Question
    I am a very athletic 44 year old male and work 8 plus hours a day on a computer.  I recently had some very concerning numbness on the left side of my face, so I went to the emergency room after calling my doctor.  They ordered CT brain scans and MRI scan to rule out any type of stroke or tumor and then had a neurologist look at me.  He ordered a C-Spine MRI and found I have herniated discs at the c5-6 and 6-7 levels.  I have since visited a neurosurgeon and he recommended Anterior Cervical Discectomy and Fusion surgery.  He said that I could attempt to manage my symptoms but that the issues I was having most likely would continue to worsen as I age.  He also said that I am more at risk of paralysis if I encountered any type of catastrophic event such as an auto accident.  Since the diagnosis was made I have began putting things together in my mind and realized that I have been living with many symptoms that are probably related to this for several years now.  Pain in my neck and left shoulder radiating down into my left arm and left scapula.  Weakness on that side, and degradation of fine motor skills in the left hand.  Probably would not even be noticed, but I play the guitar and have definitely noticed that my hand is not as quick and chord formations are harder to commit to muscle memory.  I also have noticed that when my neck really flares up I have a lot of dizziness and nausea.  
    I would like to know first of all if you agree that the surgery is necessary, I provided the MRI results below.  I also would like to know if the dizziness and nausea could be caused by the herniated discs.  The neurosurgeon indicated that the shoulder and arm pain and weakness would likely improve as well as the fine motor movements but at that time I had not related the dizzy spells to the neck problems.

Thanks so much for your time and input.

MRI CERVICAL SPINE WITHOUT CONTRAST
DATE:  8/18/08
HISTORY:  Left-sided numbness.
TECHNIQUE:  Multiplanar, multisequence technique.
FINDINGS:  There is cervical spondylosis with disc space narrowing
and dehydration of the intervertebral discs.  The vertebral bodies maintain normal height and alignment.  There is degenerative change of the posterior facets and the joints of Luschka. Specific levels are as follows.
C2-3:  No spinal stenosis or neural foraminal narrowing.
C3-4:  No spinal stenosis.  Minimal neural foraminal narrowing right due to hypertrophy of the joints of Luschka.
C4-5:  No significant neural foraminal narrowing.  No herniated or
bulging disc.
C5-6:  Left paramedian disc herniation appears chronic with some dark signal associated with the disc, possibly fibrosis or calcification.  There is neural foraminal narrowing, severe on the
right and moderate to severe on the left.  Note that the herniated disc impinges upon the anterior aspect of the spinal cord just to the left of the midline.
C6-7:  Right lateral disc herniation causing lateral recess stenosis with additional neural foraminal narrowing due to hypertrophy of the posterior facets and joints of Luschka.  There is moderate left-sided neural foraminal narrowing.
IMPRESSION:  Cervical spondylosis with evidence of herniated disc at levels detailed above.


Answer
Tom,

The changes noted in the MRI suggest you mahy need surgery -- but before surgery, I recommend a more conservative approach:  relieve the neck muscle contractions that led to the herniation.  To do so may free enough intervertebral space to free trapped nerve roots.  In that case, you will experience immediate relief of symptoms and not need surgery.  At this stage, it may be a long shot, but certainly faster, easier, less painful and less expensive than surgery, with no post-surgical recovery time.

As to the dizziness, please see the entry on cervicogenic dizziness at somatics.com/conditions.htm.  It's related.

The conservative approach I recommend is somatic education, a form of brain-muscle training that causes muscles locked into contraction to relax and to begin, again, to respond normally, in movement.  It's a rapidly-acting approach, so you'll know quickly.  Massage won't do it, and nor will chiropractic; you have to retrain the muscles at the brain-control level.  You should get an evaluation by a clinical somatic educator.

Write if you want to investigate, further, and/or get access to a practitioner.

with regard,
Lawrence Gold