ROBERT MCLAIN, M.D. - NECK AND BACK SURGERY

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9/11/2022

Cervical disc disease: My hand and arm are going numb and my Doctor thinks it’s my neck…does that make sense?

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My hand is numb, tingly, and I’m dropping things!


It’s pretty common for neck problems to cause symptoms in the shoulder, arm or even down to the hand and fingers.  Any changes in your cervical spine that irritate or compress a nerve can cause symptoms in the part of the arm that nerve goes to. That’s called radiculopathy.
Neck pain and arm pain are really two sides of the same coin. And depending on your “coin”, you may have neck pain, arm pain, or both.
The wear and tear changes of daily life can cause the cervical disc to break down, bulge, or herniate. When the disc degenerates, it loses its ability to be a good shock absorber and support and stabilize the vertebrae that make up the spine.  The disc may rupture or may just bulge into the canal and harden.  The arthritic disc can cause neck pain, muscle spasm, stiffness, and headaches. 

Colored pencil drawing of hands threading a needle (McLain 2013)
On the other side of the coin, that bulging or herniated disc may press directly on one of the nerves leaving the spinal canal and going into the arm.  Worse, a large disc protrusion may press directly onto the spinal cord itself.  Even if the disc doesn’t physically compress the nerve, it can irritate it, or it can generate bone spurs that can “pinch” the nerve even years after a recognized injury.  When the nerve is irritated or compressed, we get radiculopathy: pain running down the arm in the pattern of that particular nerve.  That pain may be severe and electric, may be accompanied by numbness or tingling (usually a very unpleasant numbness and tingling) or actual weakness. 
Neck pain can be severe and limit activity, but it’s often that arm pain that drives the patient to the doctor, because it can be intense!
If you’ve got pain in your knuckles, or a sharp pain in your wrist, is that radiculopathy?  Probably not.  Radicular pain affects the whole distribution of the pinched nerve, and pain or symptoms run down the length of your arm as far as that nerve goes.  It’s like an electrical circuit: When one light in the room goes out it’s probably the bulb.  When all the lights go out – you’ve blown a fuse!  
Anatomical drawing of the nerves innervating the spinal tissues (McLain 1995)
So, pain running down your arm to your numb, tingly hand – that’s most likely radiculopathy and it’s probably coming from a herniated disc or arthritis in your neck.  Your doctor will want to:
  • Check you for carpal tunnel syndrome – compression of the nerve in your wrist.
  • Check your shoulder for rotator cuff symptoms or tendonitis.
  • Make sure there are no signs of neuropathy (illness of the nerves often associated with diabetes.
  • X-rays and an MRI of the neck will often reveal the point of nerve irritation and help your doctors plan treatment. 
  • Physical therapy and anti-inflammatory medications are a good starting point and there are other non-narcotic medications that can be helpful. 
If symptoms persist, however, or nerve root or spinal cord compression is severe, surgery may be the most reliable and rapid solution to the problem. There are several types of surgery available – foraminotomy, disc replacement, fusion - so you will want to talk to a spine specialist about the option that suits you best.
And that is where I can come in.
 
Thanks Again!
​

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1 Comment
Henry Killingsworth link
2/16/2024 12:33:13 pm

It was interesting to me when you mentioned that neck problems can cause problems in your shoulder. As far as I know, neck injuries can be quite severe. If you sustain a neck injury, it would probably be a good idea to find a neurologist to work with.

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    I'm Dr. Rob McLain. I've been taking care of back and neck pain patients for more than 30 years.  I'm a spine surgeon.  But one of my most important jobs is...
    answering questions!

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  • Spine Surgery Cleveland Home
  • About My Practice
    • About Dr. McLain
    • My Research Background
  • Surgical Care Available
    • My Colleagues
    • Surgery at our Surgery Center
    • Disc Replacement Surgery
    • SI Joint Pain
    • Laser Spine Surgery
  • Insurance
  • Contact Us
  • Library
    • Robert McLain, MD, AAOS
    • North American Spine Society
    • American Academy of Orthopaedic Surgery Patient Information
    • MidAmerica Orthopaedic Association
    • American Orthopaedic Association
    • Disclaimer
  • Back Pain? Neck Pain? Ask Dr. McLain