Ask a doctor on the topic of Neurology

HWS high-grade neuroforaminal stenosis

March 7, 2012 | 20,00 EUR | answered by Dr. med. Ralf Berg

Hello, I have a question. I have had ice-cold hands for 8 weeks during the day and it is causing me anxiety, so I went to see a neurologist. A CT scan revealed severe neuroforaminal stenosis. Currently, I am doing physiotherapy, but it doesn't really help. What else can I do? Thank you. PS I take 50mg of Trazodone per day.

Dr. med. Ralf Berg

Dear Inquirer,

I need more information to assess your complaints:
Are both hands affected? Do you have any measurements? (e.g. with a contactless IR thermometer comparing finger, wrist, and oral or anal temperature)
Is the neuroforaminal stenosis bilateral? Where exactly is it located? Is sensation, motor function, and strength normal in the hands otherwise?
What about at night, are your hands normally warm or do you have complaints then?
Do you also have complaints in the cervical spine?

In summary: I am questioning whether the stenosis detected in the CT scan is responsible for your complaints. If you have been doing physical therapy for more than 14 days and it doesn't help at all, this suggests that we may be on the wrong track with the mechanistic approach of focusing on the "stenosis".

Just as stress or anxiety can cause sweating or restlessness, it is possible that fears can lead to arteriolar constriction and thus cause cold symptoms.

If you can/want to answer the above questions, I will be happy to contact you again.

Best regards, Dr. R. Berg