diybobMemberDecember 28, 2012 at 4:48 amPost count: 6
Dear Dr. Donald Corenman
For a long time (2 years) I’ve been experiencing neck pain from an injury type whiplash. Along with the neck pain I’ve been experiencing headaches at the base of my skull and other symptoms in my head (ear, face, jaw, eye & dental pain, dizziness, nausea, blurred vision and my worst symptom tinnitus). These symptoms are not present all the time they seem to come at different times but my neck pain at the base of my skull along with my tinnitus is always present. The tinnitus seems to change sound levels and pitch with the amount of neck pain I’m feeling.
The fusions from C3 through C6 have fixed the numbness problems in my hands and arms but have not fixed the symptoms I mention above, tinnitus being the worse.
After my surgeries the MRI and CT scan report states: “C2-C3 There is mild facet Arthropathy, greater on right. Minimal right neural foraminal narrowing is present. The central canal is remarkable. But does not report any major Damage to my facet joints.
I’ve had 2 cervical facet blocks between C2-C3. After a few days my symptoms and pains pretty much go away and my tinnitus becomes tolerable. This relief will only last a short time and I’m back to the pains I’ve described above. I have a C2-C3 Facet Rhizotomy scheduled for Jan 14.
The Pain management doctor thinks that my tinnitus and some of my other symptoms could be coming from C1-C2 Facet Joint.
What would you recommend to repair or relieve the symptoms caused by the Facet Joints between C1-C2 and C2-C3? Is there anything that can be done without major surgery as a permanent fix or possibly a long term relief?
Any help will be much appreciated,
RobertDonald Corenman, MD, DCModeratorDecember 28, 2012 at 7:14 amPost count: 8468
In general, tinnitus does not originate from the cervical spine. The acoustic cranial nerve does not exit the skull. There may be some feedback that can occur from other tracts that drop down below the base of the skull (foramen magnum).
Base of skull neck pain and back of the head headaches commonly do originate from the facets at C1-2, C2-3 and C3-4. Your CT report does note arthropathy (arthritis) of the C2-3 joint and this can cause some of your symptoms. You have a fusion of C3-4, so we can rule out that level as a cause of pain.
Since you have had diagnostic blocks of C2-3 that relieved your pain, the rhizolysis of the facets you have planned is a good next step. That is if you had a good 2-3 hour window of relief immediately after the facet injections (see pain diary).
Dr. CorenmandiybobMemberDecember 29, 2012 at 2:03 amPost count: 6
Dear Dr. Donald Corenman thanks for the reply and taking the time from your schedule, it’s much appreciated. There are not many doctors who would give this type of service, again thank you. By the way my son has nothing but great admiration for the clinic and Dr. Hawkins who performed surgery on his shoulder, no problems playing baseball since 1997.
Yes, I had good 2-3 hour window relief that lasted for several days and my tinnitus became tolerable, but not completely, this is why I feel there might still be a problem at C1-2.
I’m an engineer type and always seeking a solution and feel necessary to have a plan B. This is my way of coping and living with these crazy pain symptoms.
I’ve read there are only a handful of practitioners having the skills needed to inject at C1-2. If my symptoms are coming from C1-2 is it possible to do a Rhizotomy at this joint to get long term relief?
I have been told there are no nerves at C1-2 facet joint to burn. If this is true and from your experience what can be done at the C1-2 facet joint to get relief?
PS I’ll also send you by email information regarding the connection sensory input from the facet joints at C1-C2, and C2-T2 intraspinal pathway from the Tinnitus Research Centre, Wantirna, Australia. This is possible proof of my facet joint injury relation to my tinnitus and vision problems. Please let me know what you think.Donald Corenman, MD, DCModeratorDecember 31, 2012 at 1:25 amPost count: 8468
C1-2 does have pain and sensory nerves and can cause base of skull pain as well as headaches. There is an individual in Denver that I use to inject the C1-2 joint and he is very competent. You can call the office at (970) 476-1100 to get his name and number. I have yet to refer a patient for a C1-2 rhizotomy but under skilled hands, I believe it could be completed.
Dr. CorenmandiybobMemberDecember 31, 2012 at 1:54 amPost count: 6
Dr. Corenman, thank you for the help. You’ve given me my plan B but I’m hoping the Jan 14th Rhizotomy will do its job and I won’t have to go to plan B.
Happy New Year to you and your family!
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