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Neck Stiffness, Tingling In The Head. X-ray Showing Spine Curvature. Taken Cymbalta And Neurotonin. Symptoms Persisting. Treatment?

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Posted on Tue, 12 Jun 2012
Question: I have an ongoing neck stiffness issue for nearly 2 years now. The stiffness starts at the neck and feels like as if its travelling up the back of my head. I would also get a tingling irritating feeling at the crown of my head and numbness at the temple area with occasional lightheadeness. The irriataion feelings seem to be more prevelant when I am sitting.On consulting my GP I was sent for x-rays which showed a loss of the curvature of the spine. A course of physio was prescribed with no improvement. I was then sent for a MRI scan on the neck and cervical spine which highlighted spondylotic changes of the cervical spine with mild diffuse disc bulge at C4-C5 and C6-C7.I was then given trigger point injections with botox injections in my neck but will little improvement. As I was still complaining regarding the irritating feeling in my head the neurosurgeon sent me for a MRI of the brain and a EMG. Both were clear and he prescribed a course of Cymbalta and Neurontin. The feelings were slightly better with the medication but since the medicine has ran its course the tingling is still there. I am 39 years of age and a sales manager so part of my day will be in front of a computer. I also have slightly high BP, todays reading 135/73.
doctor
Answered by Dr. Rajinder Bajoria (3 hours later)
Hello.

Thanks for nice query.     

After going through your nice detailed description, it appear as a case Nerve Root Compression at C4-C5 or C6-C7. But to me, it appear compression at C4-C5, which is causing all the sign and symptoms you are facing like stiffness in the neck and part of head, tingling irritation in the part the compressed nerve supplies.

MRI of cervical spine has confirmed it.

Ist line of management in such cases is conservative with intermittent cervical traction, analgesic and Neurontin (which you are taking). Muscle relaxant can also help.

Give attention to posture while working on computer ,don't unnecessarily bend your neck for long hours while working on computer.

Physiotherapy has a good role to play. Regular neck exercise may help a lot.

Your current blood pressure is normal and has nothing to do with it.

‘Hope I have answered your query, I will be available to answer your follow up queries.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
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Follow up: Dr. Rajinder Bajoria (21 hours later)
Thank you for your quick feedback. Regarding the ligheheaded feelings, these symptoms seem mainly to come when I walk through a mall or store. Not sure why that is but would cervical vertigo be an issue with the spondylotic changes to the spine?
doctor
Answered by Dr. Rajinder Bajoria (2 hours later)
Hello

Nice to hear from you again.

Sign and symptoms can be there, even with aggravation when particular or typical movement presses the nerve or its fibers.

Nerve or its fibers may be copmressed intermittently or continuosly.

Intermittent compression occur with particular movement or postures.

It has been seen in some patients even simple neck movements precipitates the sign and symptoms.

So movement in the mall or store is no exception.

Lightheadedness and vertigo is also seen certain group of patients.

Vertigo is more commonly seen than lightheadeness in cervical spondylitis patients.

Hope, I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil
doctor
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Follow up: Dr. Rajinder Bajoria (1 hour later)
Thanks for you reply. One last question. Why did the EMG that was done state the there were no nerve problems and also with a doctor last week he tested my hands and reflexs and said that the nerves seem fine?

Thanks
doctor
Answered by Dr. Rajinder Bajoria (1 hour later)
Hello

Nice to hear from you again.

Pain in cervical spondylitis is due to nerve compression that causes irritation of some nerve fibers or complete nerve .There is generally no nerve damage .Once compression is removed or rectified pain also disappear.

very severe or prolonged nerve compression leads to nerve damage.


Electromyography is a technique for evaluating and recording the electrical activity produced by skeletal muscles and conducted through nerve.

Hope, I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Rajinder Bajoria

General Surgeon

Practicing since :1980

Answered : 2130 Questions

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Neck Stiffness, Tingling In The Head. X-ray Showing Spine Curvature. Taken Cymbalta And Neurotonin. Symptoms Persisting. Treatment?

Hello.

Thanks for nice query.     

After going through your nice detailed description, it appear as a case Nerve Root Compression at C4-C5 or C6-C7. But to me, it appear compression at C4-C5, which is causing all the sign and symptoms you are facing like stiffness in the neck and part of head, tingling irritation in the part the compressed nerve supplies.

MRI of cervical spine has confirmed it.

Ist line of management in such cases is conservative with intermittent cervical traction, analgesic and Neurontin (which you are taking). Muscle relaxant can also help.

Give attention to posture while working on computer ,don't unnecessarily bend your neck for long hours while working on computer.

Physiotherapy has a good role to play. Regular neck exercise may help a lot.

Your current blood pressure is normal and has nothing to do with it.

‘Hope I have answered your query, I will be available to answer your follow up queries.

Regards.