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spectreman
Trad climber
CO
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Apr 14, 2009 - 08:56pm PT
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I just read a bit more of this thread. If the nerve root is still being compressed as it exits the spine then you will have continued weakness and problems in the corresponding muscles. You also risk more permanent nerve injury. If the nerve is being pinched or compressed then the muscles in the neck and upper shoulder will reflexively spasm to try and protect the damaged area. THis only makes the problem worse and you get in a terrible cycle. Treating the muscles alone will not generally stop the spasm and tightness because there is the underlying problem. You really need to decompress the nerve with some sort of mechanical traction or skilled mobilization. Pure spinal manipulation may not be indicated with your history. If you lived in Colorado I would be happy to treat you for free! Stop by if your in the area. I'm a PT in private practice in Ft. Collins.
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bachar
Gym climber
Mammoth Lakes, CA
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Topic Author's Reply - Apr 14, 2009 - 09:03pm PT
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Specterman, thanks. I think you're right about the compression, tightness, and overall guarding. I'm tight as a rock in that area.
Low level infrared or laser? Are there any devices sold online I could try that you know of?
Right now I use a lot of heat packs to loosen things up - doesn't last too long.
ninjah, thanks for the compliments. I've seen my slides too many times to believe anyone else wants to look at that stuff..hahahha cheers, jb
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spectreman
Trad climber
CO
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Apr 14, 2009 - 09:17pm PT
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You can buy infrared devices online. The problem with the home devices and the cheaper units is the amount of power output. It is usually quite low and the therapuetic benefit would be decreased. Clinical models used in hospitals and PT practices are very expensive. I think the unit we have in our practice was around $5,000.
If there is still mechanical pressure on the nerve root then an infrared or laser device will be of limited benefit. You would only use it to try and help heal a damaged nerve. If you were going to spend some money I would think about a one time consulatation with a skilled manual physical therapist or chiropractor and then discuss options for home traction devices if the problem is compression. SOme home traction units are really inexpensive but can actually help.
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ron gomez
Trad climber
fallbrook,ca
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Apr 14, 2009 - 09:56pm PT
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spectreman, I'd like to get together with you, have a beer(or whatever)and talk. Good point about the muscles reflective response, I think some problems are manifested by this tightening and compression...and then refer pain to another sight along the chain. Keep the posts coming I'll look forward to hearing yer point of view!
Peace
John when the trout are biting, let me know and I'll swing by! Got to loosen things up again, THEN get the quality movement back.
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bachar
Gym climber
Mammoth Lakes, CA
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Topic Author's Reply - Apr 14, 2009 - 11:21pm PT
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Ron,
I like saw a ten foot trout the other day in the Gorge. It was real hungry looking too.
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ron gomez
Trad climber
fallbrook,ca
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Apr 14, 2009 - 11:35pm PT
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I'll be there in about 6 hours! Jump in and chum the waters, the chilly water temps will reduce the swelling on yer brain and the thrashing about to find shore should loosen the neck and shoulders up just fine! The Gorge DOES have some fine fishin', Peters got pretty much the same story on the fish...maybe not ten feet, but he does spy some nice specimens in the middle Gorge from up on the routes! We'll "hook" up soon Bro!
Peace
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Dr. Josh
Boulder climber
South Lake Tahoe
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Apr 17, 2009 - 01:34pm PT
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Looking at the nerve system, you need to look at essential nutrients. Calcium for bone, protein (amino acids) for muscle and the omega 3 fats for the nerves. I would up your intake of fish oil (high DHA & EPA) to around 1000-2000mg a day. This does increase free radicals in the body so the cheapest and best antioxidant is Alpha Lipoic Acid it is water and fat solvable. It would be better to include N-Acetyl-L Cysteine and Co Q 10 also. This will increase the energy of the cells, metabolism which in turn increases the healing capacity of the cells.
To get a complete package it tends to be expensive, so choose depending on budget and how fast you want to heal.
