"MRI images can give guidance for treatment but generally do not by themselves indicate the best treatment options or the expected outcome."
Los Angeles, CA (PRWEB) May 12, 2010
Tiger Woods neck pain: Can it threaten his golf career?
Tiger's withdrawal from The Players Championship due to a neck injury has caused media speculation on how this might affect his career. What are the facts, as seen by experts at the Institute for Neurological Research®(INR®), a private medical group, inc. in Los Angeles?
What we know
Reports have described neck pain for seven weeks with tingling going down the right arm to the fingers. The pain during The Players Championship was severe enough to require withdrawal from the tournament. An MRI imaging study of the neck, looking for a "bulging disk" is planned for this week. Treatment with oral anti-inflammatory medications was reported as not controlling the condition.
The medical implications
These symptoms suggest there is inflammation of one of the spinal nerve roots in the neck. The medical term is "cervical radiculopathy." This condition is similar to inflammation caused by a disc problem in the back resulting in sciatica (sometimes called "lumbar radiculopathy"). For someone in their late twenties or thirties this condition is most commonly caused by damage to an intervertebral disc in the neck. This kind of damage may appear in an MRI imaging study as a change in the shape of the disc (bulge, herniation, or protrusion), or a tear in the disc capsule, or dehydration of the disc contents (degenerative disc). One or more discs may be involved. These kinds of disc problems can occur without a specified incident or injury; or they may be associated with chronic or acute injury to the disc. Abnormal MRI findings, including all of the above, can be asymptomatic. In other words people often have disc bulges, herniations, or protrusions without having any symptoms. But an abnormal MRI may help localize the source of the trouble. Pain or tingling in the fingers of one hand combined with neck pain suggests that one or more of the lower spinal nerve roots in the neck are involved (C6, 7, or 8).
Treatment for this type of condition generally begins with oral anti-inflammatory medications, rest, and physical therapy, such as massage and hydrotherapy, if tolerated. If the symptoms persist then injections of anti-inflammatories, such as cortisone or anti-TNF molecules can be considered. TNF is a protein that is released by damaged discs and causes pain. The traditional anti-inflammatory has been cortisone, but evidence suggests that off-label injection of a specific anti-TNF molecule is a new option. Local injections of anti-TNF molecules have been reported to produce rapid relief of disc-related pain.
The most invasive option is spinal surgery, which may be necessary in some cases if less invasive methods fail to produce adequate relief of symptoms.
Is Tiger's career threatened?
Edward Tobinick MD, Director of the Institute for Neurological Research® (INR), a private medical group, inc. in Los Angeles and inventor of anti-TNF methods for treating disc-related pain, comments: "Without more information it is impossible to determine if, or to what degree, this could have an effect on Tiger's career in the long-term. People with these types of problems can suddenly get better even without treatment, particularly during the first six weeks of symptoms. As a general guideline, patients with neck pain are treated conservatively, without surgery if possible. At the INR nearly a decade of clinical experience with the off-label use of an anti-TNF approach for disc-related pain has been extremely favorable, and candidates include patients with severe and chronic pain. If symptoms do not respond to non-surgical treatment then more invasive approaches, such as surgical intervention, are considered."
"With regard to MRI images, these can give guidance for treatment but generally do not by themselves indicate the best treatment options or the expected outcome. Patients with disc bulges, protrusions, herniations or tears may have no symptoms at all; but sometimes even small bulges or an isolated tear can cause severe chronic pain. The best guide for treatment is the patient's symptoms: is there continued pain, tingling or weakness? Is there impairment of function and daily activity? Is the pain so severe that it is interfering with sleep, or requiring the use of opioids? With conditions like this the outcomes can be so variable in the short term that the best guidance comes from examining how the symptoms evolve over time."
About the INR
The INR in Los Angeles evaluates and treats patients with disc-related neck pain, back pain, and sciatica. The INR has developed patented off-label methods of use of anti-TNF molecules for treating neuroinflammatory disorders, including cervical radiculopathy and other forms of disc-related pain (U.S. patents 6419944, 6537549, 6982089, all assigned to TACT IP, LLC). For more information see the website of the INR and the INR videos.
Institute for Neurological Research, a private medical group, inc.
100 UCLA Medical Plaza
Los Angeles, California 90095
Telephone: (310) 824-6191