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What Does My Nerve Conduction Test Report Indicate?
Question: Four years - MVA - Nerve conduction test said L4, L5, S1 nerve abnormalities. No suggestion; then, had test two months ago and increased abnormalities; no suggestions; Area also had bulging discs, radial tears; told everyone my age has them; end of discussion except had Acupuncture. Now, my right leghas difficulty moving; and, a few weeks ago, after acupuncture in neck, my neck is stiff, headaches, ears feel clogged and pressure point in left shoulder. Right after MVA, neurosurgeon saw issues in neck which was fine until a chiropractor manipulated it and it returned to normal; however, he said if I have increased issues, he could do a simple surgery - obviously I don't want that, but, is it important to have my neck looked at or likely it will go back to normal. You see, talking to a doctor, in these days, is rushed; quality care, in my experience, is lacking, and, once a doctor throws out Chronic Pain without even checking MRI's etc, I have had doors closed and doctors prescribed mega OPIATES....four years of them without addressing why. I'm off, at my request, but, inactivity becaue of pain is not helping and getting answers is quite difficult.
Brief Answer:
Probably spinal degeneration disease but neck MRI is necessary.
Detailed Answer:
I read your query carefully and I understand your concern. It must be really frustrating to have gone through many doctors without an improvement of your pain.
It seems that you have already had imaging and nerve conduction studies which have confirmed lumbar degenerative disease of the spine with herniated disc and nerve roots compression. You don't mention any imaging for the cervical spine.
What you must know is that since spinal vertebrae are part of a whole, chances are that the same degenerative changes present in your lumbar area are present also in you cervical area. They are often found in clinical practice and clinical studies to go hand by hand. So that would be the most probable cause.
However, in your case considering the exacerbation after an acupuncture procedure with neck stiffness, acupuncture complications must be taken into account, two serious complications are subarachnoid hemorrhage and spinal epidural haematoma. Usually an epidural haematoma would have other neurological signs though, while subarachnoidal hemorrhage remnants could be difficult to detect now after several weeks, also with blood absorption should have some improvement.
So while a neck MRI is recommended both for the degenerative changes in the spine as well as for these complications I believe the first possibility to be the most likely one. The fact that the neurosurgeon has spoken of surgery before reinforces that.
If no such complications are not found and the symptoms are due to the spinal changes then treatment consists first of over the counter pain killers like non steroidal inflammatory drugs such as Ibuprofen combined with muscle relaxants like Thiocolchicoside or a benzodiazepines for a couple of weeks. As important as drugs is physical therapy with stretching and strengthening exercises of the spinal muscles, relaxation exercises. For a few a cervical collar can be used. Perhaps you might have used some pain killers already but I'm mentioning it anyway since you only speak of opiates.
If on MRI there is evidence of nerve root compression also treatment with medication for neuropathic pain with anticonvulsivants such as pregabalin, gabapentin or antidepressants such as venlafaxine, duloxetine (alone or in combination) could also be added. They might have a beneficial effect also on your other lower body chronic pain.
I remain at your disposal for further questions.
Probably spinal degeneration disease but neck MRI is necessary.
Detailed Answer:
I read your query carefully and I understand your concern. It must be really frustrating to have gone through many doctors without an improvement of your pain.
It seems that you have already had imaging and nerve conduction studies which have confirmed lumbar degenerative disease of the spine with herniated disc and nerve roots compression. You don't mention any imaging for the cervical spine.
What you must know is that since spinal vertebrae are part of a whole, chances are that the same degenerative changes present in your lumbar area are present also in you cervical area. They are often found in clinical practice and clinical studies to go hand by hand. So that would be the most probable cause.
However, in your case considering the exacerbation after an acupuncture procedure with neck stiffness, acupuncture complications must be taken into account, two serious complications are subarachnoid hemorrhage and spinal epidural haematoma. Usually an epidural haematoma would have other neurological signs though, while subarachnoidal hemorrhage remnants could be difficult to detect now after several weeks, also with blood absorption should have some improvement.
So while a neck MRI is recommended both for the degenerative changes in the spine as well as for these complications I believe the first possibility to be the most likely one. The fact that the neurosurgeon has spoken of surgery before reinforces that.
If no such complications are not found and the symptoms are due to the spinal changes then treatment consists first of over the counter pain killers like non steroidal inflammatory drugs such as Ibuprofen combined with muscle relaxants like Thiocolchicoside or a benzodiazepines for a couple of weeks. As important as drugs is physical therapy with stretching and strengthening exercises of the spinal muscles, relaxation exercises. For a few a cervical collar can be used. Perhaps you might have used some pain killers already but I'm mentioning it anyway since you only speak of opiates.
