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Suggest Treatment For Pain On Head,neck And Shoulders
Question: Yes please. I have a headache on the left side of my head from just below my ear and down my neck to my shoulder. This began on Sat. evening and has gotten progressively worse since then. I can't turn my neck, put my head down or bend over. I do not have a history of migraines or even headaches for that matter. I am 68 years old, female, with a hx of DM, slightly elevated blood pressure and elevated cholesterol. I feel like going to the ED is a waste of their time. Please, can you give me some direction? Thank you very much. Oh by the way, I wear a 12 microgram Fentanyl patch for sciatica and have Percocet, 5 mg for break through pain. I have also used one 800 dose of Ibuprofen. Nothing is even touching this. Thank you for any light you can shed on this.
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Brief Answer:
Cannot say in your particular case
Detailed Answer:
without an exam, but I can give general information.
That being said, Here's what you have:
Cervical spine disease
Here's why it is what you have
nerves come out of the spine in the neck and travel in particular directions (going up the back of the neck... the spinal nerve at the very top goes there. Pain in that area in that distribution has to involve that nerve. If you hit the area with a hammer the pain signal would travel from the area hit through the nerve to the spine. If one has Cervical spine disease.. same nerve... different direction of the problem.. from where the nerve gets pinched near the spine.... but it feels the same and the pain shoots up the back of the head)
Here's why YOU have it.
diabetics have an increased tendency to have bone growth (HYPER--Os (bone) tosis (growth)... HYPEROSTOSIS). Insulin... which is high in type II diabetics... causes bone to grow. Normal wear and tear will overstimulate bone growth. THat is one of the most common areas for it to occur.
Here's how to diagnosis it
Frankly... simple x-rays show bone overgrowth. While a CT scan or an MRI give better pictures, you can tell if someone has this with simple x-rays of the neck. making sure the top of the spine shows.
Here's what to do about it.
Dunno. About every 10-20 patients I see with it have the whole nerve not working... (can't move hand/fingers correctly). THey need surgery. It's helped 5/5. BUT over 90% do NOT have loss of function. And muscle relaxants that work on the spine (baclofen or carisoprodol) are particularly good to add to fentanyl and percocet.
Here's what to watch out for
The neurologic problems as mentioned. ALSO, narcotics have a tendancy to get people used to taking them. Not only do they tend to have less effect over time BUT also, some people on them start finding less painful conditions more aggravating. This does NOT apply to conditions that would be quite painful to anyone.. like for example cervical spine disease.
So.... after confirmation of a painful condition like cervical spine disease, muscle relaxants are often helpful. Generally a low dose of narcotics is the only pain drug likely to be better than placebo. Long term function is helped by physical therapy or surgery. depending.
Personally, Learning the physical therapy range of motion exercises and doing them in ultra-slow motion under a warm shower has been magical.
Cannot say in your particular case
Detailed Answer:
without an exam, but I can give general information.
That being said, Here's what you have:
Cervical spine disease
Here's why it is what you have
nerves come out of the spine in the neck and travel in particular directions (going up the back of the neck... the spinal nerve at the very top goes there. Pain in that area in that distribution has to involve that nerve. If you hit the area with a hammer the pain signal would travel from the area hit through the nerve to the spine. If one has Cervical spine disease.. same nerve... different direction of the problem.. from where the nerve gets pinched near the spine.... but it feels the same and the pain shoots up the back of the head)
Here's why YOU have it.
diabetics have an increased tendency to have bone growth (HYPER--Os (bone) tosis (growth)... HYPEROSTOSIS). Insulin... which is high in type II diabetics... causes bone to grow. Normal wear and tear will overstimulate bone growth. THat is one of the most common areas for it to occur.
Here's how to diagnosis it
Frankly... simple x-rays show bone overgrowth. While a CT scan or an MRI give better pictures, you can tell if someone has this with simple x-rays of the neck. making sure the top of the spine shows.
Here's what to do about it.
Dunno. About every 10-20 patients I see with it have the whole nerve not working... (can't move hand/fingers correctly). THey need surgery. It's helped 5/5. BUT over 90% do NOT have loss of function. And muscle relaxants that work on the spine (baclofen or carisoprodol) are particularly good to add to fentanyl and percocet.
Here's what to watch out for
The neurologic problems as mentioned. ALSO, narcotics have a tendancy to get people used to taking them. Not only do they tend to have less effect over time BUT also, some people on them start finding less painful conditions more aggravating. This does NOT apply to conditions that would be quite painful to anyone.. like for example cervical spine disease.
So.... after confirmation of a painful condition like cervical spine disease, muscle relaxants are often helpful. Generally a low dose of narcotics is the only pain drug likely to be better than placebo. Long term function is helped by physical therapy or surgery. depending.
Personally, Learning the physical therapy range of motion exercises and doing them in ultra-slow motion under a warm shower has been magical.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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