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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain and pressure in bottom back of head. Detected lordosis, clicking neck, soreness in back and shoulders, dizziness. Suggested possible hypermobility. Advice

hi, I have had a pain and pressure in the bottom back part of my head for about 2 years. sometimes its ok, sometimes its painful. sometimes when I run it pounds and really hurts and then sometimes hurts without doing anything. I am a dancer and have been told I have lordosis, also my back and neck click dreadfully and my shoulders and back are sore quite a lot. I went to a physio a few years ago and he mentioned hypermobility??? I also get dizzy sometimes when i stand too quickly?
Fri, 23 Aug 2013
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General & Family Physician 's  Response
Hi and thanks for the query,

What you describe to me deserves a keen attention form a rheumatologist. Screening for rheumatologic disease using appropriate blood tests, X rays, CT scans and MRIs could be the best thing to do. Getting an appropriate diagnosis shall orientate treatment and avoid unnecessary expenses. Treatment could range from anti inflammatory drugs, steroids, other simple analgesics , physiotherapy as earlier mentioned and other specific rheumatologic therapies.

I suggest you book an appointment with a rheumatologist. Thanks and kind regards.

Bain LE, MD/.
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Spine Surgeon Dr. Niranjan Kavadi's  Response
Hi
Thank you for your question.

All the symptoms you have described point to two diagnoses- 1. Cervical spondylosis 2. Pain related to muscular activity. Let's discuss these.

During dancing activities your neck goes through complex motion requiring repititive muscle actions. Muscular pain comes from either fatigue because of repititive use or from muscle spasms secondary to strain. Cervical spondylosis is in simple terms is arthritis of neck vertebrae where the discs degenerate and bony spurs called osteophytes develop on bones. Increased degeneration of intervertebral discs may eventually lead to instability of the spinal segments where one vertebra abnormally moves on the next one. This is called spondylolisthesis. An MRI can diagnose changes in the disc and when the changes of arthritis and instability are advanced they can be seen on Xrays. Lordosis seen in your neck is the normal curvature where your spine is swayed backwards with convexity in front. Since you have been having pain for over 2 years, an MRI of cervical spine is recommended if you already haven't had one.

Treatment options are
1 Structured physical therapy (to be avoided in painful phase) and posture training.
2 Muscle relaxant medications and local gels
3 Local heat and massage
4 Local spine injections as guided by a spine surgeon.

Please let me know if I can be of any further assistance.

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