Neck pain

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Carrico
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August 20, 2019 at 12:16 pm

Post count: 1

#30926

I am twenty-one years old. I have had chronic headaches for nine years. In January of 2019, I decided to attempt to correct my forward-head posture to see whether doing so would alleviate the headaches. I tried to do this, rather stupidly, by force of will — by consciously keeping my spine straight and pulling my head back over my shoulders. Almost immediately after starting this effort, my head felt different. I couldn’t move my head and neck more than a little out of this newly assumed posture without intense pressure and fullness in my neck and the base of my skull. Also, my intermittent pulsatile tinnitus (which I’ve had roughly since the start of the chronic headaches) got louder and more frequent, and I noticed that I could triggered with certain movements of my head and neck. For instance, craning my neck up and to the right and then bringing it back to a neutral position causes a whooshing sound in time with my heartbeat.

A few days after starting to try to correct my posture I was riding in the passenger seat of the car, trying to keep my head back over my shoulders, but also turning my head to the left to talk to the driver. This position felt very awkward for me. The car then hit a significant bump, and I immediately felt a sharp discomfort in my neck. Since then I have developed the following symptoms. All the symptoms are intermittent unless I specify that they are constant.

– constant feeling of fullness in head and neck
– constant cracking, crunching, and clunking in my neck, triggered by moving my head, lifting my arms over my head, or drawing my shoulders blades back and together
– bouts of intense pain in my throat and the base of my tongue, lasting no more than a second
– bouts of sharp pain running down the right side of my neck
– tingling at base of tongue
– hoarseness, especially after physical exertion
– feeling of a foreign object in my throat, aggravated by looking down
– rarely, pain similar in character to the throat pain, but in the thoracic spine
– pulsatile tinnitus in right ear, dependent on head and neck positioning, eliminated by ipsilateral jugular compression (i.e. pressing on the palpable blood vessel just below my right ear and behind my jawbone)
– feeling of fullness in ears, especially right ear
– constant urge to pop ears — sometimes satisfied, with some relief of the fullness
– muffled hearing
– hearing in right ear sometimes spontaneously cuts out and returns within a few hours
– double vision (with normal eye exams)
– feeling that there is not enough light in the room no matter how bright it actually is
– visual field shakes when looking at certain patterns (e.g., looking down while walking on a checkered tile floor)
– dampened sense of smell
– confusion, especially when lying down to go to bed
– nausea and dizziness, especially after talking at length or eating
– prominent pulse in right carotid artery
– engorgement of what appears to be my right external jugular vein (picture
– sudden changes in facial coloring — one moment very red, the next very pale
– all symptoms aggravated by doing things with arms, e.g. writing
– all symptoms aggravated by aerobic exercise

I should also add that these symptoms all started a few weeks after I had an epidural blood patch for a possible CSF leak causing the headaches.

Throat and eye examinations were normal. The neurologist I have seen has ordered MR scans of the head and cervical spine. He is looking mainly for glossopharyngeal neuralgia. I will have the scans done next week. From what I understand, glossopharyngeal neuralgia is consistent with the throat pain but would not account for the other symptoms. Admittedly, I have been hesitant to tell any doctor the full range of symptoms lest I be told that they’re in my head. Meantime I am hoping for any information about possible diagnostics and treatments.

Donald Corenman, MD, DC
Moderator

August 21, 2019 at 5:06 am

Post count: 8660

#30937

Cracking and grinding sensations with neck or arm motion could be from facet disease (worn cartilage surfaces that creak when you move) due to the cervical facets. Other symptoms could be from carotid artery disorders (stenosis), vertebral artery disorders, a valvular heart disorder (“a whooshing sound in time with my heartbeat”) or other neurological disorders. Ask your current physician about the possible interconnections with your symptoms and these mentioned disorders.

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.
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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