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  • desmcd
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    Post count: 1

    Hi Dr Corenman,

    I have been havings daily headaches for almost a year, have bad insomnia as a result of the headaches (cannot nap or sleep without sleeping meds) had lost weight (197 to 172 over the past year) with some bowel issues. Had various tests (head MRI + CT scan of chest/ abd + pelvis + blood tests+ EKG – heart tests – nothing showing up – having endo + colon checked next week) finally had a neck MRI ordered by the Neurologist with the following results:

    Findings: Alingment is satisfactory. Marrow signal is within normal limits

    C2/C3 + C3/C4 + C6/C7 + C7/T1 – There is no significant disc bulge or herniation Spinal canal caliber is within normal limits. The neural formina are patent. There is no nerve root impingment.

    C4/C5 – There is a small posterior disc osteophyte complex present without significant affacement of the anterior CSF space. Sinal canal caliber is within normal limits. There is mild right-sided neural foraminal narrowing on the basis of uncovertebral joint hypertrophy

    C5/C6: There is a central and right paracentral posterior osteophyte complex present with mild to moderate effacement of the anterior CSF space. There is superimposed uncovertebral joint hypertrophy, with at least moderate to borderline severe right-sided neural foraminal narrowing, There could be impingement upon the exiting right C6 nerve root. Spinal canal caliber is within normal limits

    IMPRESSION:
    1. No eveidence for significant spondylitic change at C7/T1
    2. Spondylitic changes most pronounced at C5/C6 as above

    I feel best in the morning but worsen as the day progresses. My job is primarily office computer based. Also as the day goes on I am having bladder issues (freq unrination/ prostae irritation from afternoon until end of day). I do have tingling sensations across my upper back that come and go. I did not have a neck injury that I can ever recall. At this point the Neurologist said that they don’t consider surgery if it is just pain (not that I want surgery). I am scheduled to visit a pain doctor that specializes in headaches. I am also going to be going back to physio (helped with the problem somewhat a few months back). Would like your comments as to whether this is the best course of action at this time or should I be considering something else? Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    Headaches have many sources and the cervical spine is only one of these. If the headaches are cervicogenic (caused by the cervical spine), these headaches would typically originate from the base of the skull and radiate over to the top of the eyes. Only headaches with this pattern would originate from the spine.

    If the headaches are cervicogenic, one common cause can be the facets of C2-3 and C3-4. A facet block of these structures with great temporary relief of the headache (see facet blocks and pain diary on the website) can implicate the facets as the pain generators.

    Dr. Corenman

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