Pain in the neck, base of the skull, upper back, sometimes radiating down the arm.

by Joel
(Webb City, MO)

Are there also degenerative changes in your lower neck?

Are there also degenerative changes in your lower neck?

Pain in the neck, base of the skull, upper back, sometimes radiating down the arm after surgery is a common complaint.


I have been suffering the above symptoms for several months now, ironically following a surgery on my lower back. I was doing physical therapy on my back and mentioned it to my therapist, so they had me doing basic neck therapy including traction. But I have pretty limited success with this approach.

I have since had an MRI showing a herniated disc at C5-C6 and a bulge at the level below.

I was actually scheduled for surgery, but it has initially been denied by insurance. This has given me the opportunity to rethink surgery and consider other treatment options, like chiropractic.

So I have a few basic questions.

1. Can/will a herniated disc heal without surgical intervention?
2. Are the symptoms I listed consistent with a cervical herniation in that area?
3. Do you think chiropractic can help me?
4. Any advice on choosing the right chiropractic doctor?


Thanks for your time!

Joel

Hello Joel,
Your complaint of neck pain following a general anaesthetic is not at all unusual; ask any chiropractic and he or she will tell you of umpteen cases they have treated.

During a general anaesthetic the neck is extended to keep the airway open. If there is one thing the cervical spine does not like, it's looking up for an extended period. The position reduces the size of the foramena where the nerve roots to your arm emerge.

It can certainly also affect the suboccipital region where the nodding action of the skull occurs. Headache is a common feature of this subluxation.

Perhaps you had a previous injury in the area, just lurking and waiting for such a difficult prolonged posture, maybe not; it's speculative.

1. Every chiropractor treats herniated discs virtually on a daily basis, most of which heal once the bulge has been reduced. They are more difficult in the neck than in the lower back.

2. The symptoms are consistent, but I would like to know if the following signs confirm it. Does turning your head to the affected side and then simultaneously looking up give pain in the lower neck, midback and or tingling in the arm? Is the upper limb tension test positive? Find it using the search function at chiropractic help. Is the pain and tingling in your arm relieved by raising your arm above your head?

The dorsal scapular nerve comes from C5 in the lower neck and supplies the rhomboid and levator scapular muscles. Deep upper back pain is common.

3. Yes, it's certainly likely that chiropractic can help you, though research shows that after six months of neck pain, no matter what treatment you have it's not likely to be "cured". I'm not suggesting that a case like yours is routine and a positive outcome with chiropractic is assured; much depends on the manipulative skills of the chiropractor and whether any "hard" neurological signs are present; loss of reflex, numbness or paresis of a muscle.

4. Finding a good chiropractor, one who has the skills and experience to tackle a case like yours is like locating the right architect to build your house, lawyer to take on your case or surgeon to replace a heart valve; talk to friends and neighbours and perhaps your doctor; don't rush to the first person listed in the yellow pages.

Good luck, Joel. This is one of the more painful conditions we treat, so don't feel you're whingeing about nothing. It's called iatrogenic illness; doctor caused disease. It happens in the chiropractic clinic too, so I'm not casting aspersions on medicine.

Let us know how you get on.

Dr B


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Feb 02, 2017
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starstarstarstarstar 		Not having the greatest of luck!
by: Joel Howard

Hello Doctor! Several moons have passed since I last checked in with you. I have continued to struggle with leg and low back issues, but until recently I have had some success getting my neck, shoulders, arms, etc. to settle down. This is mostly due to the work of an excellent Physical Therapist that I found. She is not afraid to try multiple modalities, including dry needling. Which I have found to be particularly helpful.

Unfortunately I have recently experienced increasing pain and unusual sensations in my traps, rhomboids and down my arms (yes both). A recent MRI has shown yet another herniated disc at the level below my last fusion. Which I understand is quite possible/likely after a fusion. I just did not expect it so soon. To my surgeons credit he fought hard for me to get an artificial disc replacement, which he hoped would lead to less stress on the adjacent discs. However, due to our wonderful American insurance he was unable to get it approved. So I am only 10 months post fusion and now have issues at the next level. I will say this level wasn't exactly healthy prior to this, but I just didn't expect trouble so soon. I thought there was a way to send you an image of the MRI, but apparently I am not smart enough to figure that out. If there is a way, please let me know. I would like for you to see it, so you could give me your opinion on whether surgery is my only option.

