Discussions By Condition: Muscle conditions

Please help with neck pain...

Posted In: Muscle conditions 4 Replies
  • Posted By: Anonymous
  • April 14, 2009
  • 05:35 PM

I am really getting desperate. Here's my story, please feel to ask an questions:

I am a 33 year old female. December 28, 2003 I was kicked in the face, around the left eye, by a horse. Results: broken nose, fractures left cheekbone & orbital floor and orbital side. A week later surgery to replace the orbit and cheekbone with screws and fix the nose.

A couple months later I started to have severe neck pain. Cervical CT/MRI/Xrays are all negative. What has followed over the years is a series of treatments to include: Physical Therapy, Chiropractor, Epidural Steroid Shots, Trigger Point Injections, Cervical Botox Injections, Nerve Root Blocks, Facet Root Blocks, Rhizotomy. In addition I recently had new Cervical CT/MRI/Xrays completed that still show no abnormalities. Rhizotomy has given me some relief though not much and the rest of the therapies gave me NO relief. I have also tried multiple medicines including medicines for nerve pain relief and various muscle relaxers and couldn't find a medicine that even touched the pain.

Right now I take sleeping pills to sleep at night and a small amount of Vicodin to get through the day.

For me the pain is in a very specific area, it does radiate beyond that area but I don't mind the radiating pain so much. The pain is in a spot directly right of C2, then radiates causing occipital headaches on right side only, light pain around the right eye and right ear, and pain that goes through the bottom of my right shoulder blade and down the lower side of my right arm and out through my pinky.
In 2006 I had an EMG which did confirm that there is nerve damage in my neck.

I have a doctor at Johns Hopkins who is willing do surgery to fuse the cervical vertebrae, but it isn't something that I am comfortable trying since they can't physically see anything wrong with me.

Can anybody help me? I can accept being in pain for the rest of my life, but I have 2 goals: (1) I want a diagnosis as to what is causing the pain, and (2) I want to find a way to treat the pain so it is at a more manageable level.

Please, if anybody can help me, you have no idea how much it would mean to me. Thank you!

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4 Replies:

