Cervical Radiculopathy Improves with
Prolotherapy Ross Hauser, M.D.
Excerpts from the Journal of Prolotherapy
A 38 year-old
male, came in April 2008 with complaints of severe pain in his neck that
radiated down his right arm with numbness of his right index finger and
posterior wrist (C6 distribution). His pain began earlier that month
after lifting a TV. Prior to this injury he was an active person who did
not have pain. He stated that his pain was at its worst when lying down
(a 10 out of 10 pain), but is helped by wearing a neck brace while
sleeping. He was taking Norco two to three times per day for pain, a Medrol dose pack, and Daypro at the time of his first visit. An
MRI
ordered by his primary doctor revealed a right sided disc herniation at
C5-C6 and C6-C7.
Upon initial exam, his right arm muscle strength was normal but had
slightly diminished sensation in C6 dermatome. Upon extension of his
neck and right lateral rotation he had shooting pains down his right
arm. The patient received
Prolotherapy
at his first visit to his entire
neck and right scapular region. He was taken off Norco and Daypro and
given Ultram for pain and Ambien to help him sleep.
He returned every 2 weeks for the same treatment and at his 3rd visit he
reported 50% improvement in pain. His pain was down to 5 out of 10. He
still had numbness of his right index finger with lying down. He moved
his appointments to every 3 to 4 weeks over the next few
prolotherapy treatments and
at his 5th visit he reported 70% improvement in pain and that he no
longer had pain unless he was lying down. His finger was unchanged at
this time.
The patient continued his Prolotherapy every 6 weeks or so over the next
few treatments and, at what would have been treatment #9, he reported
that his neck was doing “really good.” He did not receive treatment at
this visit to his neck but wanted to get his knees and feet treated for
unrelated injuries because Prolotherapy had worked so well on his neck.
He was on no pain medication for his cervical radiculopathy after his
8th visit and the sensation to his right index finger and posterior
wrist was back to normal. He was also back to full activities including
exercise. Six months after his last Prolotherapy treatment he continues
to do well.
CERVICAL 'RADICULOPATHY' SYMPTOMS SUCCESSFULLY TREATED WITH
PROLOTHERAPY
About once every two weeks a patient comes in worried because they
believe they have a pinched nerve in the neck. Typically they have had
an MRI which some some degenerative
arthritis and degenerated discs in
the neck and they have tingling in the arm and hand. So is this cervical
radiculopathy or is this just a referral pain from the upper thoracic
area. How do you tell?
THE EYES
I look at people's eyes. People who have a true 'nerve' being pinched,
really can't smile because the pain is awful. When the eyes loose their
luster and the look on the persons face is 'panic' I think cervical
radiculopathy. If the person is able to converse with me and laughs at
my jokes, then there is a good chance they have a thoracic ligament
problem.
THE HUB
A person who puts their hand between the spin and the scapula and says
that is where their pain emanates from, I think thoracic ligament
problem. In cervical radiculopathy cases, the person will point to a
specific area of their neck causing the pain. Thoracic ligament problems
can cause some
neck pain as the case study indicated but typically the
person will tell you this is a referral pain and the neck pain is
minimal compared to the thoracic pain.
NUMBINESS
Cervical radiculopathy gives 'true' numbness. If a person senses
numbness in the fingers but can feel everything, this is called
numbiness. This is a referral symptom typically from thoracic ligament
problems (generally thoracic #1-3). Numbness that is true, meaning the
person has lost sensation in part of their hand or fingers, indicates a
nerve problem. Then one thinks of cervical radiculopathy.
BREATHING
Cervical radiculopathy is not affected by breathing and vice versa.
Breathing can aggravate thoracic problems and thoracic problems can
aggravate breathing. Someone whose symptoms are affected by deep
breathing, makes me think thoracic ligament problem.
ARM MOVEMENT AGGRAVATION
Believe it or not in my experience, when arm movement aggravates the
symptoms, I think more thoracic ligament problem. Simple movements of
the arm only occur by stabilization of the scapula. Stabilization of the
scapula affects the upper thoracic segments more then it does the
cervical spine.
RESPONSE TO PROLOTHERAPY
Thoracic ligament problems often feel better right away with
Prolotherapy. Cervical radicular symptoms generally need a nerve block
to feel better right away. Prolotherapy can be used with cervical
radiculopathy but often you need other modalities also to treat the
person.
For people who have been told that they need surgery for cervical
radiculopathy I would recommend that they get a second opinion from a
Prolotherapy doctor. You would hate to get surgery and not be better because
your problem was a thoracic ligament problem and all you needed was
Prolotherapy.
The thoracic ligaments that can refer pain down the arm are those
involved with Thoracic segements #1,#2, and #3. The ligaments that
connect these vertebrae together and the ones that connect these
vertebrae to the ribs (costovertebral ligaments).
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