Check with local practitioners who check for nerve entrapments in the muscles. The could also impinge on the healing.
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the Fet
Supercaliyosemistic climber
Tu-Tok-A-Nu-La
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Apr 17, 2009 - 02:21pm PT
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Good advice from spectreman and Dr. Josh.
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Chip
Trad climber
Wilmington, DE
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Apr 17, 2009 - 03:06pm PT
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Sex. Over and over again. May take many years to fully recover.
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LongAgo
Trad climber
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Apr 17, 2009 - 08:08pm PT
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John,
Very important to get the diagnosis right as first step. Nerve compression is one thing, actual damage is another. Further, you symptoms of weakness actually could be unrelated to nerve function, as strange as that sounds. Body does a variety of perverse things after major injuries, some in short term, some in long. A good orthopedist and MRI should be your first stop. He/she will check your mobility, nerve response, muscle position, posture and a host of things to lead to a diagnosis.
In best case, you then may be helped by good PT who will do some mobilization, devise proper exercises and continually monitor you for progress and routine changes. Worst case, they may find scar tissue impingement on nerves and go in and remove it. Worst, worst case, you may have some permanent nerve damage, but even there I know from experience you can recover quite a long way, over time.
My case was not unlike yours, but different body part. I had a failed fusion surgery (bone did not grow in where 2 disks were removed, so I have just cadaver bone replacement and hardware holding me together) of two disks in my lower back (L4-L5, L5-S1. I spent three years in bed 20 hrs per day with pain managed only by narcotics, had lots of leg weakness like you describe (I think worse, frankly) and a host of other complications from being down so long. But tests showed no nerve damage in spite of scar tissue – well, some but not severe. Some docs thought, this won't get much better. But others thought PT could wake up muscles my brain had shut off (one of the things body does in “recovery” after major injuries) and regain flexibility severely hampered by long term tightness. I found a good PT after trying several who were not right for me and after the last four years 15 hrs per week in baby step routine starting in the house, then the pool, then the gym, I am pretty damn good now. Even back to some moderate climbs, and plenty of cycling and hikes.
So, I'd pass on remedies for now (except low risk non-invasive relief stuff like massage therapy) and get at the cause as first step. I understand you don't have resources for long term body work program with a PT, but how about scraping up enough for at least the diagnostic phase?
Best to you,
Tom Higgins
LongAgo
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ron gomez
Trad climber
fallbrook,ca
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Apr 17, 2009 - 08:23pm PT
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Right on Tom, the baby steps thingamajig works well. One step at a time, but finding the right cause is the KEY, only then can proper treatment be assessed. Glad you are recovering, the body does wake up and with proper movement sequences it has AMAZING rebounding ability. Keep up the work, keep moving, keep mobile and continue to get better
Peace
You've been a prime motivator for me and a lot of other climbers out there. LOVE yer routes!
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bachar
Gym climber
Mammoth Lakes, CA
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Topic Author's Reply - Apr 17, 2009 - 09:30pm PT
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Thanks Tom. I know that initially I had some nerve damage from a ruptured C6/C7 disc and then successful fusion. I wore a neck collar for 6 months and then within another 9 months did a 5.12a. Everything was good.
Then things started getting worse. I keep guessing at what it is but in the end your words ring true - I really need to pinpoint what is happening now and try to treat it.
Thanks again for your advice, I have always admired you for your feats and wisdom (believe it or not, heh heh!).
Good luck to you - see you in the Meadows sometime soon for a few pitches I hope!
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nicolasC
climber
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Apr 19, 2009 - 07:47am PT
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Just found the thread, and wanted to chime in with my one experience.
in sept 1998, I fell 14m on a wooden floor in a gym (badly made knot which came undone when I was about to be belayed down).
I broke c2 very badly but survived, broke both wrists
I also got compression fracture on c3, d12,l1 and l2, and some herniated discs.
After 5 months of casts, some surgery and 12 months of therapy, I was able to climb and run again.
I felt so good, I went back in 2003 to playing rugby.
