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Suggest Treatment For Severe Neck Pain

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Posted on Wed, 30 Sep 2015
Question: Hello Dr Spaho,
I am XXXXXXX and I am following up on my neck pain. After few back and forth questions with you, I tried facet joint injections. They did not show any thing about the pain. Further I went to a chiropractor specializing in upper cervical. His analysis is as follows: There is significant rotation of C1 vertebrae(atlas) in relation to the occiput. Also has rotation of C2 in the same direction that the atlas has rotated. It is an uncompensated rotation of C2. Looking from the top down, both the atlas and the axis have rotated in a clockwise direction.
Please advise your thoughts and how I should proceed. Thanks. XXXXXXX
doctor
Answered by Dr. Dr. Erion Spaho (16 hours later)
Brief Answer:
Instability of cervical spine should be evaluated.

Detailed Answer:
Hello again XXXXXXX and thanks for asking directly.

In this case, the rotation of C1 and C2 in respect to occiput may be related to muscles spasms, or torticollis.

In addition, there may be also instability between these vertebrae, so, plain radiography films in neutral, flexed and extended position are needed to evaluate this possibility as possible cause of your symptoms.

After evaluation, best treatment about this condition initially is use of muscle relaxer drugs (Baclofen 3x10 mg.eg.) and physical therapy.

Hope you found the answer helpful.

I remain at your disposal for further questions and clarifications.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dr. Erion Spaho (29 minutes later)
I had x ray done for flexed and extended positions. It did show some mobilty but the doctor feels that is not the reason for pain. I had fallen down 2.5 years back. Also a friend hung on my neck about 2 years back. Since then there is pain at the base of the skull on the left side. Is chiropractor adjustment couple of times a week the way to go? What are other medical tests to confirm rotation of C1 and C2 ( I want to make sure Chiro is saying the right thing.) Please advise. Thank you. XXXXXXX
doctor
Answered by Dr. Dr. Erion Spaho (4 hours later)
Brief Answer:
CT scan with 3D reconstruction of cervical spine.

Detailed Answer:
Welcome back XXXXXXX

Before any chiropractic manipulation, to evaluate more correctly the rotation of vertebrae and any related fascet joint luxation/subluxation, a CT scan of the cervical spine with 3D reconstruction is needed.

Hope this helps. Take care.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Dr. Erion Spaho (4 hours later)
Thanks Dr Spaho. Can you please tell me where I can get the CT scan you mentioned in USA on east coast in New York, XXXXXXX XXXXXXX DC area. Also is it ok to get deep tissue sports massage for my neck. Thanks. XXXXXXX
doctor
Answered by Dr. Dr. Erion Spaho (23 minutes later)
Brief Answer:
You can have CT scan everywhere.

Detailed Answer:
Hello again XXXXXXX

CT scan I mentioned you can have it anywhere, it is the most common imaging tool of today.

Just discuss with your Doctor about specifications I mentioned before.

Deep tissue massage should help in your case, because, I think, deep neck muscles too are tensioned.

Hope I helped you. Take care.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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Suggest Treatment For Severe Neck Pain

Brief Answer: Instability of cervical spine should be evaluated. Detailed Answer: Hello again XXXXXXX and thanks for asking directly. In this case, the rotation of C1 and C2 in respect to occiput may be related to muscles spasms, or torticollis. In addition, there may be also instability between these vertebrae, so, plain radiography films in neutral, flexed and extended position are needed to evaluate this possibility as possible cause of your symptoms. After evaluation, best treatment about this condition initially is use of muscle relaxer drugs (Baclofen 3x10 mg.eg.) and physical therapy. Hope you found the answer helpful. I remain at your disposal for further questions and clarifications.