Spinal Compression and Nerve Pain: Treatment Options Explored

The compression of the left arm nerve by the fourth and fifth cervical vertebrae?

I am 34 years old.
About two years ago, I experienced pain in my left shoulder blade, which caused unusual soreness in my left arm and made it difficult to lift.
After undergoing a CT scan at Linkou Chang Gung Memorial Hospital, I was informed that the fourth and fifth vertebrae were compressing the nerves in my left hand.
Due to transportation issues, I transferred to an orthopedic hospital in Tucheng for rehabilitation.
About a month into rehabilitation, the symptoms began to improve and eventually the pain subsided.
However, in the past two months, the symptoms have started to recur.
I have heard from friends that I could consult a chiropractor, but I have also been told by a familiar doctor that chiropractic care is a branch of orthopedics in other countries, but there are no licensed chiropractors in Taiwan, and many practitioners operate without proper credentials, which can lead to serious complications such as paralysis of the lower body due to improper adjustments.
I recall a few years ago that there was a report on CTS about an orthopedic doctor in Taipei who had a chiropractic license from the United States, but I couldn't find the segment.
My question is whether I should continue with rehabilitation treatment or consider chiropractic care.
If I continue with rehabilitation, is it possible for me to achieve a complete recovery? If chiropractic care is necessary, could you provide a referral?

Xiao, 30~39 year old female. Ask Date: 2001/07/11

Dr. Ye Qingnian reply Orthopedics

In the United States, there are detailed specialties, including specific training and treatment for chiropractic rehabilitation and podiatry, which are currently not available in Taiwan.
Generally, chiropractic care in Taiwan is performed by practitioners without professional training, such as traditional Chinese medicine practitioners or bone setters, which can lead to adverse effects, especially in the cervical spine.
Therefore, it is recommended to seek treatment from the rehabilitation department of a large medical center.

Reply Date: 2001/07/11

More Info

Understanding spinal compression and nerve pain is crucial for effective treatment and management. Your situation, involving a history of left shoulder and arm pain due to spinal compression at the cervical levels, is not uncommon. Spinal compression can lead to a variety of symptoms, including pain, numbness, and weakness in the arms or legs, depending on the location of the compression.

Treatment Options
1. Physical Therapy and Rehabilitation:
Continuing with physical therapy is often the first line of treatment for spinal compression and associated nerve pain. Physical therapists can provide targeted exercises to strengthen the muscles around the spine, improve flexibility, and enhance posture. This can alleviate pressure on the nerves and reduce pain. It's important to communicate with your therapist about your symptoms and any changes you experience. While physical therapy may not completely eliminate the issue, it can significantly improve function and quality of life.

2. Medications:
Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen or naproxen) can help manage pain and inflammation. In some cases, doctors may prescribe stronger medications, including muscle relaxants or nerve pain medications like gabapentin or pregabalin, if the pain is severe or persistent.

3. Injections:
Corticosteroid injections can provide temporary relief by reducing inflammation around the affected nerves. This can be particularly useful if physical therapy alone is not sufficient.

4. Surgical Options:
If conservative treatments fail to provide relief after a reasonable period (usually several weeks to months), surgical options may be considered. Procedures such as discectomy (removal of the herniated portion of a disc) or spinal fusion may be necessary to relieve pressure on the nerves. Your previous experience with surgery may influence your decision, so it's essential to discuss the risks and benefits with your surgeon.

5. Chiropractic Care:
Chiropractic treatment can be beneficial for some patients with spinal issues. However, as you mentioned, the practice can vary widely, and it's crucial to seek care from a licensed and reputable chiropractor. In the U.S., chiropractic care is a recognized profession, but in Taiwan, the regulation may not be as stringent. Always ensure that any practitioner you consider has the appropriate qualifications and experience.

Considerations for Your Situation
Given your history and the recurrence of symptoms, it may be wise to continue with physical therapy while also exploring other options. If you find that physical therapy alone is not sufficient, discussing the possibility of a referral to a spine specialist or orthopedic surgeon may be beneficial. They can provide a comprehensive evaluation and determine if further imaging or interventions are necessary.

Conclusion
In summary, your treatment plan should be tailored to your specific symptoms and needs. Continuing physical therapy is advisable, and if symptoms persist, consider consulting with a spine specialist. They can help you navigate your options, including the potential for surgery or alternative therapies. Remember, the goal is to alleviate pain, restore function, and improve your overall quality of life. Always communicate openly with your healthcare providers about your symptoms and treatment preferences to ensure the best possible outcomes.

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