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Herniated disc and peripheral neuropathy (specifically SFN)

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Unread 10-12-2012, 09:39 AM   #1
APJH
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Default Herniated disc and peripheral neuropathy (specifically SFN)

Hi everyone. I was diagnosed in May with idiopathic Small Fiber Neuropathy after EMG & skin biopsy. I'm 41, female, in good health and have been tested for all potential causes of SFN. The only thing that showed up was a B12 deficiency. Been taking B12 for 5 months and my level is now normal (will continue taking it daily to keep level up).

I take 60mg Cymbalta every morning--it doesn't eliminate the pain, but keeps it tolerable so that I can work and live my life somewhat normally. I swim 2-3 times a week and I walk 10-15 min. to & from work (I live in NYC). Walking hurts, but I do it anyway.

Last week I went to a neuropathy specialist and had a brain & spinal MRI. The results show a herniated disc in my cervical spine (C6-C7). Doc wants to do some more tests to make sure the diagnosis of SFN is correct (he did not diagnose me originally and wants to review the skin biopsy results from May).

Anyone know of links between herniated discs in cervical spine and peripheral neuropathy in feet? (I have some numbness/tingling in my hands, too, but it is INFINITELY WORSE in my feet and ankles.)

Any feedback or advice would be helpful!

Thanks for listening and be well...

APJH
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Unread 10-13-2012, 06:06 AM   #2
glenntaj
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Default It certainly is possible--

--for issues in the cervical spine to show up in parts of the body below that standard neck/shoulder/arms/hands area, particularly if there is some cord compression from the herniation (as opposed to just compression of the nerve roots that exit the spine and form into trunks that become the nerves of the brachial plexus and eventually the shoulder and arms).

However, there's nothing saying that you can't be "co-morbid"--having more than one thing going on at a time. I certainly am--I've had small-fiber issues well documented by skin biopsy, AND have osteophytic complexes in my cervical spine and some disc herniation causing foraminal narrowing in my cervical spine causing nerve root compression in the C6/C7/C8 areas and resulting in tingling/numbness in my hands, most prominently the right medial nerve distribution (thumb/forefinger/inside middle finger). The cervical situation had been mild/moderate for years and I will tolerate it unless it gets worse or results in motor weakness (a few spine people have said conservative therapy, one has said I may need a foramintomy eventually to clean out the area if the osteophytic bone spurs continue to grow, which is likely with increasing age).

I will say that my cervical spine symptoms are different/distinguishable from my other neuropathy symptoms (the latter are much more in the pulsing, electrical jolt, painful burning kind when they are around--fortunately, they are much better than when they first began, but I am unusual in that I had an acute-onset body-wide burning small fiber neuropathy that began April 11 2003, and spread over my body in hours/days, likely caused by an autoimmune molecular mimicry reaction).

It's difficult often to tease out what is being caused by problem in the spinal area from those caused farther down the nerve pathways. But nerve symptoms from spinal compression are extraordinarily common as one gets older, in both the cervical and lumbar/sacral areas (which typically produces leg/foot symptoms). You may have a bit of a "double crush" phenomenon going on--some damage to nerves from some other agent combined with compression can make symptoms flare up more than the sum of the parts would make one suppose.

How much of a work-up for causes have you had? A lot of us like to use Liza Jane's spreadsheets to track tests for various causes of neural symptoms--

www.lizajane.org
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Unread 10-13-2012, 06:23 AM   #3
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I think that if nerve pain is regularly positional in nature, that a compressive problem may be the cause.
knee/ankle, groin/lower back/elbow/wrist/cervical are likely
spots to cause this.

Treating the suspected area with a cold pack may relieve symptoms of this type for a while. 20min per session.
Aspirin or other NSAIDs may help with it too.
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