Pinched Nerve

PierceNeck

I did an admittedly quick and not so thorough search for this and didn't see anything posted previously. But if it has, please forgive me, and close this.

Oh, also, point me in it's direction.

Anyways,

I believe, and so does my doctor, that I have a pinched nerve somewhere in my neck. Which is causing excruciating pain in my right arm. It’s hard to describe the pain, because I haven’t felt it before. Like, I’ve broken my hip and wrist, have small pebbles permanently in my elbow, and suffer migraines on a regular basis, and none of those hurt like this. It’s like a really sharp ache, combined with bouts of burning, and stabbing sensations, deep in my upper arm. My elbow feels like someones driving a screw driver through it. Same for the area between my spine and my upper shoulder.

Sometimes it doesn’t hurt at all, and comes and goes during the day in waves. But at night, it’s pretty constant and at it’s strongest. So I’ve only been getting like 2 hours of sleep a night, with maybe another 2 hours of semi-conicious-just-about-to-pass-out-but-i-dont sleep.

I’m exhausted.


So I’ve been dealing with this for the past 2 1/2 weeks, and finally got an MRI scheduled in about 6 days because everything takes forever with an HMO. And I can’t even get in to see the doctor again for another 4 days after that.

Anyways, on to the point of this post.

The Vicodin/Norco (5/500mg for the Vic, 5/325mg for the Norco) I’ve been prescribed works marginally well. Maybe giving relief for an hour or so, sometimes 5 hours. But that’s during the day. At night it’s almost useless. Ibuprofen works a little, but only in conjunction with the Vicodin/Norco, not by itself. Heat from heating pads does nothing. Hot showers seem to help, but only while I’m in there. The pain comes back pretty rapidly when I get out. Plus, I can’t afford the hot water to be in there constantly. I was also given Prednisone to help with any possible inflammation, but that was just a 5 day treatment. They also gave me a shot of something, which may or may not have helped for a day. I couldn’t really tell, because the pain varies pretty wildly throughout the day. I have a neck brace they gave me, but that’s not really doing anything either.

So my question…. Does anyone have any possible suggestion for how to deal with the pain? I can handle it during the day but at night it’s crazy and I really need some sleep.

Any home remedies? Do they even have those for nerve pain?

Dhalphir

Dhalphir was warned for this.

Have you tried deep heat cream or something like that? I have no idea if it would help, but you say warm showers help so maybe the warm sensations will help.

When I had very bad muscle cramps in my calves, I used to sleep with tea towels wrapped around my calves that had been dipped in boiling water and allowed to cool slightly. Stayed hot long enough for me to fall asleep.

PierceNeck

I've tried Aspercreme, which didn't help. Not sure if that's a deep heat cream though, as opposed to a .... shallow heat cream? But heating pads, both the kind you plug in and the kind that are sticky, don't work. Not sure why the shower helps, where those don't.

And I can usually fall asleep, the problem is staying asleep. What little help the pain killers offer wears off while I'm sleeping and the pain wakes me up. At which point it's too bad to go back to sleep, even if I wait for the next round of pain killers to take effect.

Dr. Frenchenstein

i had the same thing, but in my lower back/pain down the leg. pretty much nothing works on nerve pain short of serious opiates. it sucks big time, basically just take er easy when you can. i had to suffer through PT (which didn't help) before i could get surgery. i do not envy you sir.

Pantshandshake

Well, this is a pinched nerve. The sensations you're feeling in your arm? They aren't starting in your arm. They're starting in the nerve in your neck. My bet is that the shower works, and the pain is worse at night, because of the physical position of your body in those times.

Try to emulate what you do in the shower (I'm not going to make the obvious joke here) while out of the shower. Perhaps sleeping upright in a chair?

Entriech

Have you been able to identify any position you can put your body in that reduces the pain? If so, taking steps to maintain your body in that position while you're sleeping might help. My wife had a compressed nerve at one point in her hip, and she ended up sleeping in something called a lift chair that would minimize her discomfort.

