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I have neck pain that radiates from about C3-4 up

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Posted on Tue, 19 Feb 2019
Question: I have neck pain that radiates from about C3-4 up the left side of my neck t the front behind the left eye. MRI showed moderate spinal stinosis and disc bulge at C3-4.
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Answered by Dr. Erion Spaho (46 minutes later)
Brief Answer:
Occipital neuralgia to consider.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and here is my advice.

Since there is disc bulge at C3-C4, the C3 nerve root compression is part of occipital neuralgia, a condition characterized by symptoms such as these referred by you.

Treatment for this condition is, in most cases, conservative and includes warm procedures on neck, rest, physical therapy, anti-inflammatory medications and muscle relaxants.

Also anticonvulsant medications such as carbamazepine and gabapentin and percutaneous nerve blocks may help alleviate the pain.

Surgery is reserved for severe cases that are not controlled by conservative treatment.

Discuss with your Neurologist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Erion Spaho (1 hour later)
I’m on prednisone ( 10 mg a day ), which helps a little. I also have moderated to sevete stinosis. I should also mention that my lab work showed slight elevation of my sed rate and C-reactive protein. I’m scheduled for an epidural next week. I’m presently going to PT weekly. They thought about Temporal Artiritis but my ultra sound was normal and my symptoms come and go with radiation from my neck area.
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Answered by Dr. Erion Spaho (10 hours later)
Brief Answer:
Okay for the epidural injection.

Detailed Answer:
Welcome back.

Sedimentation rate and C-reactive protein may be increased by arthritis, infections, etc. besides temporal arteritis.

I think that the epidural injection will serve as a diagnostic tool also; if there will be a significant improvement, occipital neuralgia is very likely the diagnosis.

Hope I helped you.

Feel free to discuss with me if you have further questions.
Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3916 Questions

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I have neck pain that radiates from about C3-4 up

Brief Answer: Occipital neuralgia to consider. Detailed Answer: Hello and welcome to "Ask a Doctor " service. I have read your query and here is my advice. Since there is disc bulge at C3-C4, the C3 nerve root compression is part of occipital neuralgia, a condition characterized by symptoms such as these referred by you. Treatment for this condition is, in most cases, conservative and includes warm procedures on neck, rest, physical therapy, anti-inflammatory medications and muscle relaxants. Also anticonvulsant medications such as carbamazepine and gabapentin and percutaneous nerve blocks may help alleviate the pain. Surgery is reserved for severe cases that are not controlled by conservative treatment. Discuss with your Neurologist for these issues. Hope you found the answer helpful. Let me know if I can assist you further.