Cervical radiculopathy b vitamins

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

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Cervical radiculopathy is a condition where there is compression of nerve roots in the neck.

The symptoms of radiculopathy are limited to one arm and consist of pain, weakness or numbness.

The treatment of cervical radiculopathy may include surgical and non-surgical therapies. Non-surgical therapies include medications, physical therapy, exercises, and short term neck immobilization with a collar. Surgical therapy involves relieving the compression of the spinal cord by enlarging the spinal canal. There are several ways to accomplish this depending on the cause of the compression.

While the distinction between cervical radiculopathy and vitamin B 12 deficiency is usually not a difficult one, there have been some reports describing a confusing picture when nerve disorders in the neck are accompanied by vitamin deficiency.

Cervical myelopathy due to chronic vitamin B12 deficiency or herniated cervical disc or both. Haghighi SS, Zhang R, Stein D.

OBJECTIVE: A female patient with diagnosis of combined system degeneration due to vitamin B12 deficiency and multi-level cervical disc herniation underwent a comprehensive neurophysiologic tests.

MATERIALS AND METHODS: Central conduction time (CCT) was calculated after recording of the SSEPs from cervical, brainstem, and parietal sensory cortex to peripheral stimulation.

RESULTS: The CCT between the lower cervical spine and brainstem was 3.63 msec and 3.41 msec for left and right side. All values were within the normal range. The visual EPs and brain-stem auditory EPs were also normal. The MR imaging of the cervical region was remarkable for multi-level degenerative changes as well as osteophyte formation at C4-7 segments causing canal stenosis.

CONCLUSIONS: It is possible that her symptoms are related to two separate chronic problems. The first is a history of B12 deficiency, causing a subacute systems degeneration syndrome. The second is evidence of a cervical spondylotic myelopathy.

The other instance where B vitamin therapy might be considered is inthe patient with concomitant cervical radiculopathy and carpal tunnel syndrome. Vitamin B6 has been touted by some as a useful adjunctive treatment for the carpal tunnel problem. The dose is 50 mgs of pyridoxine (vitamin B6 three times a day.)

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