Surgery & c5/6 foraminal stenosis

Hi all.

I'm new to all this so please bear with me.

I've recently been diagnosed with cervical stenosis with intermittant radiculopathy. I've seen a neurological surgeon who said if they operate it would deal with the tingling in my arm but not the pain in my neck, shoulder, arm and back. The pain is my main problem as its really affecting my life. He seemed to give very little solution to the pain. I'm on gabapentin, amiteiptaline, cocodamol etc but these are having little effe t. Does anyone know if surgery could cure the pain? If there is a cure I would rather look into it than continuing in pain and on pills that aren't working.

Any feedback would be hugely appreciated as I'm at a loss as what to do.next

Thanks Lori x

Hi Lori:  Sorry to hear about your diagnosis and pain problems.  Is the pain constant or intermittent?  Is it aggravated by cold climate, physical or emotional stress, or all of the above?  How long have you had this condition?  Do you have other trauma or related injuries, such as whiplash or falls?

I got the same diagnosis as you in October.  I did not have as good a palette of medications as you describe, but do take Tylenol or NSAIDs, Tramadol (as needed, Hydrocodone (5/325) as needed, muscle relaxers (Methocarbomal aka Robaxin, or SPZM, an herbal formula), lorazepam for anxiety as needed, and Ambien for sleeping issues when the pain keeps me awake at night.  I also used an inflatable cervical traction unit I found on Amazon that costs $30 US (Instapark brand, Amazon part B00573S4KI).  It helped a lot at first.  I also have an inversion table, too, but it does not seem to help with issues related to C5-C6, but is great for lumbar and mid-back issues.

Spent hundreds of dollars to get a new mattress and pillow and then went through mattress pads on Amazon trying to get one that did not aggravate my symptoms.  Finally got there after several tries.  Sleep is that important, IMHO.

I am getting a little better since my peak symptoms in October, but the pain is more chronic, so I would personally disrecommend surgery unless your pain is constant and unbearable.  This was the recommendation of the two best neurosurgeons in Florida for me - I went to both, as I had good insurance.

Everything helped some, including the sterioid injection in my cervical spine, but what helped me the most was ACCUPUNCTURE.  I have now had about 21 sessions.  I started with sessions 2 times per week, then reduces it to 1 x per week.  Insurance paid for the first 15.  After the very first session, I only had about 4 hours of pain relief.  But it was 4 hours of real relief... 8 hours after the 2nd and 3rd, but it got more consistent after that, like peeling layers of a pain onion, if you will. 

It does not make the bone spur or the stenosis go away, so physical activity, which was almost impossible before, is now possible but then aggravates my condition.  So, I now go to the accupuncturist one time per week to manage my chronic symptoms.  And, I try to take a muscle relaxer every night before I go to bed, as I find that reduces my symptoms.

If you dont have a good accupuncturist in your area, then I would suggest deep tissue massage therapy instead, starting at 2X/week, focusing on the upper back and neck.  Again, think "pain and spasm onion".

If your pain is constant and intolerable, then I would suggest you try the cortizone injection or accupuncture or deep tissue massage therapy  BEFORE surgery.   Surgery is not always the best option for this problem, as about 35% get no relief or more pain afterwards.  Given that, it makes sense to try everthing but surgery unless the pain is unbearable.  

In my case the surgical option was remove the disc and either replace it with an artificial one or fuse the two vertabrae together.  If I am faced with that choice in the near future, I would opt for the artificial disc first, as you can always get a fusion if that does not work, but once fused, there is no other option.

I even asked, "cant you just go in there with a laser and get rid of the bone spurs"?  The answer was "no" - that works for the lumbar region, but not for the cervical spine.

There is this little known treatment, which is an alternative therapy, available here in Florida and the US, called PROLOTHERAPY, where they inject the affected areas of your cervical spine with an irritant to cause it to heal from injury, but even though it is available in my area, I am not sure of its effectiveness; most insurance companies wont pay the thousands required for the multiple treatments, and it requires 10 or more treatments, across a couple of months.  

I sent you a lengthy post.  No links in it, with loads of helpful suggestions.  yet, for some reason, even though I have been a member of this forum for weeks now, and no links were in the post, it still got routed to the moderator.

Can someone explain why this is the case?

Hi, thx for trying to reply to me. Its a shame I cant see what you've posted. Hopefully this will get sorted x

Hi Lori

THere are 2 or 3 different types of surgery which they employ for stenosis.  Mostly they are concerned with stabilising the vertebrae with fixings whioch ultimately restrict movement.  There's no guarantee of pain relief because there's no way of predicting how the neck will react post-surgery.  I believe,  but I could be wrong,  that a 50% to 70% success rate is claimed.  However,  sometimes the beneficial effects are only temporary,  and the same issues can start reappearing within a year.  I was offered surgery ,  but I declined because of the unpredictability.  However, that option is still available if needed (open appointment at Neuro Hosp ).  I have found that the C/S condition changes itself,  and sometimes symptoms improve,  but again,  that's also unpredictable.