You may also want to pursue other kinds of painkillers the next time you talk to your doctor. Naproxen is available in higher than over the counter doses via prescription, and I know some folks think it is a more effective anti-inflammatory than Iburofen. She was also prescribed a painkiller called Tramadol, which acts like an opiate without the propensity for addiction, and she found that quite helpful in managing her pain levels. The nice thing about the Tramadol as well as that it was compatible with both Naproxen as well as continuing to take another Analgesic (tylenol in this case).

If your pain responds well to moist heat, look into some of the electric heating pads. Some of them come with an insert you can moisten, then place inside a cover to have that moist heat outside of the shower.

bowen

That's a pretty serious pinched nerve you've got there. I'm surprised they didn't give you an oral steroid for it, morphine/NSAIDs can only do so much. Looks like surgery is going to be your solution, but, heat is probably going to do little for your pain. You'll probably want to try ice on the affected area (where the nerve is, not where you feel the burning/pain).

PierceNeck

@Pantshandshake Yeah I figured out right away that laying down wasn't an option. Sleeping in a chair, or propped up against a wall in my bed, worked for the first few nights. But it's getting progressively worse. The only difference when I take a shower (I sit in the shower for this) is I lean forward instead of back. I can try sleeping like that, but I have my doubts.

@Entriech Sitting/standing up are when it's most comfortable. Actually when I'm out walking around is when it hurts the least. But that's not really going to help when I need to sleep, haha. I looked at those lift chairs, and from I saw, they're really expensive. Which I can't swing right now. I'll keep those medications in mind and bring them up when (if) I can get a hold of my doctor. I had never even heard of heating pads that allow for moisture, I'll have to look in to that.

@bowen Yeah, it's pretty bad. I'll try out some cold packs, don't know why that hasn't occurred to me yet.



I don't think my doctor is taking it seriously though. I went to urgent care on 4/25, and then saw my PCP on 4/26. I told her then that the vicodin prescribed by the urgent care wasn't working very well. Since then, I just keep getting 3 day prescriptions for vicodin/norco, and can only talk to the receptionists. (they might be nurses, I don't know) I just got a message from them that she can't change the type of medication, since I bring up that it doesn't work every time. So I'll have to call today to find out why. I'm hoping it's not because I have shitty insurance or something like that that wont allow them to prescribe me anything else.

bowen

They probably think you're a pill seeker for some stupid reason. You might want to try and find a new PCP.

Entriech

Regarding the lift chair thing. We didn't actually purchase one. Medical supply stores tend to rent them out (specifically because they are so pricy). We ended up paying something like a hundred a month to have one rented, which didn't seem too unreasonable to me really. Not saying that it's a great solution for you, but if you do think sleeping in a seated position would help, it might be worth a test run.

This is the sort of thing I was talking about with the moist heating pads.

PierceNeck

Yeah one of the problems is I'm new to the insurance. I didn't have a doctor when signing on, so I got auto-assigned to one. (Which happens to be like an hour away)

I can switch to a new one, and one much closer, however it wont take effect until the beginning of the month. So I'm stuck with this one for the near future. And I don't like the idea of having to switch PCP's in the middle of an issue.

I'm pretty sure I can't change over to a PPO either, because I think I'm locked in to the HMO for a year.

PierceNeck

@Entriech I think we actually have one of those, but I didn't realize there was a moist heat option.

And I'm definitely going to check out renting a chair like that because this lack of sleep is killing me.

Dr. Frenchenstein

actually, epidural shots were very effective, pain would subside for weeks. depending on what is pinching your nerve (mine was stenosis as well as a herniated disc) it's only a stopgap until surgery.

PierceNeck

Well that blows.

Mad Jazz

I don't have any advice beyond what you're doing already, but just make sure you're not totaling any more than 4g of acetaminophen a day. If you're taking the vic/norco as prescribed, you aren't, but it's pretty easy to not take into account the non-opiate part of those drugs, especially if you stack them.