As always, thank you for this wonderful site.

Hello Joel,
It is soon, but I'm afraid the normal course of events; after a fusion the joints above and below have to do extra work, and they start to complain.

Ask for a cervical traction unit that you can use at home; they're not very expensive. Use it lying down for about 20 minutes every day, gradually increasing the weight and not being too anxious going above the recommended 7kg. It might help.

Go on with your PT, obviously helping. And perhaps a sports massage once a week.

In my practice I do a lot of work in the upper back, keeping T2-T5 mobile. You're in a difficult place; wish I could be more helpful.

Scans are hard to send.

Dr B
Feb 03, 2016
Rating
starstarstarstarstar 		Update on my situation
by: Joel Howard

Hi, I wanted to give a brief update on my neck and arm pain condition. I have now received approximately 10 treatments from my chiropractor and I felt we were making some progress. The mobility in my neck had improved, the pain radiating down my arm had improved, headaches seemed to have improved. However this last week seems to have been a major setback. My neck is back to hurting, more pain radiating down my left arm than before, shoulder muscles are sore, etc. I even seem to be having some pain/tingling in my right forearm which may or may not be related.

So, I have a few questions. Are setbacks like this normal? Once you have a setback are you starting from scratch again? Realistically how many treatments should I have before I decide that it is not working?

As always, thanks for your time.

Hello Joel,
This is difficult for me to answer, obviously I'm not abreast of many of the facts.

My own opinion is that less treatment is better than more, for degenerative necks. So I schedule quite quickly longer periods between consultations once there's been some improvement. But that's just my own opinion. And it may not be pertinent to your case.

Also, did he perhaps change the treatment at the time it worsened. Hard for you to know, but sometimes for example if you changes from adjusting C6 on the right, to the left, then it may go south.

Use your own intuition is my best answer, and discuss it fully with him.

Good luck.

Dr B
Jan 05, 2016
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starstarstarstarstar 		Pain in the neck, base of the skull, upper back, sometimes radiating down the arm update
by: Joel

Hello! I wanted to give an update on my situation. I have found a chiropractor that I feel can help me. He did a complete exam including x-rays and asked for my MRI as well. He wanted to look all that over before doing anything. Then we had a consultation meeting. He does feel that he can help me, but made no promises of a complete cure.

I also have significant lower back issues. I had a microdiscectomy at L5-S1 7 months ago and have not had good results. I still have nerve issues in my feet and pain in my legs, especially the right one. Anyway, he is going to try to help with both. I had my first appointment yesterday and it seemed to go well. He cautioned me not to expect miracles after just a few treatments.

My gut feeling is that he can help with my neck, but that my low back issues are going to require another surgery. I hope not, but that is my feeling. In the lower back he says the SI joint on my right side is not moving freely and we need to remedy that. The good news is that my neck felt somewhat better after just the one treatment, the bad news is that my leg/back did not. But I know it can take a considerable amount of time.

Just wanted to give an update. Thanks again for your advice and time.

Hello Joel,
Thanks for this; it's always a good sign when you feel better right from the start.

As far as the lower back is concerned, we always start with any fixations in the SI joints; it may or may not make a difference. In any event, do your level best to avoid another surgery; more scar tissue, more fibrosis and so often even more troubles.

Just read the a recent letter at "disturbing letters" from someone who's had his third.

Good luck, be sensible about heavy lifting, do your exercises and whatever else your chiropractor recommends. Again, let me know how you're getting on in a month or two.

Dr B
Dec 28, 2015
Rating
starstarstarstarstar 		Pain in the neck
by: Joel

The answer to all of your questions is yes. I hope this bodes well for chiropractic helping me. I am scheduled for an appointment this week.

Thanks for your help,

Joel

Pleasure Joel, perhaps take a copy of my letter with you, and all your xrays and tests.

Let me know how your get on in a few weeks; remember, Rome wasn't built in a day.

I hope it's a happier new year.

Dr B

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