Is My Discomfort Due to Herniated Discs? Seeking Answers for Neck and Limb Pain

Q: Is My Discomfort Due to Herniated Discs? Seeking Answers for Neck and Limb Pain

First, let's confirm some conditions： You have a medium build (not tall), are somewhat thin, have a hunched back, likely have significant myopia (or a large difference between your eyes), have poor dental health (do you have a full set of dentures?), experience periodic migraines

Is this caused by a herniated disc?

Hello Dr.
Pan: Initially, I experienced fatigue easily and often felt mentally unwell (about two or three years ago).
Later, I began to have neck pain and continued to feel unwell (about two years ago).
Since last year, I have been waking up in the morning with tingling in my fingers, starting with my left pinky, then spreading to my middle finger, and eventually to my entire left hand, and even my right hand.
Then it progressed to my left foot and then to my right toes...
At its worst, I would wake up at night due to the tingling, which is really uncomfortable.
Additionally, during the day, whenever I feel unwell, my eyes often feel sore, and I also experience mental fatigue, discomfort in my neck and shoulders, and tingling sensations in my palms and soles.
I have seen several doctors and underwent physical therapy for a while, but there seems to be no improvement.
I also had an MRI of my neck, and according to the doctor, the cervical joints do not compress any nerves; they are just slightly protruding, which he said is not serious.
I also had a lateral X-ray of my neck, which did not show any obvious abnormalities, yet I still feel this discomfort...
I can feel that the right end of the second cervical vertebra is protruding and painful, and the left end of the seventh cervical vertebra is also protruding and painful.
I am really distressed and cannot find a solution.
Please help me! Could this be caused by a herniated disc?...
What should I do?

Xiao Mai, 20~29 year old female. Ask Date: 2000/11/18

Dr. Pan Yingda reply Rehabilitation

First, let's confirm some conditions: You have a medium build (not tall), are somewhat thin, have a hunched back, likely have significant myopia (or a large difference between your eyes), have poor dental health (do you have a full set of dentures?), experience periodic migraines, have trouble sleeping, have an anxious personality (easily stressed), set high expectations for yourself, feel a lot of pressure and burden, and often have cold hands and feet, as well as sweating cold.
Currently, your symptoms are not caused by a herniated disc, but if you do not change your situation, herniated discs and bone spurs will be inevitable outcomes.
You are still young, and there is a great opportunity for improvement, but it will require significant effort and time; it is not as simple as just doing rehabilitation or taking medication.
Here are my suggestions:
1.
Change your behavioral response patterns: Recognize your capabilities, do your best, not just want to do your best.
Reassess your values, ideals, and expectations, and expand your perspective in time and space.
Also, learn to relax.

2.
Adjust your posture and be aware of unnecessary movements: Your spine should be straight and perpendicular to the ground, with your chin tucked and head properly aligned over your spine (this is very important) to comply with mechanical principles.
Unnecessary movements are those that are not needed, involuntary, and unconscious, such as shrugging, frowning, or grinding your teeth, especially when using a keyboard or mouse; pay attention to your shoulders.
3.
Get a lighter pair of glasses, with a prescription that is not too precise, especially for astigmatism.
4.
Repair any dental issues that need fixing.
5.
Exercise: Engage in activities that make you sweat and even shout, choosing exercises you are familiar with to avoid injuries.

I recommend a book: "Changing Your Posture, Changing Your Mind" by Moshe Feldenkrais, published by Shih-Mao Publishing.
If your English is good, you might look for books on the Alexander Technique (I have seen some at the Eslite bookstore in Dunhua).
I genuinely want to help you; try these suggestions first, and feel free to ask if you have questions.
Take care!

Reply Date: 2000/11/18

More Info

It sounds like you are experiencing a complex set of symptoms that could indeed be related to issues with your cervical spine, including potential herniated discs. Your description of fatigue, neck pain, and the tingling or numbness in your fingers and toes suggests that there may be some neurological involvement, possibly due to nerve compression or irritation.

From your account, it seems that you have already undergone some diagnostic imaging, including MRI and X-rays, which did not reveal significant nerve compression. However, the presence of disc protrusions, even if they are not causing severe compression, can still lead to symptoms like pain, tingling, and weakness. This is because the discs can irritate nearby nerves or cause inflammation in the surrounding tissues.

The symptoms you describe, such as the tingling in your fingers and toes, could be indicative of a condition known as cervical radiculopathy, where nerve roots in the cervical spine become irritated or compressed. This can lead to pain, numbness, and tingling that radiates down the arms and legs. The fact that your symptoms have progressed to involve multiple fingers and toes suggests that there may be a systemic issue at play, possibly involving nerve function or circulation.

In terms of management, here are several recommendations that may help alleviate your symptoms:
1. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises to strengthen the neck and shoulder muscles, improve posture, and enhance flexibility. This can help alleviate pressure on the cervical spine and improve overall function.

2. Pain Management: If you are experiencing significant discomfort, consider discussing pain management options with your healthcare provider. Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain. In some cases, corticosteroid injections may be considered to reduce inflammation around the affected nerves.

3. Ergonomic Adjustments: Evaluate your daily activities and work environment. Ensure that your workstation is ergonomically designed to reduce strain on your neck and shoulders. This includes adjusting the height of your chair, desk, and computer screen to maintain a neutral posture.

4. Regular Breaks: If you spend long hours sitting, take regular breaks to stretch and move around. This can help prevent stiffness and reduce the risk of exacerbating your symptoms.

5. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy. These modalities can help alleviate muscle tension and improve circulation.

6. Lifestyle Modifications: Incorporating regular exercise, maintaining a healthy weight, and managing stress can also contribute to overall well-being and may help reduce your symptoms.

7. Follow-Up Care: Since your symptoms have persisted despite previous treatments, it may be worthwhile to seek a second opinion from a specialist, such as a neurologist or an orthopedic surgeon specializing in spine issues. They may recommend further evaluation or alternative treatment options.

In conclusion, while your imaging studies may not show severe issues, the symptoms you are experiencing are real and warrant attention. It is essential to work closely with your healthcare team to develop a comprehensive treatment plan tailored to your specific needs. Keep advocating for your health, and don’t hesitate to seek further evaluations if your symptoms do not improve.

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