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DDD at C5-7

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    Posted: Apr 26 2011 at 11:28am
Hello,
 
I've been diagnosed with moderate DDD at C5-7.  I do have some tingling and numbness into my left hand and index and middle fingers.  Also weakness in that arm at times.
 
I went to PT for 4 weeks and had manual traction by the therapist, exercises and stretches for neck and upper back (to help correct my posture), and he tried mechanical traction twice.  The second time, I was sore for a week, so he decided to stop it.  I'm wondering if I should go to another PT, since I still have my symptoms (I have continued my exercises at home).  I saw the PT in January/February, so it's been awhile.
 
Also, something that I've wondered about:  when I do a chin retraction, I feel a 'pulling' sensation down into my biceps.  Should I be feeling that?  Is that a good thing? or an indication that I'm doing something wrong?
 
I'm struggling to find an exercise program that I can do.  Is Yoga or Pilates good for DDD?
One thing that I was told is to never tilt my head backwards due to the discs bulging toward the back.
 
Thanks!
DKDC
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ask a PT Quote  Post ReplyReply Direct Link To This Post Posted: Apr 29 2011 at 3:51pm

Sounds like your PT was performing appropriate treatment interventions. Did you make any progress when you were seeing the PT in Jan/Feb? There are various settings on the mechanical traction which controls the amount of distraction force being applied. Often times with my patients, I would gradually increase the force to allow for increase tolerance. If you found some relief from PT during your previous sessions or if your condition has worsened, than it may be a good idea to see a PT to achieve better outcomes.

When performing a chin retraction, one should not experience a pulling sensation into the biceps. Are you retracting your head/chin back aggressively. If so you may be activiating your biceps subtly. Chin retraction should be done with light to mod force.
 
Yoga & Pilates can be good, but there may be some positions which may exacerbate your condition. For my patients that may have a cervical disc bulge, cervical extension (bending head backwards) is actually an exercise I have my patients peform which is based on McKenzie principles for assisting with disc reduction.   
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Thank you for your reply.
 
I wouldn't say that I made progress during my time with the PT, but I did not get any worse.
 
He told me that pretty much the discs are damaged and are not going to get better.  I just need to do things like correcting my posture, strengthening my back and avoiding certain exercises that can make it worse. (This is what my MRI officially says: moderate DDD between C5/6 with mild bilateral foraminal stenosis and moderate DDD between C6/7 with mild left foraminal stenosis.)
 
The first time with mechanical traction, a PT assistant put me on the machine for 10 minutes at 20 lbs.  I felt good the next morning after that, for about a half a day.  The second time my PT did the machine himself and he really tightened up the things that hold onto the back of your skull.  That time was for 15 minutes and 25 lbs of pull.  The next day, I woke up with an eyelid twitch and I was sore for a week.  That's when he decided to not do traction anymore.  To me, that makes the most sense though.  Pulling the verterbrae apart so that the disc 'might' go back in.  Is that possible? 
 
I probably am retracting my chin too aggressively.  I tend to overdo things.  I'll lighten up on that. 
 
I have a McKenzie book and saw the exercise for tilting the head back, but I have avoided doing it because of what my PT said.  He said that since the disc is bulging/pushing out the back of the spine, that I shouldn'd tilt back.  Hmmm......
 
Do you think 'rocking' my head back and forth on a foam roller will help with the discs?  I've been doing that some.  I haven't noticed any benefit though.
 
Thanks again for your help.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ask a PT Quote  Post ReplyReply Direct Link To This Post Posted: May 07 2011 at 2:11pm

Studies involving traction are not conclusive in regards to "getting the disc back in". I have found traction useful for helping my patients deal with pain and to give a break from pressure and irritation to a nerve. As far as not tilting your head back, it probably wouldn't be recommended with an anterior disc bulge but with a posterior disc bulge it usually isn't the case. Do you have other issues going on at your cervical spine for example bony spurs, etc which maybe why he doesn't recommend that?

As far as the foam roller, I am not aware of any studies which states rocking back and forth on the foam roller will help with the discs.
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No, no bony spurs that I'm aware of. 
This is what my MRI states:
"Moderate DDD between C5/6 with mild bilateral foraminal stenosis and moderate DDD between C6/7 with mild left foraminal stenosis. "
 
I guess my main concern is about the numbness in my fingers.  Is it possible that the feeling will come back if it's been since Oct. 2010 that I've been having the numbness?  It can get better and worse throughout the day, but it never totally goes away.  That's why I'm wondering if another PT might be able to help me.
 
Thanks!

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Ask a PT Quote  Post ReplyReply Direct Link To This Post Posted: May 11 2011 at 2:52pm
Usually for patients with stenosis, extension exercises are not generally recommended as this position can result in the foramen being closed off even more, which could furhter irritate a nerve.
 
The fact that your numbness fluctuates is probably a good thing, as constant numbness would most likely mean greater damage. If you feel your condition has changed for the worse, physical therapy would definitely be warranted. Also, if it has been awhile since you last participated in PT, it might be beneficial to see one now to reassess you, and to determine if there is anything else that you can be doing.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote DKDC Quote  Post ReplyReply Direct Link To This Post Posted: May 11 2011 at 3:45pm
Thank you so much for your help!
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