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Old 03-19-2004, 09:59 AM   #1
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Severe neck pain do not know what to do!

I have had severe neck pain for 9 days now have been to the doctor 3 times in the past 9 days and she put me on Soma, Flexiril and Vicodin ES and still no relief, i have throbbing pain in my neck and shoulders and a headache that will not go away, what do you guys think it is? she can't seem to diagnose me correctly, took x-rays, nothing. because i have headaches and no skeletal pain it is not my bones! So what should i do and what do you guys think it is? it will not go away i mean a headache and pinching throbbing neck pain for 9 days straight? what the heck is going on?????

Thanks-
keithsgirl22

 
Old 03-19-2004, 10:39 AM   #2
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Re: Severe neck pain do not know what to do!

Hi KG, A kink in your neck that lasts 9 days doesn't quite qualify for the need for pain management. PT may help, heat massage, e-stim and muscle relaxers, If you don't improve after 3-4 weeks of PT then it's time to do more extensive testng lke a MRI. But if you don't have nerve pain shooting down your arms, I don't think you need surgery, But that's kinda hard to DX with the little info you have given. Valium is the best muscle relaxer but long term it's nott a good med. It's very habbit forming, causes depression and inability to form new memories.

ASk to go to PT for some feel good stuff. Your being treated just like anyone else would that presented the same symptoms. It's not the docs fault or incompatence that it hasn't gotten better. Things take time.You could look for causes, are you sleeping on 3 pllows stacked up. A cervicle pillow may help. A pain mnagement doc could give you trigger point injections to releaase the spasm. They are shots of lidocain and an anti inflamatory. A physical medicine doc would be the best thing if you know you don't need surgery.

Without an injury, I can't imagine waking up with blown discs or some gross abnormality. Kinks hurt, but they get better with time. You could ask to try a lidocaine patch for your neck if your not ready for TP injections into the muscle spasm. There are those icey hot patches you could try to relax your neck too. Or Chiropractic.
Good luck, Shore

Last edited by Shoreline; 03-19-2004 at 10:42 AM.

 
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Old 03-19-2004, 12:15 PM   #3
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Re: Severe neck pain do not know what to do!

Thanks Shoreline! Let me give you some more info.maybe you could help me more.
About 4 years back i was in a car accident and i never had headaches before then, but after the car accident i started to get chronic headaches, but my doctors seem to think that it has nothing to do with my headaches now. So, about 9 days back i started to get a headache that even made my teeth hurt, so it progressed and started to get worse, it went down into my neck and shoulders, so my Dr. put me on 2 kinds of muscle relaxers and Vicodin extra strength. still pounding headache, shoulders feel better but neck still hurts, so i do not know what is wrong, i also work 2 jobs and one of them i waitress and i have to waitress tomarrow for 9 hours and i do not know if i can do it!! So what do you think it is? My doctor ruled out spasms she said they were better from the muscle relaxers, but said she did not know what was wrong with my neck. It does start to hurt down my left arm, and this is not the first time it has happened, i get headaches and neck pain almost everyday, just this time it got really bad!! So any help with your experience would be great!!

Thanks-KG

 
Old 03-19-2004, 01:15 PM   #4
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Re: Severe neck pain do not know what to do!

[QUOTE=Shoreline]Hi KG, A kink in your neck that lasts 9 days doesn't quite qualify for the need for pain management. PT may help, heat massage, e-stim and muscle relaxers, If you don't improve after 3-4 weeks of PT then it's time to do more extensive testng lke a MRI. But if you don't have nerve pain shooting down your arms, I don't think you need surgery, But that's kinda hard to DX with the little info you have given. Valium is the best muscle relaxer but long term it's nott a good med. It's very habbit forming, causes depression and inability to form new memories.

...

Shore, another question, you are in high demand.

I, too have neck pain (cervical disc bulging, but not too severe), but lots of spasms in neck and shoulders...TMJ, have had splint therapy, ESI's, PT, MT, now in Pain Mgmt. He has prescribed Valium since my last ESI, but I have not taken it for long...less than a month, but it does work! What, in your opinion, is a better long-term muscle relaxant. I've used Soma and it is OK, but not as effective as the V. Skelaxin's are like takin' a baby aspirin.

Thanks Shoreline, take care, and have a decent weekend.

Del.