I got twice hurt, and developped pain in the shoulder and the slight weakness in the hand. The doctor I saw at the time did just some injections. He may have thought it was a carpal tunnel syndrom.
What I now understood is that I had developped a nerve compression at the place where the nerve exit the spine.
I was able to get very good relief from a chiropractor, (not the run-of the mill PT guy)
In Jan 07, I got very sick with something similar to the flu.
then a few days later, I got tinglings, then pains then loss of strengths from the shoulder to the end of the fingers.
Pain was atrocious for months. Atrophy of the arm and shoulder was very very noticeable.
After 9 months of multiple x-Rays, scans, electric testing, and visits to doctors and spine surgeons, I ended up finding by myself the description of the Parsonage-turner syndrom on internet.
I managed to get an appointment with the head of rare neurological diseases in France, went to see him, and bingo, he
confirmed that I had been most probably a victim of such Parsonage-turner syndrom.
The current theory about this disease is, as far as I can understand, :
For a few unlucky people, an infection may trigger an inflamation/immune reaction in the brachial nerve nexus (where nerves which exit the spine at multiples places come together before splitting again) and destroy nerves.
Once the nerves have been destroyed, there are 2 regrowth opportunities:
 growth of new nerves from the spine outward
innervation of muscles by extensions of nerves from neighbouring muscles.
Depending on the seriousness of the destruction of the nerves, the recovery if it happens can take from 2 years to 5 years.
I have so far recovered the sensory bit, but not the motor control of some muscles. my arm and shoulder look quite strange as some muscles are strong from climbing (yes, I still climb, albeit at a lower standard) and some are simply not present.
The only drug which "may" help rebuild nerves is vitamin B12.
All this to say that:
1. Nerve compression provokes tinglings and pain if the sensory nerves are impinged upon. and/or loss of strength and atrophy if the motor nerves are impacted
2.if prolonged the nerve compression can lead to permanent damage. Physical therapy can re-align vertebrae and relieve pressure. In some case, spine surgery may be necessary especially
ay if bone growth occur in the little conducts through which nerves exit the spine or if the disc is so compressed that the conduct is made too small.
3. an nerve which is pressured is inflammed. an inflammed nerve takes more room, A nerve which wants to take more room in a cosntricted conduct is pressured even more , => vicous circle which sets up the scene for a chronic condition. An anti-inflamation drug which can eb taken for a long time is often prescribed (such as Ibuprofen)
4. and this is my interpretation, a inflammed nerve can be the bed for a more serious condition, such as the Parsonage-Turner condition or any of the very rare neurological condition.
So my reccomendation to Bachar:
a/ Get checked for nerve integrity (i will try to find the exact english name for this procedure)
B/ keep on eating B12
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bachar
Gym climber
Mammoth Lakes, CA
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Topic Author's Reply - Apr 19, 2009 - 11:59am PT
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nicolasC.
Thanks for sharing your experience. That's a harrowing story, I wish you further success in the future.
Very good info for me too, thanks much. Points 2 & 3 really hit home for me...
"2.if prolonged the nerve compression can lead to permanent damage. Physical therapy can re-align vertebrae and relieve pressure. In some case, spine surgery may be necessary especially ay if bone growth occur in the little conducts through which nerves exit the spine or if the disc is so compressed that the conduct is made too small.
3. an nerve which is pressured is inflammed. an inflammed nerve takes more room, A nerve which wants to take more room in a cosntricted conduct is pressured even more , => vicous circle which sets up the scene for a chronic condition. An anti-inflamation drug which can eb taken for a long time is often prescribed (such as Ibuprofen) "
It makes me wonder if after time a successful fusion can become "overgrown" with new bone material and start to impinge on the nerves emanating form the spine - the very ones that were pinched in the initial disc rupture?
I also wonder if after time, general muscular "tightness" and loss of mobility in the affected area can cause nerve impingement? For me that would be in the neck and shoulder girdle.
Thanks again, good luck.
