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Neurology (Expert Forum)
Chronic headache and neck pain
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Chronic headache and neck pain
by ali136, Mar 19, 2003 12:00AM
Almost 2 years ago, I was involved in an accident and broke my right cervical and a rib in my back, both on my right side. Since then, I have had chronic neck pain with a chronic, steady headache. I have gotten migraines all my life, and now I get them more frequently. I have had x-rays, an MRI, physical therapy, and chiropractic care. Nothing has helped. My doctor wants me to go back to physical therapy and has me on two medications: naproxen and cyclobenzaprine. I also take imitrex for my migraines (which hardly helps). Even with these two medications, my pain is peak high. The muscles on the left side of my neck are extremely tight and sore, with the right being less painful. I've been to a few doctors, but no one is telling me what is wrong exactly. I've read some of your answers in this forum, and I see you recommend an EMG quite frequently. What is that exactly, and what does it involve? My doctor does not believe there is nerve damage, because I have full feeling and usage of both arms. I am very frustrated, and don't want to believe that I will be living with this pain for the rest of my life, paying for pain medicine along the way. I'm 22 years old.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Mar 19, 2003 12:00AM
An EMG or electromyogram is a test that looks at the integrity of your nerves and muscles. There are two parts: the nerve conduction studies where the tech/doc stimulates your nerves by sending little shocks up the nerve and records your sensory and muscle responses. We look at a number of things here including the time it takes for your nerve to react and how much it reacts. The second part is the needle examination in which a very small microphone located at the end of the needle is placed into different muscles to listen to the activity and monitor it on the screen. It's a little bit uncomfortable, but can be very helpful when we're looking at diseases that affect the nerves and muscles.
In your particular case, that doesn't seem to be the primary problem. An EMG is not helpful for chronic pain in the absence of neurological problems like weakness or sensory loss, especially with negative diagnostic testing. I agree with you in that you're way too young to be living with chronic pain that's debilitating. One thing that you may consider are botox injections to relax the tense muscles in your neck and head. This can be done by a headache specialist and has helped a number of our patients here at the clinic. There are other muscle relaxants that may also be helpful. There are special techniques that we recommend for our patients with neck/head tension that physical therapy can do including ultrasound massage and heat therapy. Finally, alternative treatments such as acupuncture, yoga, and meditation have been helpful in some of my patients. Good luck.
In your particular case, that doesn't seem to be the primary problem. An EMG is not helpful for chronic pain in the absence of neurological problems like weakness or sensory loss, especially with negative diagnostic testing. I agree with you in that you're way too young to be living with chronic pain that's debilitating. One thing that you may consider are botox injections to relax the tense muscles in your neck and head. This can be done by a headache specialist and has helped a number of our patients here at the clinic. There are other muscle relaxants that may also be helpful. There are special techniques that we recommend for our patients with neck/head tension that physical therapy can do including ultrasound massage and heat therapy. Finally, alternative treatments such as acupuncture, yoga, and meditation have been helpful in some of my patients. Good luck.
The treatment takes about 10 minutes and lasts about 3 months. I found Stanford by calling the manufacturer of botox. Best to go to a pain clinic where they have experience. I contacted several private doctors--they are more interested in cosmetics.
I wish you luck.
Sincerely,
Kimster