Question
QUESTION: Respected Sir,

My age is 58 years. When i got up in the morning on 23 April in Tanzania, i had a severe neck pain. I was hospitalised for 8 days for vomitting and giddiness. MRI procedure was done for Multiplanar and multisequential images acquired through cervical spine without IV gadolinium contrast. Following was the findings:
1. Reversal of cervical lordosis identified.
2. Decreased intervertebral disc height of C5/C6 noted alongwith decrease vertebral body height of C5 and C6.
3. At C5-C6, postocentral disc protrusion seen with slight inferior migration causing moderate right and mild left neural foramina stenosis alongwith moderate anterior dural sac identation.
4. At C6-C7 posterolateral discosteophytes complex seen causing bilateral mild neural formanina stenosis alongwith mild anterior dural sac identation.
5. At C4-C5, posterolateral discosteophytes complex seen causing moderate anterior dural sac identation without significant radicular compression.
Then i came to India for treatment. Could you recommend the further course of action and in how many days would it take to recover? I still have severe pain in the right hand elbow (below the elbow). Should i consult a neurosurgeon also?

ANSWER: Dear Pawan Kumar Garg,
Thank you for taking time to write to me. I am so sorry to hear of your severe neck pain.  You mentioned that you came to India for treatment. Did you have any treatment yet? If so what did you have? It sounds to me like the severe pain in your right hand below the elbow may be related to either the disc protrusion and disc height narrowing. If it were me I would take the MRI disc and results to a orthopedic surgeon and a neurosurgeon to get opinions. I am curious if you may also feel numbness or burning or tingling in your hand. Are you experiencing any weakness?
Is there any paralysis?  I have seen many patients who have suffered a disc induced neuropathy. Of them every one of them have improved with non-surgical spinal decompression. I suggest that you consider seeking a doctor with this experience to see if you are a candidate for this miraculous treatment. It is of the greatest importance that you seek attention immediately due to the potential serious nature of this problem.
Can you please take a moment out to rate my answer and consider top nominate me as volunteer of the month.

I wish you a speedy recovery,
Dr. Ron Nusbaum
www.backclinicsofcanada.ca

---------- FOLLOW-UP ----------

QUESTION: Respected Sir,
Thanks a lot for your valuable suggestion. I am working as Attache in the High Commission of India, Dar es Salaam, Tanzania and sent by the Indian High Commision to India for this treatment. I have been taking treatment by specialist orthopaedic doctor in India since 5th May (17 days) and taking medicines only. There is no improvement and the pain in my right hand is not subsidizing. This problem started in Dar es Salaam on 23rd April. Physiotherapy exercise had been done in Dar es Salaam for two days in the hospital when I was admitted (from 26th April to 3rd May).
Now I am experiencing severe pain in my right hand below the elbow. I am experiencing weakness, numbness in last two fingers of my right hand and a sense of burning in my hand. Paralysis is not felt in my hand. Today I consulted a neurosurgeon and he told me that neck operation has to be done if there is no relief within 6 weeks of taking medicines.

I shall be grateful if you give me your opinion whether neck operation is a viable option for this problem? What physiotherapy exercise is helpful in my case? How many days it will take to cure this disease ?

Once again thanks for your co-operation.
Regards,
Pawan Kumar Garg

ANSWER: Dear Pawan,
Firstly let me tell you how genuinely I sense your pain and anguish.  Please know that I wish to help you but as I have certain limitations in that not being able to directly examine you and see your MRI.  With regards to your question about surgery, I hesitate surgery unless all conservative viable options have been considered. It may be that you could be a candidate for my non-surgical spinal decompression with laser therapy.  I don't believe that medicine alone can help you.  Please go to my web site at www.backclinics.ca to learn more about non-surgical spinal decompression.  If you have had any testing of your problem which included manual traction and felt even slight reduction of any symptoms then I strongly suggest that you find a doctor with non-surgical spinal decompression experience to be evaluated for candidacy for this procedure.  I wish I could help you in some other way. For now I offer you all the best wishes for a complete recovery with the almighty's help.

Dr. Ron Nusbaum

---------- FOLLOW-UP ----------

QUESTION: Respected Sir,

With almighty's grace, my pain has started to reduce with medicines only. Previously i had severe pain on shoulders and the whole right hand. Now the pain has reduced to below elbow and palm of the right hand. But severe pain is there in the palm only.

As I still have pain and orthopedic doctor is giving medicines only and he has denied physiotherapy exercise.
My main question is whether I will recover from medicines only or I have to go for physiotherapy in addition to medicines. Also please advise whether going to Tanzania by 4th June is feasible or not as in Tanzania the medical facilities are not apt.
Your advise has been really useful. Thanks for helping me.
With kind regards,
Pawan Kumar Garg

Answer
Dear Pawan Kumar Garg,
I am so happy that your symptoms have diminished.  As I have not examined you  myself I cannot safely tell you if you will likely recover from medicines alone. What I can sy is that I have found that when my patients have suffered from pain due to damaged spinal discs, they have performed the best when undergoing non-surgical spinal decompression. I wish I could help you more. I do wish you a speedy and complete recovey from your pain.

Regards,
Dr. Ron Nusbaum