If on MRI there is evidence of nerve root compression also treatment with medication for neuropathic pain with anticonvulsivants such as pregabalin, gabapentin or antidepressants such as venlafaxine, duloxetine (alone or in combination) could also be added. They might have a beneficial effect also on your other lower body chronic pain.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you for you in depth answer. I had cervical imaging right after a MVA four years ago; neck wasn't a problem until Chiropractor manipulated, but surgeon saw some issues. Acupuncture should be innocuous, but, for some reason, a needle in my neck and top of skull did cause a reaction. I hesitate to report to any doctor because, Chronic Pain label has caused them to prescribe drugs only. Off of opiates because I demanded it and finally know that going to the Military Hospital where I got lost in the cracks, is only delaying any kind of help.
I take your advice with gratitude. This is a great service provided - doctors here have little time to listen, especially when the patient (in the beginning) didn't look like pain is as great as it is. All of this suffering I have to say must be for a reason; I'm hoping I can prevent others from going down this misreable path. Again, thank you very much. And, because I don't like to appear like a hypo, do you understand that acupuncture could possibly do such damage? I've had acupuncture from one of the finest; this was a different experience altogether. Also, having my insurance pay for some of the worst treatment ever, I don't take lightly; so, if an MRI is recommended, I appreciate your recommendation. I thought the issues would go away, but it's been a month now. Without a Provider after having one who only gave meds, so, am grateful for this site even though I know it's not a substitue for finding a doctor who will listen. Thank you very much for your indepth answser. I've been communicating with a terrific colorectal surgeon on this site; his insight and advise after I was "butchered" by a surgeon, has been invaluable. I am grateful for the opportunity to at least get opinions and accept that there is no responsibility on your part.
By the way, nerve conduction tests, MRI's, and other tests are only as good as the doctor who reads them. Abnormal nerve endings; bulging discs, radial tears - from MVA, but no advice from there. We have a broken system and, having never had need for anything other than routine, I haven't realized how little communication between doctors there is and how few really try. My mission, if I ever am on my feet again, is to be a patient advocate because their are many who don't fight like I do. What happens to them? Sorry, this is more for a counselor, but, I'm disappointed in the way healthcare is so bad in many cases and many people don't have the support of family - they truly must succumb to drugs and the couch. No need to respond, but thank you very much.
I take your advice with gratitude. This is a great service provided - doctors here have little time to listen, especially when the patient (in the beginning) didn't look like pain is as great as it is. All of this suffering I have to say must be for a reason; I'm hoping I can prevent others from going down this misreable path. Again, thank you very much. And, because I don't like to appear like a hypo, do you understand that acupuncture could possibly do such damage? I've had acupuncture from one of the finest; this was a different experience altogether. Also, having my insurance pay for some of the worst treatment ever, I don't take lightly; so, if an MRI is recommended, I appreciate your recommendation. I thought the issues would go away, but it's been a month now. Without a Provider after having one who only gave meds, so, am grateful for this site even though I know it's not a substitue for finding a doctor who will listen. Thank you very much for your indepth answser. I've been communicating with a terrific colorectal surgeon on this site; his insight and advise after I was "butchered" by a surgeon, has been invaluable. I am grateful for the opportunity to at least get opinions and accept that there is no responsibility on your part.
By the way, nerve conduction tests, MRI's, and other tests are only as good as the doctor who reads them. Abnormal nerve endings; bulging discs, radial tears - from MVA, but no advice from there. We have a broken system and, having never had need for anything other than routine, I haven't realized how little communication between doctors there is and how few really try. My mission, if I ever am on my feet again, is to be a patient advocate because their are many who don't fight like I do. What happens to them? Sorry, this is more for a counselor, but, I'm disappointed in the way healthcare is so bad in many cases and many people don't have the support of family - they truly must succumb to drugs and the couch. No need to respond, but thank you very much.
Brief Answer:
Thank you and stay positive.
Detailed Answer:
I am really sorry you have had such negative experiences. Where I live XXXXXXX health care quality is considered as the absolute best so I am surprised to hear that, I guess there are imperfections there as well. At times overworking makes communication difficult and doctors not always give their best, happens to me as well, perhaps less likely on this site because answering or not at a certain moment is a choice and I can take some more time for the answer.
You are absolutely right, tests are only as good as the doctor who reads them. If no recommendation was made at the time, the advice which should have been given for bulging discs and radial tears are pretty much the same as those for the neck which I already gave you before. We are not always successful though, modern medicine as advanced and complex as it has become is still limited.
As for the remark for acupuncture, whether MRI shows a complication of acupuncture or not, it wouldn't necessarily make that acupuncturist more or less able in his profession. Every procedure can have side effects, when there are rare and chances for potential benefit surpasses the rate of side effects we recommend it (people shouldn't stop driving altogether because there happen car accidents, do they?), but there will be the rare case where complications can follow.