 
Old 03-19-2004, 05:31 PM   #5
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Re: Severe neck pain do not know what to do!

KG,

I would talk to your PCP about getting an MRI. I had the same problem. Woke up with a headache that wouldn't go away. No recent trauma, etc. I had an MRI done, honking big herniated disc was found as well as finding out, that at 43, my spine was a degenerating mess.

Wound up with surgery, etc. Now on chronic pain management.

But, that may not be the case for you. If your pain has been going on that long though, I would certainly think it would warrant further radiology studies.

Good luck. I am also a "Keith's girl"

God bless,

Lea
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Old 03-19-2004, 07:13 PM   #6
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Re: Severe neck pain do not know what to do!

KG -
I agree you should speak to your Doc about an MRI, last fall I had sudden arm pain, they thought it was AVN, it wasn't, they decided then it was my shoulder so they operated and nothing.. turns out my cervical spine was so herniated it was compressing my cord severely, ironically I didn't have neck pain until I neared my surgery but I did have shoulder and scapula pain and later arm and loss of feeling completely. It came on all of a sudden. I had severe whiplash some 20 or so years ago from an accident and it progressed into a herniation with an acute onset. I know of several other folks who are in or were in the same situation of having orginally whiplash then some years later having herniations.

While I was in the hospital for my fusion a few weeks back many of the nurses there commented that doctors often miss the diagnosis when there's not arm weakness, numbness or neck pain and attribute it to the shoulder, so this may in fact be your case.
It could also be the case of a very severe migraine and stress. It definately warrents getting looked into further.
As far as along term muscle relaxer I use Flexeril, it builds up into your system and seems to have a better effect if taken several times a day over several days period, have been on it for years. Skelakin messes with your memory bigtime, well for me it did, and valium is actually used to calm you down but some doctors use it as a muscle relaxer, it is no different than Xanax. It does cause depression especially if you are prone to it so it isn't a very good long term solution.
There are also various other muscle relaxers out there, some work chemically in the brain such as Skelakin where as others actually work on the muscles themselves. I don't recall all the various types but some have been around years and if you did a bit of research you'd probably find them.

Good luck and I Hope you get better soon!

 
Old 03-20-2004, 10:53 AM   #7
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Re: Severe neck pain do not know what to do!

Hi Delilah, I agree valium is the absolute most effective muscle relaxer, It works both on the brain and the smooth muscles, where most MR's only act on the brain and not the smooth muscles.

Med use is different for everyone. My wife also has TMJ disfunction, splints and the whole nine yards. No surgery because she has seen what surgery has done to me. Anyway, I have taken valium and had problems discontinuing it after just 3 weeks, However my wife has taken high doses, 40-60 mgs per day for up to 6 months and then tapered off in about a week with no withdrawal or unpleasant side effects.

If I took that much I would be climbing the walls and shivering like a wet chiwawa. So the amount of time it takes to develop physical dependence is different for everyone. Docs do tend to start to get uncomely after the second refill on Valium though. I've also taken all the others, Robaxin, skelaxin, flexerill, soma, you name it I have a bottle in my med cabinet, next to valium, I think Soma is the next best effective MR but that's my personal preference.

I also use Klonopin for the herky jerks from opiates so the combination of Klonopin and Soma comes pretty close to what Valium can do. Have either of ya'll had Occipital blocks to ease the tension and headaches. My wife has had good luck with the OC blocks. You need a good PM doc, preferably an anesthesiologist when it comes to needles close to the spine. Again, my personal preference. But all her blocks were done by the anesthesiologist in my PM clinic. They are done out patient.

Another method to break up the spasm is Robaxin infusions. Although oral robaxin isn't much to write home about a series of Robaxin infusion can be very helpful. Each infusion was a higher dose and gave her more relief.

I really don't went to try to DX someone's neck problems because it can be so many different things. You basically have to go through the hoops.
GP's use something called the medical model to treat many conditions. A medical model is just a way to treat a patient that presents X Y and Z symptoms. If you present symptoms of Cervical turticolus, Stiff neck with neck protruding prone, There is a medical model that says, treat with pain meds, anti inflammatory and muscle relaxers, 90% of folks that present these symptoms will improve in time, If you continue to have problems, the next step is to initiate PT, use heat, e-stim and massage.

