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MENINGITISMeningitis should always be considered in the patient with a stiff neck and headache, simply because it is so serious. Not many patients with meningitis appear in the chiropractor's office, because this patient is SICK! It is a highly infectious disease, so the doctor is also at risk. In hospital the patient will be immediately be placed in isolation. Because we chiropractors treat so many patients with headache, this is a rare but very serious disease that we should keep in the back of our minds. Severe headache is the most common symptom (87%) followed by neck stiffness 83% according. The classic triad of diagnostic signs are:
This is not the typical stiff neck where you can't turn your head to the side, but flexing the head onto the chest is very painful. The classic test of Kernig is done with the patient lying on their back, with the hips and knees bent. If straightening your knees causes neck pain, then it's definitely time to get to hospital. Not to your doctor, nor to your chiropractor. Do not pass GO, do not collect $200, GO STRAIGHT TO THE HOSPITAL. Remember this illness may be highly infectious. Your family and acquaintances should immediately be alerted. The condition may be viral or bacterial. In the latter a rash is common. Meningitis is a medical emergency. FROM THE COALFACEFor years I had a weekly date with a good friend at the squash court. He had a spondylolysthesis, a low back condition that required occasional visits to my couch. We knocked a few kilos off after work, added a few more back with a couple beers, and generally shot the breeze. We were also BMW motorcycle fans, and enjoyed a few rides together. One day he didn't arrive for our date. It was not like him. He phoned the next day to apologise, telling me his better half was in hospital with a very stiff neck."In hospital? Why not in my office?" I asked foolishly. She died three days later. A teacher, she caught it from a child who survived. Headache, stiff neck, high temp? Don't mess with it.
The meninges form the covering of the brain and spinal cord. Here you can see them peeled back during an autopsy of a patient who died from meningitis. Can you see the little bleeds where blood vessels have ruptured? The meninges extend from the brain right down to the low back, covering the brain and spinal cord. That is why in Kernig's test, straightening the legs stretches the meninges and reproduces the neck pain. In a slipped disc in the lower back something similar happens, but without the infection. If flexing your head causes low back pain, then make an appointment today with your chiropractor. For more information,
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To return from Meningitis to HEADACHE.
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