Good luck man, nerve pain sucks balls.

PierceNeck

Talked to the doctor, they don't want to prescribe me anything stronger/different from what I have now until I get the MRI. Which seems reasonable, but it's still another 5 days of nothing new.

Ketar

Try to get a referral to a pain specialist. I had similar issues due to 2 herniated discs in my lower back, with terrible pain all the way down my right leg. Vicodin/Norco didn't help much at all. Epidural injection + physical therapy helped me pretty well for about a year, but things got worse again and the injections and PT didn't help much at all the second time around.

The pain specialist I started seeing the second time ended up putting me on Lyrica in addition to the norco, and that was marginally better but still not a great relief. Surgery ended up being the only option once I'd maxed out on epidural injections, but the surgery went well and I was totally pain free afterward.

Siska

Perhaps try this Vulcan neck pinch! ---> http://answers.yahoo.com/question/index?qid=20100612131657AAH0nQq
Might work if the nerve is pinched by a knotted up muscle, rather than something in your spine.

Windburn

Without appropriate imaging, etiology (and therefore treatment) is difficult, but your symptoms sound like cervical radiculopathy. There is a lot to say on this topic, and I am more than happy to discuss it with you, but your question was specifically toward how to treat the pain.

There is considerable debate on what actually causes pain when a nerve is compressed (stenosis, disk herniation, etc.). It may seem self-evident, but the fact of the matter is nerves don't tend to hurt simply by squeezing them. Numbness and paresthesias are expected and more characteristic or nerve compression. This is why, for example, lumbar decompression surgery for low back pain is not very successful. Whereas, if someone has low back pain and numbness or weakness, it can be very successful...for the numbness and weakness (not so much for the pain component). There is some though that inflammation around the nerve is an irritant (in the same way that tendonitis is painful to a tendon). This is why anti-inflammatories are useful for treating this kind of pain. Steroids (oral and epidural) are very effective, as well as NSAIDs. I know you have tried ibuprofen. You might try naproxen instead. It may work better for you. After that, you might ask your physician for a prescription stength NSAID, such as Mobic. Do be cautious with prolonged steroid use if you find it is effective for your pain. They are not without side-effects. I just saw a lady in clinic today with avascular necrosis of both her hips and right shoulder secondary to a 2 week course of IV steroids in the hospital followed by a short oral taper at home for a COPD exacerbation. She now needs bilateral hip replacements and a shoulder replacement (she is only 45 years old).

Next category are the so-called "nerve pain" medications: Neurontin and Lyrica. Their mechanism of action is not well understood, but they can be extremely effective for some people. Both of these are prescription only, and some physicians are not comfortable prescribing them if they don't do so regularly (particularly PCPs). This may seem obnoxious, but if you were to have some reaction to the medication, you would want a physician that would be familiar enough with that drug to triage it appropriately.

Narcotics unfortunately are not very effective. Very strong types and high doses can help, but they come with serious side-effects and they are not a long-term solution. In the short term, you may benefit from something likely percocet or oxycontin over norco/lortab. In spite of the reasons given to you over the phone, the number one reason these drugs are not "called-in," is because they can't be. They are schedule II drugs, which require a special, physical script. Urgent care centers also typically don't prescribe them as the abuse potential is very high in that setting. If your pain is unbearable, go to a full ED, preferably one that has spine coverage (orthopaedic surgery or neurosurgery). If surgery ultimately is not a feasible option for you, long term (eventually very high dose) narcotics may be your only option. You will need to see a pain management physician for this.

The suggestion made previously in this thread about positional therapy is excellent. If you find that certain positions are less painful, trying to mimick them in other aspects of your life (such as sleeping position) can be very helpful. For example, if you have foraminal stenosis, extension of the neck tends to be exacerbating, but flexion can be relieving. If you have disk herniation, the opposite is true.

Muscle relaxants help with associated pain, meaning your neck and shoulder muscles spasm to try and brace your neck and body against the pain. If this is a component of your pain, they may help. If not, they will do nothing for your "nerve pain."