Perhaps something to bear in mind is that surgery cannot be undone,  so whatever the outcome,  that must be managed.  My choice has been to stick with the symptoms I'm used to rather than take a chance on new symptoms appearing,  but it's different for everyone , and it's a difficult decision to have to make.  One thing I was particularly aware of was that I didn't want to resent having made a bad decision.if surgical outcomes were not favourable.

hi Lori, I too have the same thing as you and I too am a member of the closed facebook group Cervical Spondylosis Support Site, it's been a godsend, good luck hunny x

yes Gerry I'm in agreement I think I'd rather try and manage what I have rather than have surgery and make matters worse....

Seems the safer choice,  unless the symptoms are unbearable.  Also seems the service providers can lessen their sense of engagement by turning it into a lottery of difficult choices for us.  Basically,  I think there's a point where,  perhaps because of their lack of focussed investigation of C/S,  they only feel comfortable when they have handed the problem back to us for decision making....and I understand that approach because I'm aware of how their hands are tied by a lack of good research and proven methods of treatment.  The reluctance to delve deeper into the dynamics of C/S has always been a sore point with me.  I've read the research,  and it's 99% inconclusive because they always only test the treatments on offer,  rather than think 'Well, that doesn't seem to work.  Maybe we should try a new approach'.  Far as I'm concerned,  professionalism should mean knowing everything about your subject matter,  and not overlooking any possible solutions.  Rant, rant  rant !

Perhaps the biggest sense of unfairness to come out of it,  particularly in regard to the 'choice' issue raised on this thread is....if we don't opt for the recommended treatment because of the risks (which seems like a sensible thing to do ),  are we then being nudged out of the care system by virtue of having made a 'possibly' good choice.  Some little 'catch 22' stuff going on in that set up !

I'm on most of that med as well I have disc degeneration in c5-c6 and bone spurs and due to pain in back, buttocks and back of legs Dr thinks my back has something wrong too. I'm due to c a specialist in 3 weeks and same as u as hear surgery is high risk but pain & radiating arm pain is taking over. It's awful but hope u get some answers xx

Thank you all so much for ur feedback. I so appreciate it xx

Hi Lori

I'm on the same medication as you and also find it doesn't help. I was diagnosed with CS and spinal stenosis in April 2014 after a MRI scan. I had been suffering with the pain for over a year at that point. It was a bit of a shock as I'm only 35 but after the acupuncturist lady told me she could feel a lump in the back of my neck last March I knew it wasn't just stress. Last September I had a series of cortisol and nerve block injections around the area as they couldn't inject them directly into the damaged area as they said there was only a 2mm gap. I found they didn't help at all and if anything I have more nerve pain with sciatica too now. In October I agreed to have surgery. My consultant said I will need two operations and I'm going for the first pre op tomorrow and will then be admitted on Thursday before having the operation on Friday morning. I'm really nervous about it but got some great advice off another person on here called Cheshireguy who had already been through the surgery. I like you would rather opt for a long term option than take lots of tablets all the time. Have you been given the option to have the injections? They didn't help me but I've read that others have benefited from them so may be worth a try for you before surgery? Hope this helps, A

Thanks so much for ur advise. I'm only 31 so I'm shocked by the problems I've got. I feel like I've got the back of an 80yr old! I wish u all the very best with ur surgery. Pls let us know how it all goes when ur up to it xx

I'm only 35 as well and I feel same as you Lori its not good. Good luck Syd on your op xx

I know exactly how you feel it's hard as it drains your energy too plus people think you look okay but don't see the pain! Thanks I will let you know I get on xx

Thanks Kelly xx

Hi well I had a ACDF operation on C5/6 and a cage fitted. My throat is very sore and I have pain in that area but more down the back of my neck and upper back. I'm still getting the nerve pain and numbness in my arms (mostly left side) but was told that would be the case and that it will take 12-18 months for the new nerves to settle down. My consultant said it may feel worse the first few months but it should improve. On the plus side they are going to regularly review me after they decided to not also operate on the damaged area at C6/7 last week plus they want to see how the stenosis is affecting me. Fingers crossed I feel better soon xxx

Hi Syd.

Thanks so much for getting back to us

I'm so glad it went ok. Sorry to hear you're in pain but suppose its to be expected. Hope you make a speedy recovery and this is the start of moving forward.

Please keep us updated of your recovery.

Outof interest what area are you from and where did you have surgery? Xx

Pleased it went OK bet your relived its over, can't believe it takes that long for nerves to feel better. I've been offered surgery but the thought petrifies me, your so brave well done. How long will u be out of action? Hope the pain doesn't last too long for you take it easy xxx

Thanks Kelly I just thought if it saves me from taking lots of pills and helps a bit then it will be worth it ;-) Told by my consultant to have a 8 week recovery period off work. I'm looking forward to getting the bandage off my neck on Friday and stiches clipped at the ends as its very tight on my neck so is uncomfortable more than anything xxx

Hi Lori I'm in the north west and would love to tell you where I had it done but were not allowed to say on here however I can say they were amazing at the hospital where I went. I believe its the leading one in the country? Yes I'm looking forward to the benefits of my surgery and hopefully less pain. I have a 3 month post op appointment so should be a lot better at that point. Hope you find some relief for your pain too xx