See ya' at the crags, jb
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Grant Meisenholder
Trad climber
CA
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Apr 19, 2009 - 12:20pm PT
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Hi John- some very good advice here regarding PTs and nerve regeneration. I'm a PT student, so I'm not able to help you yet, but I might suggest that if you have a PT school nearby, swing by and see if they need victi--- er, practice cases. My school here in San Diego (usa.edu) recruits people from the community so that we students can have experience with the actual pathology we're studying. At no time are we allowed to perform any procedures that have potential to cause further damage. Our professors, who are very experienced PTs, do the hands on stuff in those cases.
Just a suggestion. And yes, the bone can grow (osteophytes) and impinge on the nerve roots (stenosis). Good luck!
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Coldfinger
Mountain climber
Bethany, CT
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Apr 19, 2009 - 07:40pm PT
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I have had remarkable results from a chiropractor trained in the "Gonstead Method" and have also dealt with some quacks who did more harm than good. Also you might find a Traditional Chinese Medicine (TCM) practicioner/ Qi Gong healer on the West Coast. TCM has a very different model of how the body works and I have had good results on an issue that western medicine could not address. Good luck
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midarockjock
climber
USA
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Apr 19, 2009 - 07:54pm PT
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I have heard climbing stories about mushrooms and energy.
They may have been on top rope so I'm not certain about
the nerves.
I don't know of any places to trigger for gold at this
time. I'll look more into those noted injuries to determine
outcome.
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nicolasC
climber
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Apr 20, 2009 - 04:55am PT
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Hi Bachar,
The medical tests you should undergo are called
electromyography and nerve conduction tests.
They are often used to affirm/infrim the carpal tunnel syndrom.
In Electromyography, a neurologist will be using very little needles to detect the electrical activity of the nerves and the muscles, both on a scope and with aural feedback. Depending how the muscles are innerved, the activity will be different: if the muscles are well innerved, the signals will be "loud and clear", if the nerves are very damaged, the muscles will host fluttery signals of self activity, if the nerves are beign regrown from neighbouring muscles, the signals will be again different, etc.
In nerve conduction tests, the doctor will quantify the activity in the brain which is triggered by very small electrical pulses done through the little needles. Through various measures of the quality of signal transmission, and the speed at which it travels while changing the point where the pulses are applied, he can pinpoint where the nerves are compressed and by how much.
Both tests are not really painful, just not confortable.
Regarding X_ray and RMN and 3D vizualization, the diagnosis is quite difficult. there are some patients which have very little openings for the nerves to pass and almost no nervous symptoms, and you have patients which have average clearance and yet suffer from nerve pinching.
I have another story to share with you, whioch exhibit some positive things about nerves and getting back to full fucntionning.
First: One word of caution: be very wary of muscle relaxant drugs.
The first and second specialist I saw had misdiagnosed my neck-shoulder pain and got me to take a lot of muscle relaxant.
As I was cleaning the garage, I bend over to pick up a paper, I displaced a lumbar vertebrae. The pain was agonizing despite the morphine I was taking for my Parsonage-Turner (yet undiagnosed).
I ended up having to see yet another doctor for this sciatiq nerve, whch was burning up my leg from the knee upward. I was extraordinarly concerned beause I became unable to walk upstairs 2 steps at the time. I saw part of the quadriceps muscle of the leg disappear on the same side as my arm which was shrinking.
The diagnosis of the surgeon was easy to make (I was dragging my feet, I had lost nerves sensitivity and msucle control on my feet, etc). The X-Rays were clear-cut. It was a matter of fusing the vertebrae back in place and letting enough room for the nerve.
Yet I did postpone the surgery (I did not know which one was most importnant, neck or lumbar), stopped the relaxant, went to see my chiropractor for my lumbar area and increased the Ibuprofen to relieve the inflammation while keeping B12.
After a few weeks,the lumbar troubles began to recede, I regain the sensitivity of my foot, I regain the control of the muscle. After a few moe weeks, I had almost regain the thighs muscles.
