pulling down the left side of my C6 and C7, impinging the radial nerve. He told me what he discovered and I almost cried, not because I was in pain but because finally, someone had found the source of the problem. So naturally the next question was, how do you massage a muscle in front of the spine? His response, "I'll move your trachea (windpipe) over to get to the muscle". The whole thing sounded kind of squishy but at this point I was a believer so we proceeded. Bill took his time, explained to me that the trachea was actually relatively soft tissue and could be moved, which is exactly what he proceeded to do. He knew he could only massage that particular muscle for a few seconds at a time because the phrenic nerve would be affected. Important note: Yet another reason why you shouldn't try this yourself, I was completely relaxed on my back on a massage table and if he continued his massage on those spinal muscles for more than 10 seconds at a time I would feel like I was going to pass out. And not because he was holding my windpipe in his other hand but because the phrenic nerve innervates your diaphragm... the muscles that make you breathe. Yes this guy knew what he was doing. And yes here is his phone number: 303-838-7940. If you're not in Colorado call and ask either Bill or Sally exactly what kind of massage therapist you should seek out in your local area given your symptoms. Every doctor's office in the world should take a lesson from Bill and Sally Foster. Our sessions were an hour and a half in length, affordable, and I never felt rushed.
Orthopedist: With Bill and Sally's help things had improved tremendously but there was still a slight tingling that would fire up every so often. I finally visited with the orthopedist who took x-rays which really didn't reveal anything new, or at least anything I didn't already know. The orthopedist's advice was to continue with the massage, traction without downward pressure (I'll cover that detail in the traction device blog post), and he suggested I increase the frequency of my isometric exercises. This guy was pretty good because he picked up on the benefits I had received through massage therapy and detected that I probably had a small but weak muscle group somewhere in my neck and/or spinal area, and isometrics would help strengthen them. Sure enough after about a week of doing isometric exercises (yet another blog post, I promise) the pain and tingling sensations were gone.
SUMMARY: You need a proper diagnosis in order to treat any medical condition, and to be honest I'm still not sure cervical radiculopathy was the correct diagnosis for me. In my mind I had some sort of postural condition, (or lack of conditioning), an environmental influence (my desk, my seat, my posture in the car - who knows?) or something that caused my longissimus muscle to spasm and pull on my C6 and C7 vertebrae, irritating the nerves coming out of there. So here is what I'd do if I had to do it again, or if I were you suffering from the same symptoms:
Get x-rays, rule out anything obvious right off the bat.
I'd visit with a Craniosacral Massage Therapist or an Orthopedist, or any health professional that you feel comfortable with whom you feel won't rush to judgement and will listen to all of your symptoms and understands what you're really experiencing. Sure doctors and physical therapists have to be knowledgeable also, but I got the notion that Bill and Sally (and my Orthopedist) were more thorough and less likely to say to themselves, "... that sounds like....", even before I was done describing all of my symptoms.
Listen to and implement the medical advice you receive. These medical professionals didn't go through all of that training for you to ignore their instructions. Give them feedback too. If they say to take action and you should be felling better in 2 weeks and you're not, then call them on day 15 and follow up. I'm really critical of the medical professionals out there today but ultimately, they're only human. Sometimes it takes a few tries to get your particular situation right.
Hi Everyone- Sorry for the delay in getting these postings finished. Work got busy but I'll start posting these blogs every few days, thanks for your patience.
Posted by Rich Leach on 01/27/2009 at 11:07:AM
Very helpful -- thanks so much Rich! I feel better just knowing that there's a light at the end of the tunnel!
Posted by Art CR on 01/29/2009 at 12:02:AM
Reading your blog was enlightening. Now I know what you went through this past year with your neck- at least now I know where to go for information on how you're doing. I'm really pleased you've made progress and it's largely under control.
Posted by Julia Hubbel on 02/15/2009 at 9:33:PM
Thank you so much, Rich! It was especially thoughtful of you to take the time to document and share everything with us!
Posted by Shirley Dotson on 02/25/2009 at 9:36:AM
I have been diagnosed with c6 radiculopathy on the right side. The symptoms are now appearing on the left side too. Physical therapy did not help me at all. Craniosacral message sounds good.Thanks for the information
Posted by Madhulika Sharma on 02/17/2010 at 11:24:PM
Can you elaborate on the traction device you used?
Posted by K Garrison on 04/12/2010 at 2:02:PM
@K~ It's on my short list to provide a little demo of the things and products that I used to help me; I appreciate your patience but it should only be a day or two for me to get this done. I'll post to this blog so if you subscribed to the postings then you'll get an email when it's ready to go. Thanks!
Posted by Rich Leach on 04/12/2010 at 2:07:PM
Thanks! Nearly everything you mentioned happened to me this past January and I'm just now back at work. I had the same problems you mentioned but on my right side. I ended up going to a DO, MD, chiropractor and two neurologists. The last neurologist put me on PT and it has helped me get rid of most of the pain but the off and on tingling in my right forearm and hand remains. She also ordered an EMG (awful test) for carpal tunnel and ruled it out so basically the problem is due to the foramen (stenosis) which in turn irritates the nerve passing between C6 and C7 when my head is looking straight ahead or up. If I tilt my head down and to the left the tingling goes away immediately. As of 4/13/2010 I'm using posture excercises, cold and heat packs on C7, long showers and a Saunders Neck Traction device for therapy. Currently I pump it up to 40 psi for nearly instant relief so I can at least make it through a work day. I've had it for a week and will post here again after a few more weeks to let you know if the tingling is diminishing.
Posted by Jim Ed on 04/19/2010 at 1:36:PM
Hi Rich, So you didnt have any disc herniation or osteophytes that was causing the radiculopathy, I was getting very excited about this blog until I couldnt find anything about these causes. This is what I have. My last treatment of traction with a Physio exacerbated the symptoms. Hoping to hear if the other treatments you used will alleviate my symptoms. Would like to know about your exercises etc. Great Blog
Posted by Karen L on 11/04/2010 at 4:43:AM
here is my radiologists report after evaluating an MRI: At the C5-C6 level, there is a small right paracentral soft tissue disk herniation. There is no spinal cord compression or significant foraminal stenosis. This could result in a right C6 radiculopathy. I have been doing isometric exercises and my symptoms have gotten worse. Any advice? What about an inversion board? I used to be prone to back spasms and once or twice a year I use my friend's inversion board and all of my symptoms are alleviated.
Posted by george warga on 11/20/2010 at 11:16:AM
George- Sorry to learn about your situation. Since I'm NOT a doctor, all I can do is give you my opinion, but obviously go with what your real doc says to do.... Since your radiologist doesn't see any compression you may need to seek out other causes of your pain, unless he/she sees the radiculopathy as a certainty. Again, getting the correct diagnosis is vital. The inversion board helped me to provide traction (but make sure your doc tells you the limits you should work within, avoid going fully inverted!) and traction is a commonly suggested treatment to help relieve some of those radiculopathy symptoms. This could be a good time to consult with a physical therapist and present your symptoms and diagnosis to date, then see what the PT suggests. Good luck and keep us posted!
Posted by Rich Leach on 11/20/2010 at 11:44:AM