What could cause numbness and muscle tightening from the abdomen to the toes following an accident?

Hello,

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Thank you for your query. You need to send me images of the MRI. Also, tell me do you feel instability while walking? Do you have a change in your writing? Are your symptoms progressive when you compare them with last year? Please send me images.

I hope this has helped you. Thank you.

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Since you do not have images, so let us consider that your problem is because of the cervical spine. Now, in your case, there are multiple other issues. So you must be carefully evaluated if the cervical spine is so symptomatic. If you have any doctor's notes mentioning your clinical examination, then it will be helpful for me. Otherwise, I would suggest you wait and watch as if now. Get yourself recovered from other injuries and then see how symptomatic you are because of your cervical spine. The only absolute indication of surgery in the case of cervical spine myelomalacia is bladder and bowel incontinence.

I hope this has helped you. Thank you.

Hello,

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As I suggested in my previous answer, your cervical spine does not seem to have gross compression. Also, your report does not mention anything about myelomalacia. So I suggest focusing on physiotherapy, and you do not require any intervention for your cervical spine.

I hope this has helped you. Thank you.

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These reports are really helpful in understanding your condition. Well, due to trauma, there is an injury to your cervical spinal cord, which is the reason for myelomalacia. Also, there is a fracture of the spinous process at that level which is a sign of instability. You have weakness in one of the upper extremities, and your lower limbs are more or less fine. Now in this situation, I feel if there is ongoing compression or instability (fracture of the spinous process is indirect evidence of this), you should get operated on. The surgery will stabilize your cervical spine so that it does not cause further damage to your spinal cord. What is the treatment protocol your doctor is following? Complete immobilization and cervical collar? Or are you sitting up and moving using a wheelchair?

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That is great if you are moving around. Then surgery is not required. Yes, a pubic rami fracture can also cause numbness, or any fracture, like the tibia in your case, can cause numbness for a long. It will settle down on its own. Get your vitamin B12 checked, and you can start tablet pregabalin for numbness.

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Tablet Cymbalta is also a nice and effective medicine. Gradually you can increase its dose upto 120 mg in a day in divided doses. You should take Baclofen if muscle tightness is too much and bothering you. Otherwise, a little spasticity is good and helps in walking and standing. Bending the neck forward and then you have tingling is typical of spinal cord compression or myelomalacia. But it would be best if you kept a watch on your symptoms. If they increase, you should consider getting them operated on. It is not normal to have this.

I hope this has helped you. Thank you.

Hello,

Welcome back to icliniq.com.

You can have more muscle tightness usually after too much exertion and when you rest, that is normal and it will be relieved with gentle exercises. Myelomalacia is edema or swelling in the spinal cord. You can call it a bruise. As seen in the rest of the body, the swelling subsides with time. In this case, too, it will. But it may or may not have a residual effect on nerves. So let us see. I feel you should repeat the MRI after three months. Continue your exercises till then and you will improve

Thank you.

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It has been almost two and a half months if anything worse had to happen, it would have been by now. So chances of paralysis are remote now. Neuroplasticity is the word used for regeneration or you can say healing of nerves. Sensory also shows neuroplasticity but lesser than the motor and the good thing is the body adapts to sensory symptoms nicely. Motor weakness is not adaptable. So we are more worried about motor recovery instead of sensory recovery. Going back to work will help you as it will keep you busy, will help you to get back to your normal life, and will keep you positive. It might be a possibility that your symptoms are worse as you are stopping Gabapentin. But I did not get why are you stopping Gabapentin when you can take Cymbalta and Gabapentin together. There is no harm in that.

Thank you.

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Thank you for getting back to me.

As we have discussed before, it is a time-consuming process. Our nerves are very delicate. They cannot bear even a small amount of trauma. And when it comes to recovery, they take a lot of time and sometimes do not recover completely. As advised by your neurosurgeon, it may take up to two years to recover. As far as medicine is concerned, no medicine can fasten this process. Instead, medications are to alleviate your associated symptoms. You can take whatever drug suits you, but you need to take care that you should not be habitual to any medicine. You can give a medicine holiday for a few days in between and start it again. I hope to answer your query with this.

Hope this helps.

Thank you.

Hello,

Welcome to icliniq.com.

Cymbalta is nothing but a drug used for neuropathic pain. There is no harm in taking it for years. We give it to our patients for very long., so there is no harm in taking it. Moreover, the maximum dose you can take is 120 mg. I hope you are taking less than this. So I advise you to continue with that. Yes, when the nerve recovers, then there is an increase in excitability. That is a known fact. I do not know about the brain entering it after six to nine months. If you can share the link, I can go through that and explain it to you better.

Thank you.