Q. I have increased twitching in the left thumb. Is that a sign of cervical disc herniation worsening?

Answered by Dr. Tony Magana and medically reviewed by iCliniq medical review team.

 

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Hello doctor,

I am a 32 year old female with asthma. I have cervical disc herniation for 10 years. Over the past 5 months, symptoms were back with tingling, weakness and shooting pain in arms. I tried medications like Celebrex, Lyrica and also massage, physiotherapy, chiropractor and acupuncture, but the symptoms are getting worse. I did an MRI neck around 3 weeks ago which showed straightening of cervical spine due to muscle spasm. MRI indicates cervical spondylosisdeformans C5-C6 - broad-based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT]. Posterior osteophytes were also mentioned. Now, for the past 2 weeks, I have increasing twitching in the thumb especially left which is becoming almost continuous. Is that a sign that the disc is worsening?


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Dr. Tony Magana
HARVARD MEDICAL SCHOOL
Neuro Surgery, Spine Health, Spine Surgery

Hi,

Welcome to icliniq.com.

A herniated disc in the neck can cause three potential problems:

  1. Injury and degeneration of the disc can cause neck pain that is not related to nerve problems, and this is not usually a need for surgery.
  2. If the disc and bone spurring that form for long-standing problems compress the spinal cord, there can be myelopathy or spinal cord dysfunction which causes problems with walking and weakness of arms and legs. Based upon what you have told me you do not have this yet.
  3. The nerves leave the spinal cord and exit to the right and left. Sometimes disc herniation and chronic bone spurring can compress the nerves and not the spinal cord causing cervical radiculopathy which is most likely what you have.

As long as you do not have spinal cord dysfunction or significant weakness due to nerve compression, then you can try nonsurgical treatments like physical therapy, pain medication, or steroid injections.

If you continue to have significant arm pain or neurological symptoms for more than 6 weeks or develop weakness then you may need surgery.

An EMG/NCS (Electromyogram/Nerve Conduction Studies) test looks at the function of your nerves in the arm. It might be helpful if you get this test done to confirm that the MRI findings and pain you have correlate, before deciding whether to undergo surgery.

 
 
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