Topical agents (lidoderm patches, topical steroids, capsaicin, heating pads, etc) typically aren't very effective, because their penetrance is not very deep. Narcotic patches can work, because they elute a small amount of narcotic into the systemic circulation, but the same problems pertain as described above.

Finally, I'm not familiar with Siska's linked maneuver, but I will say that you should be extremely cautious about any manipulative therapy in the neck. Typically when it comes to chiropractic interventions, we say that for mild-moderate symptoms it can be effective (if temporary). Some people swear by the adjustments they receive, and if it works for them, great. However, we never recommend and actively advise against any manipulative therapy in the neck. There are several reported instances of permanent injury or paralysis that have occured.

Let me know if I can be of any more assistance.

PierceNeck

My muscles do spasm, so they're sore. But that's no big deal. It's that deep ache that feels like it's in my bones that's keeping me up at night. In fact, it's happening right now so it's taking a while to type this in between all the rocking and breath holding and why me?ing. My thumb has been numb for most of the time, but over the past couple days I seem to be getting feeling back. The skin on my bicep is also sorta numb. I didn't mention this earlier because my primary concern is how to deal with the pain, specifically during the night. The pain seems to get worse, and spread, as time goes on. I guess the best way to describe how it works is to liken it to the tide coming in. Each little wave pushes it further, and then it recedes but not all the way, and then another wave comes in and it's a little further now, and so on.
First it was just in my upper arm, that ache I keep talking about. It's progressed into my elbow and shoulder area as a regular pain now, where as it used to only be during the waves of pain. And now the waves are moving down my forearm. Plus I'm getting the sensation of needles stabbing my shoulder and tricep area a lot now. Which is new. Every once in awhile it shoots down in to my fingers for a second.

My grandfather has one of those "back machine" where you strap your ankles in and then are inverted. Do you think this could help, at least temporarily, by decompressing my spine?

Is there any kind of dietary supplements that might help my body to naturally deal with it?

Oh also, I have trouble lifting anything heavier than, say, a coke can. Just really weak.

And, am I right to assume that if this is in fact a compressed nerve, I'm basically going to have to have surgery?

I'll probably hold off on posting more until I get my MRI results.

Dr. Frenchenstein

it sounds pretty seriously pinched (mine was debilitating as well) and i'm betting surgery will be your only option. But, it's impossible to tell without the MRI. My mom had a pinched nerve in her neck, she got a few epidurals and it went away, so you never know.

Basketballs

What happens when you have your arm (that does hurt) hang down in a supported position? I'm talking your arm is pretty much down as far as it can go, but then your forearm is resting on something with your elbow at a 90° angle.

I think pantshandshake may have been onto something also. Move your neck like you're trying to touch your ear to your shoulder that doesn't hurt and then let your head hang down towards your chest at the same time.

Both of these positions will unload your nerve if it is one of a couple common nerve problems in the neck. It is hard to tell in real life where the pain is coming from (hence the need for an MRI) and almost impossible over the internet. Hopefully one of these positions will help a little with your pain!

milehigh

Dr. Frenchenstein wrote: »

it sounds pretty seriously pinched (mine was debilitating as well) and i'm betting surgery will be your only option. But, it's impossible to tell without the MRI. My mom had a pinched nerve in her neck, she got a few epidurals and it went away, so you never know.

Not to derail, but how has your surgery held up? I know someone with similar issues (bulging disc causing nerve pain in the leg) and they have a feeling they'll eventually have to have it done. Just curious how it went since I hear an equal number of horror vs success stories in the matter.

Dr. Frenchenstein

Dr. Frenchenstein was warned for this.

it went great for me! I'm almost out of PT, and playing sports, going to the gym, etc.

PierceNeck

Went and got my MRI today, should have the results in a few days.

Side note: I had to take my nape piercings out and now I can't get them back in. Total bummer summer.

Pantshandshake

Now you have to change your forum name...

