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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Cervical Stenosis, Herniation @ C1-C7 Pinched Nerve. Numbness In Fingers, Increasing Pain, Taking Cymbalta. Alternate Medication ?

I am a 49 y/o male with cervical stenosis , hernations @ C1-C7 pinched nerve Right side , numbness in thimb , pointer middle finger , @ night pain and numbness is woresnsed, I was given cymbalta, 20 mg , by Neuorlogist, Just stated to taking it, is it a good medicine, I ahve been on clebrex, mobic, soma, flexoril , naproxen NO Help I Sustained head trauma on Septmeber 11, 2001 at the terrorist attacks. The pain and numbness are getting progressively worse.
Tue, 4 Dec 2012
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General & Family Physician 's  Response
Hello. I'm Dr. Christensen.
I'm sorry you're so uncomfortable. As you've discovered, cervical stenosis can be resistant to treatment, especially when multiple levels are affected (as in your case). Cymbalta is one of several medications that are used for conditions like yours. Pregabalin (Lyrica) and gabapentin (Neurontin) are other examples of medications used to treat pain caused by damaged nerves. It usually takes several weeks to determine whether or not these drugs will be helpful for a given patient. Unfortunately, most patients have at least some residual discomfort even when the medications work well. Therefore, other modalities -- physical therapy, acupuncture, core strengthening, chiropractic manipulation, etc. -- should also be explored. Some patients do eventually need surgery when all other options fail to reduce their pain.
Cymbalta is generally well tolerated, but it does have some side effects. The most commonly reported ones are nausea, fatigue, dizziness, constipation and insomnia. Young adults using this medication may experience suicidal thoughts. Some patients have suffered from liver damage while taking Cymbalta, and this drug could cause serotonin syndrome (an uncommon side effect characterized by agitation, tremors, rapid heart rate, sweating, flushing, diarrhea and sometimes seizures). Finally, Cymbalta should not be discontinued abruptly, as this could lead to a withdrawal syndrome (insomnia, electric shock-like sensations, agitation, confusion and headache). If you and your doctor decide Cymbalta is no longer indicated, you should taper your dosage gradually.
I hope that answers your question, and I hope you feel better soon.
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Cervical Stenosis, Herniation @ C1-C7 Pinched Nerve. Numbness In Fingers, Increasing Pain, Taking Cymbalta. Alternate Medication ?

Hello. I m Dr. Christensen. I m sorry you re so uncomfortable. As you ve discovered, cervical stenosis can be resistant to treatment, especially when multiple levels are affected (as in your case). Cymbalta is one of several medications that are used for conditions like yours. Pregabalin (Lyrica) and gabapentin (Neurontin) are other examples of medications used to treat pain caused by damaged nerves. It usually takes several weeks to determine whether or not these drugs will be helpful for a given patient. Unfortunately, most patients have at least some residual discomfort even when the medications work well. Therefore, other modalities -- physical therapy, acupuncture, core strengthening, chiropractic manipulation, etc. -- should also be explored. Some patients do eventually need surgery when all other options fail to reduce their pain. Cymbalta is generally well tolerated, but it does have some side effects. The most commonly reported ones are nausea, fatigue, dizziness, constipation and insomnia. Young adults using this medication may experience suicidal thoughts. Some patients have suffered from liver damage while taking Cymbalta, and this drug could cause serotonin syndrome (an uncommon side effect characterized by agitation, tremors, rapid heart rate, sweating, flushing, diarrhea and sometimes seizures). Finally, Cymbalta should not be discontinued abruptly, as this could lead to a withdrawal syndrome (insomnia, electric shock-like sensations, agitation, confusion and headache). If you and your doctor decide Cymbalta is no longer indicated, you should taper your dosage gradually. I hope that answers your question, and I hope you feel better soon.