My understanding was: the chiro (he holds the chair of chiro at the state university) was able to put back the vetebrae in palce, thus relieving the pressure. Ibuprofen reduced the inflammation. b12 MAY have helped the nerve rebuild.
what was key was probably the limited time (2 weeks before the visit to the chiro) during which the nerve was damaged.
Disclosure: I have absolutely no finacial ties with Ibuprofen industry. It is not a miracle drug, yet it is a strong anti-inflamation / anti-pain drug with good tolerance. I have taken it at large dose for long period of time (with suitable blood tests). It exist as a generic drug (thus quite cheap).
This is what got me to think by myself about my own neck-shoulder-arm troubles. I learned much more than I ever wanted to know about nerve conditions. After a lot of researching, I self-diagnosed myself as a Parsonage-Turner victim.
I am well aware of the risks of self-diagnosis. this is why I am sharing with you not the symptoms, but the scientific investigation tests that a doctor should conduct to affirm/infirm a proper diagnostis.
The last year consensus among the neurologists I have consulted is:
1 says No,
1 says maybe,
2 says above my head, very rare condition, we'll go with the specialist advice,
2 says definitely yes, among which the head of the national rare nreve diseases taskforce, who is the ONe guy who gets to see most of the cases...
Of course, You may have noticed that I take pride in having understood the troubles I am suffering from.
Please understand that it was the only way I could find to "compensate" for my loss. By understanding, I was no longer a victim, I was stronger than my illness.
My arm can let me down, My leg can drag me down, but my brain is still there. Muscles don't define me, it is what I do that matters.
Through dedication, research and understanding, I affirm myself above the slings and arrows of outrageous fortune.
My wishes for recovery go to you, Bachar
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midarockjock
climber
USA
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Apr 20, 2009 - 12:47pm PT
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I went to Main Place Mall in Orange CA. to look for
a alpinist store. I found none, however on the 2'nd
floor there was a free Nerve Regeneration test being
conducted with the use of a 36" monitor showing
the spinal cord, which is hooked to a black box to
receive pressure inputs for visual output to the
digital imaged spinal cord vertebrae's and disc.
Dr. Victor Baez said he did not mind if I noted
his name, business address being 630 S. Glassel
Suite 102, phone number 714-454-3421and email
drvictorbaez@gmail.com also noting he specializes
in Spinal Cord injuries. He stated you may have a
$20.00 analysis as part of the promotional price
which is more than the test noted above.
Open Distal Radius Fracture.
http://i295.photobucket.com/albums/mm130/midarockjock/odrf80.jpg
5 weeks 90 degree cast almost up to my shoulder.
Take note of the scar at my wrist. 5 weeks in a straight
cast up to my elbow, and then a velcro cast. I did the
Muir trail at this time with later. Fractured Fissure came
a few months after completing the trail and sin pizza
con ongos. I had 2 tko's up to this time, 10 counts and
beyond occured after this operation.
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LongAgo
Trad climber
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Apr 20, 2009 - 08:36pm PT
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John,
I think you are right to wonder about "new bone material starting to impinge on the nerves ..." and if "muscular tightness and loss of mobility in the affected area can cause nerve impingement?" You might add possible impingement of scar tissue.
But all goes back to the same point: these things can be diagnosed and ruled out or in by nerve tests discussed on the thread (how I found out about my nerve situation too), MRI and other tests. Bone spur and scar tissue removal is possibility if these are problems. Of course, as another poster says some people get by with some impingement and some nerve damage without operations and just the right kind of regular PT and/or "manipulation." I’m doing OK with a bunch of scar tissue revealed in an MRI, but only with a continuous maintenance regime. That may not work for the next person.
Problem is without that diagnosis in hand, you can't go on to make a good call about a promising treatment regime, which usually involves the least invasive approach first and any operation as a last resort (unless impingement is very obvious, dangerous and easily removed).
Sure hope you get some tests.
Best,
Tom Higgins
LongAgo
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