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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Severe Migraine And Neck Pain

Hi Doctor, I had a near slip and fall in 2006 and experienced neck pain on the right side that shifted to the left over the last nine years. I developed migraine with aura and always had tension in the base of the skull and chronic pain on the left side of my neck that was relieved with chiropractic care. I have since had two children. I was experiencing more stress, more lifting and then recently symptoms started changing. No migraine aura, but my mid back was sore and my neck was not getting the fix by chiro. I changed chiropractic care and the maneuver was mirror image. He said I had forward head posture tilted to the left so he would adjust me with my head to the right of the table and because my lower spine had a slight curve he put my legs to the left and would use drop table method. After ten visits my neck was so tight and inflamed I couldn t even turn it. Went to massage and took muscle relaxants and anti inflammatory...somewhere in-between the meds and massage I started feeling burning sensations on my arms and now feel it all over my body. This was my MRI findings. no prevertebral soft tissue edema is noted the height of the cervical vertebral bodies is well maintained. c2-3 the canal and neural foramina are patent. there is a shallow annular bulge. c3-4 there is left uncovertebral spurring. The canal maintains its caliber as do the neural foramina. c4-5, there is a disc space narrowing and there is a facet arthropathy and uncovertebral spurring slightly more prominent on the left side resulting in minimal left neural foraminal narrowing. The right neural foramina and the canal maintain their caliber. c4-5 there is disc space narrowing and there is facet arthropathy and uncovertebral spurring slightly more prominent on the left side resulting in minimal left neural foraminal narrowing. The right neural foramina and the canal maintain their caliber. c5-6 there is disc desiccation and endplate spurring with an annular bulge with superimposed central to right paracentral disc protrusion which flattens the right ventral aspect of the cervical cord. The neural foramina still maintain their caliber. c6-7 there is a desiccated disc and there is an annular bulge with right paracentral disc protrusion which flattens the central aspect of the cervical cord. The neural foramina are patent. Impression: mild reversal of normal cervical lordosis and a gentle left sided tilt of the cervical spine. Degenerative changes are seen at c5-6 and c6-7 with central to right paracentral disc extrusions causing flattening of the cervical ford at this level. The neural foramina at these levels maintain their caliber. This all sounds scary to me but when I went to see a neurologist who was very arrogant. He said all my symptoms were not nerve damage. Ok? So what exactly is causing my burning sensation all over my body that shifts to different locations. legs, arms, back, tongue, head, hands, feet. I understand anxiety adds to these issues but I can t imagine this is all in my head. I go from burning to pins and needle pain to shooting pins and needle pain. please help! thank you.
Fri, 30 Nov 2018
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Neurologist 's  Response
Hello,

I am afraid that I have to side with the neurologist, arrogant though he might have been. While the MRI shows some mild degenerative changes of the spine, these are often found in many people, in particular as we age. There is no compression of any nerve root or the spinal cord matter in that MRI interpretation. Even if we were to discuss the competencies of the radiologist who interpreted the MRI there would still be the issue of the symptoms, compression of the nerves or the spinal cord doesn't cause such burning sensations in the tongue and head, their innervation comes from the brain, inside the skull, not the neck. It's the distribution of the symptoms which doesn't fit at all.

There is no doubt that there was initial inflammation and muscle spasms but it seems that the symptoms have been perpetuated by the coming in play of superimposed psychological factors. Of course that doesn't mean that you don't need help, I would still suggest treatment with medication like Duloxetine, which has the benefit of being a common choice both for anxiety as well as being a first choice treatment for pain due to nerve damage, so it's a good choice in any case.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Olsi Taka,
Neurologist
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Suggest Treatment For Severe Migraine And Neck Pain

Hello, I am afraid that I have to side with the neurologist, arrogant though he might have been. While the MRI shows some mild degenerative changes of the spine, these are often found in many people, in particular as we age. There is no compression of any nerve root or the spinal cord matter in that MRI interpretation. Even if we were to discuss the competencies of the radiologist who interpreted the MRI there would still be the issue of the symptoms, compression of the nerves or the spinal cord doesn t cause such burning sensations in the tongue and head, their innervation comes from the brain, inside the skull, not the neck. It s the distribution of the symptoms which doesn t fit at all. There is no doubt that there was initial inflammation and muscle spasms but it seems that the symptoms have been perpetuated by the coming in play of superimposed psychological factors. Of course that doesn t mean that you don t need help, I would still suggest treatment with medication like Duloxetine, which has the benefit of being a common choice both for anxiety as well as being a first choice treatment for pain due to nerve damage, so it s a good choice in any case. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist