Localised debilitating pain and tingling in lower neck

by Courtney F.
(Tennessee)

Localised debilitating pain and tingling in lower neck

I'm miserable! I appreciate the opportunity to receive your help.

I am 17 year old girl and recently had to pursue my G.E.D. because the pain my neck gives me is that bad.

It gradually started about 4 years ago, and really seemed to be insignificant, maybe from poor posture in school chairs. But within the last year, it just seemed to go downhill very fast. I have seen just about every kind of doctor there is within that year, taken just about every test, as well as just about every kind of pill, even narcotics, muscle relaxers, osteoarthritis medications. I did 3 months of PT, and 2months of Chiropractic care, which I am still doing.

All symptoms:
Pain, highly localised to between C6 and C7. Only on the right side, and with a combination of pressure with my finger and a movement, something snaps and it causes severe pain for just a second.

There is some sore throat like pain going from around there to my shoulder blade. It also goes up into my inner right throat, and a little bit into my ear.

There is some occasional tingling in my right pinkie and ring finger, usually when I sit in a soft recliner; and it occurs in my upper right shoulder just a smidge as well.

There is a major, uncomfortable localized (meaning only a quarter sized area or so) tingling a vertebrae or so below that on the right side. It does not hurt, its just really bothersome.

My shoudler blade snaps not with every movement, but when I feel the need and try to raise my shoulder back to a level position.

That said, I have my right shoulder that droops noticeably if you ask someone to look.
I feel like the muscles underneath my shoulderblade droop also, and as if I can't properly activate it.

I also have a big problem with that in what appears to be my trapezius muscles on the right side. For example, when picking up a milk jug with my left hand, the right side will become very painful while holding it, and i feel the muscles on the left working normally. When I use the other however, it doesn't hurt more than usual, i just don't feel on both the outside and inside, it activating, literally. Like when you flex you biceps, it doesn't flex!

When I have my right hand extended out to my side fully, it does hurt the lower right side of my neck when holding up against pressure.
I have pain 24/7. I have to constantly shift and move, though that doesn't help. It is always constant. Only Icyhot on it helps, and that has burned my skin too much I can't use it very often.
My skin on top of the c6 area, feels a bit diminished in sensitivity. Below that and over to my shoulderblade, it feels tender and just odd.

Other than that, I can move freely, my right side, almost too freely, without any pain, except when:
I open the refrigerator door or similar movements: the same thing that snaps when I press on it seems to slide into something and it hurts like crazy!
Strength seems normal, though I have had to lose athletic strength from giving up sports. Endurance, eh, not as good as my left. Not too noticeable though. I am right side dominated.

I don't recall any significant injury other than maybe heavy backpacks in middle school, my mother having a minor car wreck when she was pregnant with me, playing basketball, and I often straightened my hair every other day (meaning I had my hand over my head with my neck bent for at least half an hour when doing that)

A recent MRI of my right shoulder showed a "tendonopathy" of either the supraspinatus or infraspinatus tendons, and a mild bursitis in the shoulder. A recent MRI of my thoracic spine showed no abnormalities. A cervical MRI of about 15 months ago was normal as well. Recent Xrays all normal, one a long time ago showed I had a "insignificant subluxation of c4-c5" but apparently that has cleared up.

Bottom line is nothing has improved. None of my pain is relieved for more than 5 minutes after I see the chiropractic and do his exercises. I feel like the next step is seeing a psychiatrist!!

Oh and another thing, I just had ligament, steroid, injections done last week. It was one in the c6-c7 middle ligament. I felt pretty good for 2 days, and then it went away.

I think I've thrown everything down that I can think of. I apologise if thrown together in a rush. I actually want to be a doctor -- and I'm so disappointed. I'm miserable and have spent so much time that I shouldn't be spending. I hope I have shared enough information to even have a little bit of light shed on this. Thank you so much in advance!!

P.S. if relevant at all, I am prone to kidney stones for an unknown reason, and have a permanent, congenital hearing loss, and my feet tend to easily fall asleep.

-Courtney F.

Gosh Courtney, that really is miz.

I wish I could click my fingers and come up with an easy solution. Alas, not.

That "insignificant" C4-C5 subluxation is almost certainly at the root of it all. An old injury that you don't remember.

And that snapping sound speaks of an unstable joint. You've never clicked your own neck?

The referral to the shoulder and fingers is not unusual, the nerve roots emerge from the lower neck, but the referral to the throat does say to me: "wait a moment, is there something else going on?" But you've been turned inside out with any findings, so probably ignore that thought.

The deep upper back pain is consistent with a C4-5 nerve root injury.

It's good that you're doing the exercises given by your chiropractor. Keep them up.

I have a few things to suggest:

1. I don't often recommend it, but seeing that instability seems to be at the core of your problem, a cervical collar might help. They usually don't, but perhaps give it a try for a few weeks.

2. That low shoulder suggests you have a short leg. Ask your chiropractor to evaluate that. Sometimes a simple, inexpensive orthotic inside your shoe can do wonders. Don't pay hundreds for the expensive ones.
Leg length inequality ...

A home traction unit, one you use lying down, stretching your neck for about twenty minutes a day can work wonders.

Ask your mum to massage your neck for a few minutes every day.

The last I'm reluctant about, especially if you're happy with your chiro. But different chiros do it differently. Is there a colleague in the same practice you could go to for a few treatments? Find a good chiropractor may be your next step.

There's nothing profound about all that, Courtney, but it's my best shot. Let us know in a month or two how you are getting on.

Oh, could you send me the X-rays? Use your digi to photograph them on a bright window with sky background and send to Contact.

I wish I could be more helpful.

Dr B



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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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