Arm muscles atrophy from herniated disc.... HELP!

[tonydisc]

Hi,

5 months ago I herniated a disc in my Neck C5/C6, with compression on the C6 nerve root.

I even had surgery to decompress at the 2 month mark. BUT, I still have weakness in my left arm. Also, a lot of atrophy in deltoid, wrist extensors, and Teres major.

Has anyone else recovered from something like this? I'm not talking pain, the pain is gone, but the muscles jst refuse to grow back and are staying small. Has ANYONE been through this and regained their muscle at some point?

I could understand it if the muscles were growing slowly, in small increments, but they are just not growing at all, there is no sign at all. Does this mean they are dead?

Thanks,

T

 

[musclemom]

Who did the surgery, a neurosurgeon or an ortho?

Anyway, the muscles can't be "dead." If you have no numbness or tingling, just the weakness and atrophy, considering you're three months out from surgery, you're still within the time frame to not be anywhere near full recovery yet, and your surgeon should have told you that.

Questions:

1. Is the weakness getting better, even if it's slow?

2. Are you still attending PT? (if you're not, sounds like you should be, unless they released you to home exercises, which you should still be doing).

3. Have you brought this issue up with your surgeon? They really should have given you reasonable expectations and so forth before you even went under the knife, but they should be giving you a progress report when you go in for follow-up. If you've been released from the surgeon's care then you need to find a neurologist.

This isn't a muscular issue, this is a nerve issue. As long as you're seeing improvement, no matter how slow, things are healing. Nerves take a very long time to recover.

 

[footdoc]

muscles are not dead....it may be a year or more before you start to recover much size there

 

[tonydisc]

thanks for the replies.

It was a neurosurgeon that did the operation, it was a posterior microdiscecomy without removing the disc or doing fusion.

1) As for strength increase, there was a small increase for a couple of weeks after the pain went away, but then it stopped dead and has stayed the same until now, months later.

2) I am doing PT at home, just a few exercises I was shown I can do at home.

3) I did bring it up in my follow up after the surgery. The neurosurgeon said since there was no improvement in strength by this time, chances are i will never get it back. He said there should have been at least SOME strength improvement since the surgery.


I realise that nerves take a very long time to heal, but I don't understand why many people have nerve injury and it doesn't heal. I have talked to a lot of people who herniated a disc, and they never recovered their muscle atrophy. But I was hoping to find some stories with happy outcomes.

Thanks

 

[musclemom]

thanks for the replies.

It was a neurosurgeon that did the operation, it was a posterior microdiscecomy without removing the disc or doing fusion. The neurosurgeon said since there was no improvement in strength by this time, chances are i will never get it back.

As for strength increase, there was a small increase for a couple of weeks after the pain went away, but then it stopped dead and has stayed the same until now, months later. I am doing PT at home, just a few exercises I was shown.

What?! Did I read your timeline correctly? You only had the surgery three months ago, right? Get a second opinion. Something's not right, starting with the dr's attitude. You don't hit maximal improvement until 6 months to a year or more after neurosurgery, and it sounds as though the surgeon is being dismissive of you and isn't answering your questions very well. Loss of strength and atrophy is something that (good) doctors are usually highly concerned about and will do everything they can to correct and they should make darned sure you understand what's going on and why, especially if you have problems that are going to be chronic.

 

[tonydisc]

Well yeah we were concerned about the strength loss and atrophy which is why we did the surgery. I think he meant that we were hoping to see some improvement, but the fact that there was no improvement at all after a few months, might mean it was permanent. I realise that maximum recovery takes up to 2 years, but what is disheartening is that there has been no sign of improvement even beginning after 3 months.

 

[musclemom]

Well yeah we were concerned about the strength loss and atrophy which is why we did the surgery. I think he meant that we were hoping to see some improvement, but the fact that there was no improvement at all after a few months, might mean it was permanent. I realise that maximum recovery takes up to 2 years, but what is disheartening is that there has been no sign of improvement even beginning after 3 months.

Working with the information you've given and assuming you're a relatively young (under 35) person and that you're being reasonably complete with your history (i.e., that you didn't suffer complete loss of feeling or use of the arm at the time of the injury), something just ain't right. You need to see another physician. At the very least, you need something called an EMG, which would be done by a neurologist. That should have been done before the surgery and you should have another one now.

Collect copies of all of your records from every doctor you've seen since the injury occurred, especially copies of every imaging study done, and see a good neurologist.

A doctor just spreading his hands and saying "well, I warned you, these things can happen" is not a sufficient answer. At the very least you are entitled to knowing exactly what's going on with your arm and shoulder and why.

I wish you the best of luck.

 

[tonydisc]

Working with the information you've given and assuming you're a relatively young (under 35) person and that you're being reasonably complete with your history (i.e., that you didn't suffer complete loss of feeling or use of the arm at the time of the injury), something just ain't right.

Do you mean by this, that since I did not have total loss of feeling or use, that by now I should have seen improvement, so something really is not right? yes I am 30 years old, and was extremely fit until the injury.

I actually did have an EMG before the surgery. But I have not had a follow up EMG since I figured no matter what it tells me, there is nothing more we can do now anyway since I already had the surgery and am doing PT. The EMG before surgery showed active denervation, but my NCV test came back completely normal. That part always confused me.

Thanks for all your replies.

 

[musclemom]

Do you mean by this, that since I did not have total loss of feeling or use, that by now I should have seen improvement, so something really is not right?

Correct. Assuming your function wasn't declining before surgery, your arm should be in BETTER condition than it was before the surgery.

I actually did have an EMG before the surgery. But I have not had a follow up EMG since I figured no matter what it tells me, there is nothing more we can do now anyway since I already had the surgery and am doing PT. The EMG before surgery showed active denervation, but my NCV test came back completely normal. That part always confused me.

Thanks for all your replies.

Actually what I mean by something ain't right is the fact that your surgeon should be all over this problem like stink on shit. He's taking the "oh, if I act like it's normal the patient will think it's normal" approach. I'm telling you, what you're dealing with is not normal. By being totally hands off the surgeon is placing himself in a position where he might have less culpability because "everything looked fine to him," you weren't complaining and that's how it will look like he acted. If he sent you for more exams or studies then it would be clear down the road that he knew you weren't progressing the way you should.

What they don't get is that is the attitude that gets them sued faster than if they threw everything at a problem but the kitchen sink. Patient's know when you care, and they know when you try. He's not trying.

You need a new doctor, and you need a doctor OUTSIDE of the system you're in currently (they will cover each others asses). If you have an HMO this means you may need to pay out of pocket if you don't have a sympathetic PCP. Most teaching hospitals are outside of "systems" so if you could get a referral to the best known teaching hospital in your area that would give you a fairer shot (try to make the appointment with the head of the department). You need to see a neurologist. You need to emphasize that what you want is full functional return (focus less on the atrophy, that makes you look superficial, the atrophy should improve with return of function).

Think about it for a second. You're a young, healthy man. One of your arms is not functioning correctly. You've expressed this to the doctor who was supposed to have operated on you to fix this problem and he's saying "well, these things happen." In your guts you know it ain't right, why else did you post the thread you did?

Now, maybe the surgeon DID fix the problem but you could still have something else going on (which is why a good doctor would have scheduled you for another EMG). By not trying to resolve what's causing the weakness and atrophy he's falling down on his job. You need to get to the bottom of this problem and waiting for your surgeon to help you out is clearly not the way to do it.

 

[kiddstephen]

did you ever recover strength? i'm in the same position as you except its my spinal accessory nerve. Immediately i had improvement, but it never got better as the months went by.. I'm post op 6 months.