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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for chronic neck pain and headache

yes thank you , i have chronic pain in my neck for almost a year now the pain is gone to my right arm making it weak and have presure headaches..it feel like a whiplash which i has 22 years ago in a car accident i have notified my doctor has send for neck xrays and blood work to see if its arthritis this week dont have results yet, i am excrutianing pain and think i should go to emergency or schedule an appt. on monday .what kind of specialty doctor should i see because i dont trust chiropractors i should see a doctor that can help me
Mon, 19 Dec 2016
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General & Family Physician 's  Response
Hello Dear. You are probably having cervical spondylosis. You need to consult an orthopedic surgeon.

Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common, age-related condition that affects the joints and discs in your neck. It develops from wear and tear of the cartilage and bones found in your cervical spine, which is in your neck. While it’s largely due to age, it can be caused by other factors as well.

Factors other than aging can increase your risk of cervical spondylosis. These include:

1. neck injuries
2. work-related activities that put extra strain on your neck from heavy lifting
3. holding your neck in an uncomfortable position for prolonged periods of time or repeating the same neck movements throughout the day (repetitive stress)
4. genetic factors (family history of cervical spondylosis)
5. smoking
6. being overweight and inactive

If you have the sudden onset of numbness or tingling in the shoulder, arms, or legs or if you lose bowel or bladder control, talk to your doctor and seek medical attention as soon as possible.

If your pain and discomfort start to interfere with your daily activities, you may wish to make an appointment with your doctor. Although the condition is often the result of aging, there are treatments available that can reduce pain and stiffness.

Investigations to be done by your doctor include:

Making a diagnosis of cervical spondylosis involves ruling out other potential conditions, such as fibromyalgia. Making a diagnosis also involves testing for movement and determining the affected nerves, bones, and muscles. Your primary care physician may treat your condition or refer you to an orthopedic specialist for further testing.

Physical exam
Your doctor will start by asking you several questions regarding your symptoms. Then, they will run through a set of tests. Typical exams include testing your reflexes, checking for muscle weakness or sensory deficits, and testing the range of motion of your neck. Your doctor might also want to watch how you walk. All of this helps your doctor determine if your nerves and spinal cord are under too much pressure.

If your doctor suspects cervical spondylosis, they will then order imaging tests and nerve function tests to confirm the diagnosis.

Imaging tests

1. X-rays can be used to check for bone spurs and other abnormalities.
2. CT scans can provide more detailed images of your neck.
3. MRI, which produces images using radio waves and a magnetic field, helps your doctor locate pinched nerves.
4. In a myelogram, a dye injection is used to highlight certain areas of your spine. CT scans or X-rays are then used to provide more detailed images of these areas.
5. An electromyogram (EMG) is used to check that your nerves are functioning normally when sending signals to your muscles. EMG measures your nerves’ electrical activity.
6. A nerve conduction study is used to check the speed and strength of the signals your nerves send. This is done by placing electrodes on your skin where the nerve is located.

Treatment options:

Treatments for cervical spondylosis focus on providing pain relief, lowering the risk of permanent damage, and helping you lead a normal life. Nonsurgical methods are usually very effective.

1. Physical therapy

Your doctor might send you to a physical therapist for treatment. Physical therapy helps you stretch your neck and shoulder muscles. This makes them stronger and ultimately helps to relieve pain. You might also have neck traction, which involves using weights to increase the space between the cervical joints and relieve the pressure on the cervical discs and nerve roots.

2.Medications

Your doctor might prescribe certain medications if over-the-counter drugs don’t work. These include:

i. muscle relaxants, such as cyclobenzaprine, to treat muscle spasms
ii. narcotics, such as hydrocodone, for pain relief
iii. anti-epileptic drugs, such as gabapentin, to relieve pain caused by nerve damage
iv. steroid injections, such as prednisone, to reduce tissue inflammation and subsequently lessen pain

3. Surgery

If your condition is severe and doesn’t respond to other forms of treatment, you might need surgery. This can involve getting rid of bone spurs, parts of your neck bones, or herniated disks to give your spinal cord and nerves more room. Surgery is rarely necessary for cervical spondylosis. However, a doctor may recommend it if the pain is severe and it’s affecting your ability to move your arms.

4. Home treatment

If your condition is mild, you can try a few things at home to treat it:

i. Take an over-the-counter pain reliever, such as acetaminophen or an anti-inflammatory drug such as Advil or Aleve.
ii. Use a heating pad or a cold pack on your neck to provide pain relief for sore muscles.
iii. Exercise regularly to help you recover faster.
iv. Wear a soft neck brace or collar to get temporary relief. However, you shouldn’t wear a neck brace or collar for long periods of time because that can make your muscles weaker.

Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini     
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