Question
I am seeing an orthopedic dr. for back/neck pain, numbness in my left hands in my thumb, pointer & index fingers as well as a burning pain in my forearm. I went for a lumbar MRI and here is the impression:

multilevel degenerative changes, worst at L4-5 from shallow left foraminal disc protrusion, resulting in severe left neural foraminal narrowing with impingement of the exiting L4 nerve root. There is no spinal stenosis.

I have had this MRI as well as another MRI on my Cervical spine which I am waiting on the results. I have also underwent an upper & lower extremity Electromyagram to which I am also awaiting results. The pain mgmt dr who administered the EMG said that I had Ulnar Nerve Entrapment in my left forearm and neuropathy in the nerve that runs down the left outer part of my left leg down into the left side of my foot which causes numbness. Sometimes when typing (which is what I do all day) my pointer and index finger on my left hand ill start tremoring or bouncing uncontrollably. I tried shaking my hand out as well as clenching a fist which stops the tremor for the moment and then it begins again when I try to type.

My question to you is:

my doctor is a shoulder specialist and is sending me for epidural steroid injections on Monday and I want to know if there is any other alternative treatment. Everyone I have talked to who has had the injections said that they are only temporary relief and I just want to be fixed.

Answer
Dear Bradley,

Your condition is the net result of degenerative changes that are occurring in your neck and in your lower back.  

You will not like this answer, but there is nothing that will fix your degenerative problem in the spine.

There are, however, many things that you can do to manage the symptoms related to your condition. Some things might help, and other things might not be as beneficial. You might even respond best to a combination of several approaches. The most important thing is to always start with the least invasive and damaging, and end with the most invasive procedure.

This is the order that I recommend:

1) Conservative Care... Physiotherapy, traction, spinal decompression, manipulation, massage, acupuncture, stretching, strengthening, electrical stimulation for pain management, bracing, splinting, ice, heat, nutritional/dietary changes, supplementation, homeopathy, herb therapy, enzyme therapy for inflammation and pain, altered kinesthetics, etc.

2) Intermediate care... Short term medication (NOT long term narcotics or long term NSAIDS), epidural injections, neuroablations, facet joint injections, steroid injections, Hyalgan injections, epidurals, injections of Traumeel, trigger point injections, etc

3) Surgical intervention... laminectomies, discotomies, spinal fusion, etc.

You have many options Bradley.  All or some might be beneficial. Some cause permanent injury and damage (surgery) and should only be done after everything else fails.  NONE of them will make you grow a new disc in a damaged neck or back.  None of them are going to "Fix" you.... so, what do you want to do?  What do you want to try?

I hope that this helps you!

Keith Biggs, DC
http://www.eastmesachiropractor.com
http://www.arrowheadhealth.com