[JeremyC]

#28328

Dear Dr Corenman,

First of all, a big thank you for creating this website and providing quality information to all of us who are in pain. It is greatly appreciated.

Previously healthly and active 32 year old man, I have been suffering from many symptoms for the past 2 years after a “minor” slip and fall playing sports, including:

– Constant upper neck pain and strong pressure feeling in back of neck.
– Headache/head pressure and mild dizzyness
– Intermittant body wide (strongest in neck, arms and head/face) tingling/prickling. No or very little tingling in hands/feet.
– General unwellness and malaise
– Intermittent upper back of neck pain (left side) when swallowing
– When lying on my back I feel strong tension/tightness of deep neck muscle(s) on left side.

After the fall I only suffered relatively minor neck pain/stiffness. 6 weeks after I started having right sided occipital neuralgia (diagnosed by neurologist) pain that I get only when tilting head right and back, and pain at tip of right shoulder when tilting head left. The shoulder pain disappeared with osteopath mobilization after 6 months of chronic pain.

After the osteopath mobilization, and a upper gastroscopy (during which I woke and was agitated, and possibly could have further injured my neck) in the same week, my health and symptoms dramatically deteriorated.

For the past 18 months I am constantly feeling like the entire cervical area is irritated. Unfortunately I have not been able to find the cause of my suffering as every neurologist and neurosurgeon I have seen were reassured by my cervical MRI. Could it be conceivalble that a problem in my neck could cause “bodywide” tingling in this way?

I have many symptoms and have been to dozens of doctors, one who diagnosed me with Lyme disease. I have been treated with antibiotics for 8 months with no improvement. I am sceptical about this diagnosis and really believe my the origin of my problems are coming from my neck.

My MRI does show a prominent bulge posterior to the dens (appearing black on MRI) which is 1mm away from spinal cord, but the other side of spinal cord is not compressed in any way:
https://www.dropbox.com/s/lqwjnvvb80dvuzy/2018-05-22_23-22-17.pdf?dl=0

Could this possibly cause symptoms?

Based on the information provided, would you have any suggestions of “outside the box” conditions/injuries that I could suggest to my doctors to explore? Further investigations to diagnose the cause of my neck suffering? I have read all the material provided on your website but unfortunately have not found a “matching” cause to my symptoms.

I am a father of 2 young daughters and am now unable to work. I am desperately searching for any advice which could help me.

Kind regards,
Jeremy

[JeremyC]

#28330

A few additional comments:

– When I fell playing sports 2 years ago, it felt like a snap and I got a sudden rush of heat going up through the back of my neck

– I am sceptical of Lyme disease as the Elisa test was negative, but I was diagnosed using a test from Germany (Armin Labs).

– I get mild temporary relief from neck pain/pressure by holding head upside down
– stretching my neck (tilting head right and back) causes pain in my face near left cheekbone/jaw area
– In January 2017 when my symptoms “exploded”, the back of my neck (C2 spinous process area) felt like it was swollen and numb. This sensation has subsided but is still present.

[Donald Corenman, MD, DC]

#28333

Your symptoms could be originating from the cord but with no significant cord signal change or compression (the C2 level does not count unless there is instability as seen on flexion/extension films) that is unlikely. Lyme disease is less likely but I cannot comment on this test from Germany as I do not know how reliable this test is.

It sounds like one or more facets could be involved. Maybe the next step is to find a pain doctor who is well skilled and consider facet blocks to determine if they could be involved.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[JeremyC]

#28340

Thank you for your reply.

Perhaps I should also mention that I have a full range of movement with only no or mild pain (at times I feel the neck “catches” in the upper cervical area and feel acute pain but this is rare). My pain is a constant pressure/tightness (even some mild numbness…) in the neck, yet I do not feel stiffness (just some mild stiffness in the morning on rotation). It’s like a giant hand is constantly pushing/squeezing on the the back of my neck. This started 1 year ago, a few months after the acute phase of symptoms, and 1 year after the initial fall I mentionned. It is constant. At the same time this symptom appeared I started also feeling pressure/tightness in my face (cheekbone and upper teeth/palet area), which vaguely feels like I have been stung by a bee… It has been a year now and has only mildly subsided.

My initial post was written to keep things as simple as possible, but I would also like to add that I have been feeling very unwell for 18months. No fever but feel “sick”, many different abnormal nerve sensations (vibrating, buzzing, hot/cold, etc.), always very cold even in warm weather, and this constant strong pressure in neck (and head but less so) which is among the worst of my symptoms. Often it feels like the muscles in my neck are numb but the skin on top is not.

If it is not possible or very unlikely that all my symptoms could be explained by a neck condition/injury, I am under the impression that I may have developped 2 distincts problems in the same year (for example neck injury + Lyme disease), which is making the doctors diagnostic job very difficult.

Among the various “outside the box” causes to my suffering, I have come accross suggestions such as atlas misalignment and twisted dura. These often come up in pseudo scientific blogs and I am therefore cautious when reading about this. In your experience, have you come accross patients with many problems which have dramatically improved with a “atlas adjustement”? Does the twisted dura theory sound in any way plausible? I have a scientific background, but as my sufferining continues to go on, through desperation I am opening up to more “alternative” views. An form of Atlas adjustment or chiropractic high velocity menipulation would be a last resort me. I am French living in Ireland, and I am under the impression the standard of chiropractic care (and all health care in general)in the USA is much higher than here.

I will continue to fight to regain my life whatever the cost. My family is counting on me. Once again, many thanks for the information and advice you provide. For many of us, it will improve our lives and those of our families, and so I cannot thank you enough.

Kind regards,

[Donald Corenman, MD, DC]

#28344

“I have come accross suggestions such as atlas misalignment and twisted dura” are not plausible theories. It does sound like some form of an inflammatory condition of which Lyme disease is but one of the possibilities. Maybe a consultation with a Rheumatologist could be another step. You certainly might have two different disorders so that pain doctor consultation is also in play.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[JeremyC]

#28360

Thank you, I will certainly follow your advise and look into getting those appointments.

– Considering that many of the symptoms appeared a few days after an osteopathique cervical adjustment, does any damage/displacement come to mind that could have been done? Are there circumstances where a chiropractic adjustment is the only treatment to fix certain issues? I have seen many physios (no adjustments) and nothing has helped the neck problems.

– Do you have any thoughts on the upper back of neck (left side) pain I have when swallowing (and to a lesser extent when yawning)? Could a facet issue possibily cause this?

My final question is a rather peculiar one… Would you have any advice for me on how to be taken “seriously” by future doctors when presenting with such a set of symptoms. I have suffered greatly from not being listened to, and feeling and being told my symptoms are not possible so it must be anxiety/depression, despite that I do not suffer from this. This has greatly harmed my condition and my relationship with work and certain friends. I am fortunate to be fully understood and supported by my close family and friends.
Ultimately I gave in and have seen a psychiatrist and psychologist, which has only cost me a lot of money and has not helped in any way. At this point I am deeply upset and desillusioned by many medical doctors and would be willing to travel anywhere in Ireland and France (possibly border countries as well) to find a doctor that would be interested to really help me find the cause of my suffering. If money were not an issue, I would gladly travel to the USA to see you or any specific doctors you would recommend. If by any chance you have doctors here in Europe that you would be willing to recommend, please feel free to send me an email.

Thank you and kind regards

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