So many 'symptoms' so may questions

by Danielle

So I have recently gone to my navy medical for help and they basically tell me I am fine; the usual answer. I have had a neck issue for several months now; previously had a shoulder surgery which they said "your neck has been over worked and will go back to normal when your recovery from shoulder surgery is completed".

So I am now at 8 months after surgery and have began to get worse on my neck. Sometimes I can't feel my face, it feels numb and drooping but I can feel my fingers touching my cheeks and mouth.

Also I have weird sensations down my arms; it's pain but at the same time numbness and tingling. And the worst one of all is if I tilt my head to the right I feel "normal" but as soon as I tilt it left I can feel the blood drain as if I had my body flipped upside down.

I have had a kink in my neck for about 8 months and I know it's hitting some nerve but not which ones. I have the MRI readout if you would like it. I am in desperate need of help!

Hello Danielle,
You need to find someone skilled in doing Adson's test. It's quite subjective so only a person who does it regularly will know the difference between what is normal, and what is not.

The blood supply to your arm passes through a narrow space called the interscalene triangle, along with the nerves. If they are being pinched in that area, usually by a subluxated first rib, then if you tilt your head to the side, rotate and look up, and simultaneously take in a deep breath, then the pulse in your wrist lessens and even ceases; it will feel as though your arm is starved or drained of blood. There are other variations of this test that I won't go into. It's called a thoracic outlet syndrome.

However, this may be more complicated than that; the sensory nerve to your face doesn't come from your neck. The trigeminal is a cranial nerve, so the facial numbness has nothing to do with your spine. Do you have any jaw joint, or TMJ, issues?

Neither of these areas of entrapment would show up on an MRI of your cervical spine.

Then that tilting of your neck is also very similar to what is known as Spurling's sign; that certainly is an entrapment in the cervical spine with immediate referral to the arm.

Your shoulder may be normal, but there's obviously something else going on. My advice is to see a neurologist who can examine you more thoroughly. In short it's complex and will take a skilled and committed neurologist, or chiropractor with a strong background in neurology, to work it all out.

The search function at Chiropractic Help will enable you to find out more about these terms; it's in the navigation bar on your left.

Good luck, I hope this has contributed. Let me know when you have a diagnosis that is clearly correct and suggested course of action.

As a rule of thumb trust those able to examine you rather than some unknown quantity on the web. There's no harm using your own brain and doing a bit of your own search though; particularly when you feel you're being given the run around.

Dr B

» So many 'symptoms' so may questions.

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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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Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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