I hope you do achieve the goal of helping others with your experience. It would be beneficial for them as well as for yourself I believe.
Thank you and stay positive.
Detailed Answer:
I am really sorry you have had such negative experiences. Where I live XXXXXXX health care quality is considered as the absolute best so I am surprised to hear that, I guess there are imperfections there as well. At times overworking makes communication difficult and doctors not always give their best, happens to me as well, perhaps less likely on this site because answering or not at a certain moment is a choice and I can take some more time for the answer.
You are absolutely right, tests are only as good as the doctor who reads them. If no recommendation was made at the time, the advice which should have been given for bulging discs and radial tears are pretty much the same as those for the neck which I already gave you before. We are not always successful though, modern medicine as advanced and complex as it has become is still limited.
As for the remark for acupuncture, whether MRI shows a complication of acupuncture or not, it wouldn't necessarily make that acupuncturist more or less able in his profession. Every procedure can have side effects, when there are rare and chances for potential benefit surpasses the rate of side effects we recommend it (people shouldn't stop driving altogether because there happen car accidents, do they?), but there will be the rare case where complications can follow.
I hope you do achieve the goal of helping others with your experience. It would be beneficial for them as well as for yourself I believe.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
I certainly do not blame the acupuncturist; it was a fluke; Murphy's Law, if you understand, seems to apply to me.
I got lost in the cracks from the very beginning between civilain and Military; have some great doctors; some who chose not to listen. It happens; I'm not critical of all.
Thank you so much.
Healthcare is not what it use to be.....patients are rushed in and out; doctors don't make the money they once did, so see more patients. It's rather a shame. But, I understand where you are coming from. Answers from you and others on this site would never come from a doctor waiting for his next patient. Thanks you very much
I got lost in the cracks from the very beginning between civilain and Military; have some great doctors; some who chose not to listen. It happens; I'm not critical of all.
Thank you so much.
Healthcare is not what it use to be.....patients are rushed in and out; doctors don't make the money they once did, so see more patients. It's rather a shame. But, I understand where you are coming from. Answers from you and others on this site would never come from a doctor waiting for his next patient. Thanks you very much
Brief Answer:
Thank you and good luck!
Detailed Answer:
Thank you for your appreciative words for our HCM community.
I hope things will work out for the best.
Thank you and good luck!
Detailed Answer:
Thank you for your appreciative words for our HCM community.
I hope things will work out for the best.
Above answer was peer-reviewed by :
Dr. Shanthi.E
My neck continues to stiffen; would constant "tingling, needles" in feet be caused from cervical or lumbar.
Four years - no treatment other than injections and Physical Therapy but I didn't have a doctor dictate what to do; she just gave opiates. I'm off opiates; all pain meds, but, life is lousy, and, I wonder if my brain will ever be normal after being treated or,not treated.
I have burning along my entire spine; and, when I breathe, there's a place that pushes in. This is beyond comprehension; the surgery errors got in way of any awareness of back issues.
Four years - no treatment other than injections and Physical Therapy but I didn't have a doctor dictate what to do; she just gave opiates. I'm off opiates; all pain meds, but, life is lousy, and, I wonder if my brain will ever be normal after being treated or,not treated.
I have burning along my entire spine; and, when I breathe, there's a place that pushes in. This is beyond comprehension; the surgery errors got in way of any awareness of back issues.
Brief Answer:
Tingling, needles could be due to spine, but neuropathy likelier.
Detailed Answer:
Tingling and needles can be caused by your spinal issues. However especially if the symptoms are bilaterally symmetric as you seem to be implying, peripheral neuropathy is also possible.
The distinction should be made by nerve conduction tests like the one you said to have had 4 years ago showing nerve root changes. If these symptoms appeared prior to that test you had back then, then spine issues with nerve root compression is likely, if symptoms appeared later though, a repeat exam would distinguish from a later developed peripheral neuropathy. The treatment I mentioned earlier with anti-depressants or anticonvulsants might be beneficial in both cases and they don't cause dependance issues which you seem to fear.
I hope to have been of help.
Tingling, needles could be due to spine, but neuropathy likelier.
Detailed Answer:
Tingling and needles can be caused by your spinal issues. However especially if the symptoms are bilaterally symmetric as you seem to be implying, peripheral neuropathy is also possible.
The distinction should be made by nerve conduction tests like the one you said to have had 4 years ago showing nerve root changes. If these symptoms appeared prior to that test you had back then, then spine issues with nerve root compression is likely, if symptoms appeared later though, a repeat exam would distinguish from a later developed peripheral neuropathy. The treatment I mentioned earlier with anti-depressants or anticonvulsants might be beneficial in both cases and they don't cause dependance issues which you seem to fear.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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