  • Sounds to me like a tear in the splenius capitis muscle. This would also account for the radiating pain. I'm an LMT who specializes in this type of injury. This is the most common neck sprain I have seen....unfortunately, this type of injury does not always heal in such a way to provide complete relief. It is common for the patient to have neck pain in this area for life, although some things can be done to minimize that. An injury such as you describe fits nicely with this. Injury to this muscle will not always show up in CAT scans. Rarely, in fact. What did the PT do, exactly? Did it help at all? If the docs are stating that you have permanent nerve pain, what is their solution-- the cervical fuse? How long were you involved with physical therapy? The Rhizotomy, how long ago was that? You state some relief from this but not total. Could you be more specific about the effect of this surgery for you? The only way that I know of to treat this type of chronic pain in this area without surgery would involve physical therapy direct to the affected muscle as well as strengthening the surrounding supporting muscles at least twice weekly for life as well as home exercised to be done daily. What is your status with doing things (ROM-type and strengthening exercises) at home?It sounds like a small thing to do, but are you taking magnesium supplementation? It can really help even very severe muscular pain.
    Harmonium 322 Replies Flag this Response
  • Thank you so much for answering me! I have attempted to answer your questions below: Sounds to me like a tear in the splenius capitis muscle. This would also account for the radiating pain. I'm an LMT who specializes in this type of injury. This is the most common neck sprain I have seen....unfortunately, this type of injury does not always heal in such a way to provide complete relief. It is common for the patient to have neck pain in this area for life, although some things can be done to minimize that. An injury such as you describe fits nicely with this. Injury to this muscle will not always show up in CAT scans. Rarely, in fact. What did the PT do, exactly? Did it help at all? If the docs are stating that you have permanent nerve pain, what is their solution-- the cervical fuse? How long were you involved with physical therapy? I need to look back at my notes to answer this one, as the PT was a few years ago. I do remember that I initally saw a different therapist each visit, however the last few appointments I requested a specific person b/c she seemed to take me more seriously than the others. I will review my notes and come back to this question. As for the cervical fusion, the Drs seem willing to try the surgery, however they state the outcome is unknown, anywhere from being worse off to better. The Drs seem to feel that it is a good gamble, however I don't, at least not quite yet. The Rhizotomy, how long ago was that? You state some relief from this but not total. Could you be more specific about the effect of this surgery for you? I have had this procedure twice. The first time 12/28/07 in C2/C3/C4 and the second time recently 1/27/09. As for relief, it's difficult to describe levels of pain, but I do feel that the rhizotomy helped with some pain though not much. I'm sorry that I don't have a better answer than that, it's just hard to describe. The only way that I know of to treat this type of chronic pain in this area without surgery would involve physical therapy direct to the affected muscle as well as strengthening the surrounding supporting muscles at least twice weekly for life as well as home exercised to be done daily. What is your status with doing things (ROM-type and strengthening exercises) at home? Currently I do alot of stretching and some isometric exercises for my neck. Also last fall I started some lifting, but then cold weather hit and I admit that the pain increased, due to cold weather or shots wearing off I'm not sure, and I stopped working out at all. I currently am going to start working out again to try to build my upper back and neck muscles. It sounds like a small thing to do, but are you taking magnesium supplementation? It can really help even very severe muscular pain. Not currently, however I will look into it, I'm willing to try just about anything.
    Anonymous 42789 Replies Flag this Response
  • It is my belief, and my experience helping others with similar situations, that the cervical fusion would do more harm than good. However, I'm not a doc, just an LMT with experience treating neck injuries. Seems kinda like over-kill to me......treating a soft-tissue abnormality with bone fusion. While it may indeed provide some relief....there are many complications that can and do occur commonly, not least of which would be this making things worse. You wouldn't be able to go back an 'undo' this procedure if the results were not favorable, whereas with other methods, it's always an option. If I were you, I would try to find a specialist in your area for soft-tissue manipulation. It does sound like some effort has been done in the past in this type of problem....but some of these things, particularly what I think you are experiencing from your post, require a long-term, intensive therapy for the area. If it has been years since you have done PT, you should try that again first before resorting to any type of surgery, IMO. Please note, however, that a real commitment must be made from you to not only find someone who is qualified and takes you seriously, but to go through this type of manipulation on a very, very regular basis for quite some time. The benefit of doing so would be a permanent solution to your pain, free ROM and a cessation of your headaches as well. It IS a painful process, getting everything working optimally again, but theoretically would be less pain in the long run. And I really cannot stress enough that it does require real effort on your part-- this is no 'quick fix' although it's usually a very effective one if the time and effort is put forth by you and a highly qualified therapist.Also note that the most recent Rhizotomy, the one in January of this year, will not have the full effects or relief for up to one year post-surgery. This means you could have more relief than you are already experiencing ahead of you this year. Continued and sustained soft-tissue work would only help hasten this. Are you in the US, if you don't mind me asking? I have some contact numbers throughout the county that may provide assistance to you. If you want, you can e-mail me at harmonium77@gmail.com and we can speak more personally and privately about this. If that is not a viable option for you, I would research local sports therapists in your area-- someone with real experience treating soft-tissue and nerve issues in a person your age and from trauma, not wear-and-tear. A good therapist will have a meeting about a plan of action and interview for both of you before actually laying hands or touching you at all. They will not hesitate to work with your doctors on this-- anyone who does hesitate to work with your existing docs is not a good match. A local university or sports team could give you some contact numbers. You want someone with experience in neuromuscular therapy, someone credentialed. I am sorry to hear of your injury and problems thereof.....I ride horses too, an injury like yours is one of my nightmare scenarios. I really do think you can get some relief from this with the right therapy, however.
    Harmonium 322 Replies Flag this Response
  • I sent you an email and look forward to talking with you more, thank you so much!
    Anonymous 42789 Replies Flag this Response
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