Category Archives: Neck

People With Longstanding Lumbar Nerve Root Problems Have “MRI Invisible” Lesions

Radiculopathy (sciatica) cases were categorized by their pain diagrams and physical findings. Only 16- 37% of cases showed MRI findings.  If there is an MRI-visible issues – only 22-78 % cases have symptoms (positive  predictive values of MRI-visible nerve involvement).  … Continue reading

Posted in Back Pain, Insurer issues, Neck, radiculitis | 3 Comments

Manual Therapy May Help Trigeminal Neuralgia

A case  demonstrating that work on the neck can be helpful in Trigeminal Neuralgia (TN).

Posted in Manual Med, Neck, Trigeminal Neuralgia | 1 Comment

Perineural “Tarlov” Spinal Nerve Outlet Cyst Pains – Overlooked and Treatable

I have a patient with multiple level cysts where the nerves exit the spine in the neck. He also has some mild foraminal stenosis. He is symptomatic with arm and referred upper back pain. Getting his problem taken seriously has … Continue reading

Posted in Abdominal pain, Back Pain, Neck, pelvic | 1 Comment

Chronic Nonspecific Neck Pain Cut in Half With Just an Epidural Of Local Anesthetic

Chronic neck pain without a disc protrusion or facet indications (negative blocks) gets no respect. One can have pain from internal disc disruptions in a neck disc and have nothing to show for it. Now it looks like the patient’s pain can … Continue reading

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Snapping Sound in Neck

I had a patient with rather audible and palpable snap with neck rotation. She was concerned she had loose joints in neck. It turned out to be coming from a snapping Splenius cervicis muscle.

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Neck Pain Not Synonymous With Anxiety

Examination of a chronic neck pain group found no association of pain and anxiety – So don’t call them nuts!

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Prior Motor Vehicle Accident (MVA) Doubles Chance Persistent “Troublesome Neck Pain” .

A Saskatchewan Study found people with previous MVA had twice the rate of persistent neck problems. Insurers like to play down this association but in fact this is real.

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Is Cervical Spondylotic Myelopathy Genetic?

Old age change in the neck leading to narrowing of the spinal canal is the bane of older subjects. A Chinese study suggests, in their population, it is related to Vitamin D receptor polymorphisms

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New Hope For Refractory Neck Pain – Botulinum “Botox” – But Not Cheap

Botox reduced pain in chronic neck pains (average 9.1+ years) for at least 2 month versus placebo -randomized and blind !! 150 – 300 unit was used per sesssion.

Posted in Botox, Neck | 1 Comment

Unresolved Shoulder Pain – Look at the neck

Came across a good power point presentation of a case of shoulder pain not helped by surgery and how the neck should have been considered: Available here

Posted in Neck, shoulder | 3 Comments

Fibromylagia, Bad Neck (and perhaps arm pains)but Normal MRI? – Need a Functional MRI

In the neck, imaging can be next to useless in many cases of unresolved neck pain. Incredibily, some people are told nothing showed on imaging so it has to be in their head. Now functional (multipositional) upright MRI is demonstrating … Continue reading

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Advanced Disc Degeneration Still Very Painful

Article states “there has been a belief that DD initially causes pain because of the penetration of fluid nuclear material through annular fissures, and that pain eventually resolves as the nucleus becomes fibrotic and can no longer penetrate the fissures”. … Continue reading

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Neck Cheap Home Cervical Traction

I have found inflatable neck traction very useful for neck radiculopathy cases. A cheap source is available on ebay

Posted in Neck | 2 Comments

Whiplash – When Does “Give It Time” No Longer Apply

Recent metanalysis of studies suggests recovery is not great after 3 months

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Unresolved Whiplash? – Look for Shoulder Impingment.

11/220 cases of whiplash, examined medico-legally for non-resolution, had comorbid subacromial impingment, many of which had been missed. This adds to the growing legion of real problems missed in whiplash cases.

Posted in Insurer issues, Neck, shoulder | 2 Comments

Etanercept (Enbrel) for Radiculitis (Sciatica)

The common and disabiling pain condition is chronic lumbar radiculopathy (chronic back pain/Sciatica). Despite the widespread promotion of treatments of neuropathic pain a recent analysis of neuropathic pain treatments has concluded the following: “To date, no medications have demonstrated efficacy … Continue reading

Posted in Back Pain, Drugs, Neck, neuropathic, radiculitis | 35 Comments