If the patient continues to have problems you are starting to fall out of that 90 % that would have recovered from X Y and Z treatment. So the next step is Diagnostics and consults with specialists. Normally surgeons. Surgeons are only going to operate if they find a nerve problem they feel they can fix or a gross abnormality in physiology. Likely a surgeon would suggest something like an Epidural to try to reduce inflammation and would continue meds short term.

If you know your not a candidate for surgery but need care you GP isn't capable of, like Occipital blocks or Robaxin infusions, you need to find a Physical medicine doc capable of doing these procedures or a PM clinic that offers a multi faceted approach to PM. Robaxin infusion and Occipital blocks may be enough to break the cycle of pain and the PM clinic is more likely going to feel comfy using stronger meds to really break the cycle. Yes you can use a short course of morphine or Duragesic and discontinue it in 2-3 weeks without any major withdrawal.

For both of y'all, I would look into physical med docs or PM clinics that offer these modalities of pain intervention. Lidocaine patches may also help when you not able to have an infusion every day. This is a case where a PM clinic may not be needed for lifelong treatment but may be able to help with modalities to get through an acute flair up. Hopefully something like a clinic I described or a physical med doc is in your area to try some of these things when your not responding the way the medical model suggest you should.

There is a medical model that GP's use for almost every presentation of symptoms. The majority of people respond to the X Y Z treatment, but when it become apparent your not part of that 90% population then you need to look outside the model for alternative treatment. Acupuncture is an option, Chiropractic is an option. A full service PM clinic that has docs that can do just about any pain intervention procedure would be ideal to help both of your problems,

. I just don't know what you have available your area. Robaxin infusions aren't complicated, trigger point injections aren't complicated nor are Occipital blocks. You just need to find a doc or clinic that has experience with these modalities.

I'm a lumbar mess and just from the few painful kinks, I can't imagine having your neck be the source of tremendous pain. It's kind of hard to go through life without turning your head.

Hopefully one of the modalities I have mentioned will be available in your area. If not through a local doc or clinic perhaps at the nearest medical school that has a physical medicine program or PM clinic that can offer you these things.

I'm sorry KG if I seemed to minimize what your going through. I didn't realize it was quite as complicated as it is. There are treatment options aside from surgery and having to take LA opiates for the rest of your life. The key is to break the cycle with one of these options, It's just a matter of finding docs that are familiar with these modalities and have seen the benefit from them.

Medtronic's, The company that makes the intrathecal morphine pump will gladly pass along the names of docs certified by Medtronic's to do pump implants and maint. I know your not looking to have a pump installed, But the name of a doc that does pump work may lead you to a practice that offers more than just pumps and opiates.

Hopefully you can find a practice or clinic familiar with these methods of pain intervention. Good luck and contact Medtronic's, get the names of pump docs and see if it leads you to a local clinic or practice in which you may be able to find these services.
Good luck, Shore

 
Old 03-20-2004, 11:49 AM   #8
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Re: Severe neck pain do not know what to do!

Shore,

wouldn't it be great if things weren't always so complicated?

Of course you are absolutely correct about trying conservative treatments first, but with today's technology, getting an MRI certainly wouldn't hurt.

I opted for 3 months of conservative treatment. Did the ESI's, before the pain was so intolerable, I finally had the surgery. Still had pain, but was doing okay, until hit by a drunk driver in December, now, Holy Cow! I am a mess
I just had the neurotomy from C3-8 and looking at possible disogram of the L4-5,L5-S1. as well as lumbar ESI. Just started Duragesic 3 weeks ago and my neurosurgeon is suggesting I go on disability and actually wrote a letter to that effect. It's amazing how quickly things go to hell in a hand basket.

My PM took me off the Soma. Said it was too addictive now, they are going to change the scheduling rating on it, and it builds up some toxicity, but I agree with you, it does help. Was told Valium causes rebound headaches after any type of longterm use, even though it too is a good muscle relaxer as well.

I am a psychiatric nurse, and have seen my fair share of abuse of pain meds, even Ultram, if you can believe that, so I was a little put out when I found out that I was going to have to require opiates to function.

They give me Baclofen, but really Soma or Zanaflex work best for my muscle spasms. Sorry to ramble.

You sound pretty knowledgeable.
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Old 03-21-2004, 01:07 PM   #9
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Re: Severe neck pain do not know what to do!

Hi there,

I've been dealing with serious neckpain for 30 years. I've had two cervical fusions, the last one which failed.

