Bone spurs onto nerves

[tracy_from_oz]

Hi Doc,


I just wanted to ask a quick question if i may.

I posted asking for diving doctors in another thread but i wanted to ask generally if someone has a bone spur in their neck/spine/shoulder region, it presses on a nerve and causes pain/numbness, can this exculde them from diving or learning to dive?

A friend wants to learn to scuba dive.
She has always had a sore shoulder and neck on and off but would always go away so she put it down to pulled muscles etc. However she had a car accident and it got a little worse, and then fell over and then the pain/numbness was onset 24 hrs for a couple weeks.
She is still under going medical treatment for it and i believe thinking of getting a cortisone shot for the pain. The doctor says she will always have this condition but it is managerable. The condition has dramatically improved over the last 2 weeks and continues daily, however she does have pain constantly over the course of the day still. It lessens daily but is still there hence the reason for the shot to live completely pain free.

So i am wondering if this will stop her from learning to dive, or if she is able to learn will this increase her risk of dcs or could it give fake indications of dcs when really it is the bone spur?
I know we will have to watch her well in regards to dcs.
Also with the cortisone shot will this mask/increase the risks of dcs or anything else?

Thank you for your time

tracy

 

[Dr Deco]

Hi

We need an answer from one of the medical moderators.

Dr D

 

[TSandM]

One of the spooky things about DCS is how nonspecific the symptoms are. You can search the SB archives, and find repeated questions from people saying, "After the dive, my shoulder is sore, is it DCS?" Or, "My hand was numb after a dive. I was treated for DCS, but it turned out to be a disc in my neck." The symptoms can be very difficult to sort out.

I have some arthritis in my neck, and I've had neck and shoulder pain after diving that has given me some worry about, "Could this be DCS." Your friend will face that after most dives, I would think.

As far as I know or could find in the literature, there are no data about cortisone and diving. It would be very difficult to find any data about cervical spurs and DCS, as the number of people with either is small, and the intersection of the two groups would be smaller yet.

If your friend dives, he or she will have to assess the symptoms after each dive and try to figure out what is out of the ordinary enough to be concerning.

Carrying very heavy equipment suspended from one's shoulders is not easy on someone with arthritis in the neck or shoulders.

 

[tracy_from_oz]

Hi guys.

Thank you for the info and help.

I have read some articles from the net about bone spurs, the fact they believe around 42% of people have them however there is only a small number of people who have any problems with them and the bone spur itself is not really the problem with many living years without knowing they have any until they have some trauma that causes it to lean into a joint/onto a nerve/dislodge itself and float free etc.

Mike pm'ed me in the thread where i asked about a diving dr in NYC, and i think the best bet is to make an appointment and talk to the doctor. The Doctor Mike suggested is also a neurologist and dive knowledgable who has treated dcs patients.
I have no doubt many dive with pinched nerves and bone spurs but my main worry is can it increase the chance of developing dcs?

I know that she is having treatment 4 x a week which has been working wonderfully but there is still pain which is why the shot was suggested, which if works will make her pain free hence making her quality of life better, although i wondering can this mask dcs symptoms if one gets bent?
She never had problems really since the accident so i am hoping that this calms itself down as i know many live with bone spurs etc.
I think seeing the Doctor is the best bet.

I am wondering if anyone on the board has experienced this or has dived with pinched nerves.
I have no doubt we will always watch her closely in regards to dcs.

tracy

 

[plankspanker]

I had this exact problem last year and had a lot of the same concerns as the symptoms (numbness in one of my arms and shoulder pain) are similar to what dcs victims describe. Mostly I worried about making the problem worse with the shoulder strap digging into my shoulder. I ended up having surgery where they removed the bone spur which took care of the problem. Is this sort of surgery an option for her?

 

[tracy_from_oz]

Hi Plank

Thank you for this information.

We do not know yet if surgery is an option but I am thinking if it is, that's a pretty big surgery to have bone spurs removed from the neck/shoulder/back region, well I am guessing it is.
I myself would be a little worried about that type of surgery and any negatives associated with operating near the spinal cord or vertebrae.

Plank my i ask and please feel free not to answer my question if it is to personal or you feel uncomfortable but what was the surgery like?

Thanks

tracy

 

[cdiver2]

I had the same problem a couple of years ago and did not know I had them, until.
I woke up one morning and could not move my left arm, for a couple of hours, the emergency room said it was a stroke. As I was going to PNG in six weeks I called DAN to find a diving neurologist and found one. He disagreed with the stroke call and got another MRI on the neck, he found four herniated discs and three bone spurs one that I could easily see was sticking into the CNS. His call go and enjoy your diving but for future reference if you get any numbness go straight to the emergency room, at the moment an operation could be more dangerous and right now I could live with the symptoms, pain and stiffness in the neck. It took a couple of weeks to get a full range of movement in the arm but I have had no other problems since.

 

[TSandM]

To answer one question above, there should not be an issue with cortisone injections masking DCS symptoms. Cortisone is not an anesthetic, but an anti-inflammatory. The pain of acutely ischemic or damaged tissue as a result of DCS would not be affected.

 

[ScubaCatgirl]

Tracy,

If your friend does end up diving. Tell her not to mention it to the dive shop. The reason I say this was I went on a diving vacation w/a cortizone shot that relieved my pain from the 2 herinated disc's I had in my neck. I opened up my big mouth cuz I was impressed that I was able to complete 2 dives with an injury such as this. I got banned from diving for the rest of the week. Wasted a lot of money.

To give you some history. My disc's were completely blown & at the time of this diving incident, I was doing the conservative treatment in order to avoid surgery. In the end, conservative treatment only helped temporaily (sp?) & I ended up having an ACDF (anteriour cervical disc fusion). To this day, I have pain, although not as bad as I used to have, on a daily basis. I take muscle relaxers, anti-inflamitory & Ultram (an asprin pain-killer). I still dive & have no problems diving now. Only thing I had to change in my diving due to this surgery is I DO NO lifting what so ever. My Neurosurgen cleared me for diving, but said I'm to never, ever lift anything over 25 pounds. Thus when I dive, I have someone throw my gear into the water & I gear up in there. After the dive, I take my gear off in the water & hand it up to the DM.

With that being said, I think the advice of her Neurologists, Neurosurgeon or DAN medical personnel are more qualified as to whether or not she should be diving.

Good luck to her. I know how bad that pain is & I don't wish that on anyone!

 

[DennisW]

I have this exact problem. I have two compressed disks in my neck and a bone spur. I sent an e-mail to DAN with no real results except to wait until my condition healed before I dived again, because the condition could mask DCS problems. Well, the condition will never heal, so I decided to dive anyway. My Dr. told me that I should not limit my activities, so, I am not limiting them at all. Yes, there is always numbness in my the fingers of my left hand. Yes, sometimes there is shooting pains and numbness in my left arm. Yes, sometimes the pain in my left forearm is pretty severe. Diving sometimes aggravates my condition, but it is well worth it. I take a tylanol arthritus in the evening so I can sleep better. I only take something during the day if I am really uncomfortable. (I don't like taking drugs at all.)

My Dr. gave me the oral steroid treatment which helped tremendously. The next treatment will be the shots in the area of the bone spur and compressed disks. Surgery is always a last resort when the condition is so bad you cannot function anylonger without it.

I wish your friend all the luck in the world. If she wants to dive, then dive.