PierceNeck

Ok so I saw my doctor today and... well, I really didn't understand all the technical medical mumbo jumbo. But what I came away from the visit with is that I have a cervical stenosis because of a disc shifting. (4mm-10mm) All I know is that I chose not to get the heavier narcotics as addiction runs in my family, and I seem to be getting by ~ok~ with the norco. And she's submitting a referral so we can see if surgery is necessary or if physical therapy looks like it could work. She was leaning towards surgery though.

Now I have to call the guys who did the MRI to get it put on disc so I can bring that with me.

I suppose this thread doesn't really serve a purpose at this point, since there's not really a lot I can do about the pain aside from what's already been suggested. Just wanted to update anyone who was curious.

And thanks for the suggestions guys!

Dr. Frenchenstein

Dr. Frenchenstein was warned for this.

that is exactly what i had (but mine was L-5, S-1: lower back), plan for surgery dude... unfortunately. ask about epidurals, they were the only thing that helped me, but not for long. good luck!

Windburn

To answer you previous question, the "back machine" you were referring to probably won't help much with your cervical stenosis. The reason it "may" help with low back pain is that it leverages the body mass of your entire upper body to decompress (temporarily) the lumbar spine. In the case of cervical pathology, you are relying on the mass of only your head to achieve the same effect. They do make cervical decompression devices, but I refer you to my previous caution against any form of cervical manipulation.

MRI's can be a double-edged sword. If I was to scan 100 people, most (if not all) adults would have some pathology in their spine. Yet most of us do not suffer from back pain, radiculopathy, or myelopathy. You need to be very careful that the pathology seen on your MRI corresponds to your symptoms. If you have a lateral disc bulge at C4 and numbness that radiates to your thumb and index finger (C6), surgery to correct the disc herniation would likely not fix your symptoms (and possibly cause new ones).

From what you said, it sounds like you were not seeing a specialist. This is perfectly fine, but you need to see an orthopaedic spine surgeon or spine neurosurgeon for a more thorough evaluation. As you said, make sure to bring the MRI disc with you (very important). If you just bring the report, you will have wasted a visit. He/she will need to review the actual images to determine a plan of care. The report is nearly worthless. Also, I hope you didn't go to one of those Open MRI's. The quality on those is so poor, I frequently have to have my patients rescanned in a better MRI (with sedation for claustrophobia).

IcyLiquid

Dhalphir wrote: »

Have you tried deep heat cream or something like that? I have no idea if it would help, but you say warm showers help so maybe the warm sensations will help.

When I had very bad muscle cramps in my calves, I used to sleep with tea towels wrapped around my calves that had been dipped in boiling water and allowed to cool slightly. Stayed hot long enough for me to fall asleep.

minion warn

Geth

How could we have become so different, @Dhalphir? Why can we no longer understand each other? What did we do wrong?
Warned @Dhalphir (2 points for 1 week) for ""

IcyLiquid

Dr. Frenchenstein wrote: »

that is exactly what i had (but mine was L-5, S-1: lower back), plan for surgery dude... unfortunately. ask about epidurals, they were the only thing that helped me, but not for long. good luck!

Minion warn

Geth

Every point of view is useful @Dr. Frenchenstein, even those that are wrong - if we can judge why a wrong view was accepted.
Warned @Dr. Frenchenstein (2 points for 1 week)

IcyLiquid

Pantshandshake wrote: »

Now you have to change your forum name...

Minion warn

Geth

Information propagation is slow. Many voices speak at once. We do not understand how you function without consensus, @Pantshandshake.
Warned @Pantshandshake (2 points for 1 week)

IcyLiquid

Dr. Frenchenstein wrote: »

it went great for me! I'm almost out of PT, and playing sports, going to the gym, etc.

Minion warn for being a shithead

Geth

Every point of view is useful @Dr. Frenchenstein, even those that are wrong - if we can judge why a wrong view was accepted.
Warned @Dr. Frenchenstein (2 points for 1 week) for "being a shithead"