It all started with me being hit by a drunk driver, which after he hit me he plowed me into a utility pole. Car was totaled. Right after the accident, I had severe pain and weird symptoms but every dr told me it would go away, blah, blah, blah. For three years I was diagnosed with everything under the sun and given a myriad of medications to ease the symptoms. Finally in my 4th year since the accident they did a myelogram (shows you how long ago it was!) and found I had a ruptured disc that shattered and was pressing on every nerve around. When I had the fusion, I felt like a million bucks and the 3 years of agony was over. At the time, I was experiencing debilitating headaches with unbelievable neck pain, arm pain, weakness and numbness.

Then in 2000, the same symptoms returned after an otj injury. Lo an behold, I had the same disc rupture again. This time they put in a titanium plate and unlike the first surgery, I never felt good or painfree post-op and the symptoms did not all resolve, thus this resulted in a "failed surgery". It looks like I'm in for another round of this nonsense as my symptoms have progressed significantly and now my right hand and arm are basically useless. I'm scheduled to see another neurosurgeon this month and I have a feeling that it's gonna be a repeat of what's happened the last 30 years. I'm at the point where I can just about assure myself when a disc goes bad now. I've also had a herniated disc at L5-S1 for four years and now it looks like that's trying to rear its ugly head too. Experience is the best teacher I guess.

Anyway, I'm not trying to say you have the same problem at all. As Shore said, it may just be a matter of some PT and gentle care; however, do not let it go for long like I did and don't believe whatever they tell you, when you know something is not right. You will end up being misdiagnosed again and again and in the meantime you will suffer needlessly. Neck pain is horrible and difficult to describe to people who do not suffer with it. It affects every aspect of your daily function because it involves the arms, hands, head and shoulders which you need to move with all the time. Before too much longer, I would request to have an MRI done. The test is easy (as long as you're not too claustrophobic), non-invasive (they don't even use contrast for cervical MRI's) and doesn't take long. Insurance shouldn't have a problem with it since you are having classic symptoms.

Again, it may be nothing at all to worry about. But take it from someone who's been there a few times (and will be again I'm afraid) that if a disc is compressing a nerve or has shattered, it won't go away if you try to ignore it, which is a feat in itself! Maybe give it a little more time; then, if no improvement, request to move to the next step. Good luck, Linda

Last edited by lindao1; 03-21-2004 at 01:21 PM.

 
Old 03-22-2004, 11:13 AM   #10
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Occipital Nerve Blocks

Dear Shoreline,

Thanks for the input. I'm grateful for your knowledge as it allows me to work more efficiently with my PM doc. I think the majority of my pain, primarily muscle spasm and muscle tension is as a result of my TMJD, although my neck has given me probs off/on for years -- the real fun started with TMJD.

I have a wonderful wonderful wonderful PM doc and I trust him, and appreciate his capability and humility. How many people can you say that about, let alone a medical practitioner? I took your previous posts re: ESIs under advisement BTW before going with this doc and the ESI's...he would totally live up to your standards! I have had 2 ESI's w/facet joint injections. The 2nd go round he included an occipital nerve block. The relief has lasted for few weeks with the occipital procedure, but I feel it slipping back again, and needed some ideas before I make another appt. w/him.

I'm with your wife, no surgery for TMJD, many come out the worse for it.

Thx. again and best regards, Del.

 
Old 03-22-2004, 11:56 AM   #11
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Re: Severe neck pain do not know what to do!

When things get tight back there, I use these microwave heated wraps filled with herbs. They stay warm for about a half hour. I've already had a big neck operation, ACDF 4-level with corpectamy at C-6. If I hold my head in the wrong position for too long, I get muscle aches. If I get really tensed up, I might also get a headache, though it's not that common with me. Of course you should get all the tests done to see what's going on inside the neck, but the neck wraps have helped me get through things before and after my operation.

 
Old 03-27-2004, 11:38 AM   #12
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Re: Severe neck pain do not know what to do!

I broke my neck years ago. A year ago I started experiencing terrible neck pain day after day. Finally in the summer, I decided to try a PT. I went to him twice a week for almost 3 months. I was amazed at how much he helped!! The pain went away. To think my DR just wanted to put me on pain meds saying it was stenosis and I would have to learn to just "live" with it....with the help of meds. Not!

Good luck

 
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