Weakness in neck, headaches

[limirl]

I got back from a dive trip to the philippines recently, my last dive was actually November 30th. Several hours after my last dive that evening I experienced very faint tingling & numbness in my foot but it was not constant as it seemed to come and go. The next morning I went back to the dive shop and discussed it with them, their personal opinion was it was not DCS but I should get it checked out anyway. We tried to get a consulting doctors opinion from the local chamber facility but he was unavailable. Since the symptoms were very slight and not constant I travelled onwards to thailand about 36 hours after my last dive. I had no further problems on the flight there but the symptoms would still show up and then disappear. The day after arriving in thailand I felt like I had a hangover effect, slightly woozy with a slight headache. I called DAN, they also did not think it was DCS but advised me to see doctor. I ended up seeing a neurologist who wasn't sure of the exact cause without further tests but in the meantime prescribed some blood circulation meds and something for the headaches. It was okay for a few days then the headaches returned but nothing too severe, it just felt like I had that hangover feeling. Also my the back of my neck felt very tense and weak almost. It seemed to me the headaches were caused by this tenseness in my neck.

Upon my return here to the US I have tried to see a doc specializing in dive medicine and describing my symptoms to him he recommended that I see a neurologist. Unfortunately since its the holidays most practices are closed and I cannot see one of the neurologists until the new year. DAN seemed to think I may have picked up a musculoskeletal injury of some sort. Could it be a pinched nerve in my neck causing these constant headaches, I have had them for a month now and its kind of annoying ?

Any opinions, advice on this.
Thanks.

 

[TSandM]

There are a lot of possible causes for chronic or recurrent headaches. Musculoskeletal problems are on that list, for sure, as are sinus infections, eye problems, tooth issues, and a host of other things. You might consider seeing an acupuncturist while you are awaiting your neurology consultation -- acupuncture may not address the underlying cause, but it is a recognized and approved method for chronic pain control.

 

[cutlass]

Any news on this?

Generally, headaches directly caused by a pinched nerve have an origin high in the neck; viz., the cervical vertebrae C2 and C3 which is roughly in the area behind the lower jaw. Pinched nerves lower in the neck can affect the neck, shoulders, upperback, and down various regions of the arm and hand. It's a bit unusual to get a pinched nerve so high in the neck without a previous noteworthy injurious event such as a blow to the area or a jolt such as whiplash from a car accident. A degenerative cause (a failing disc for example) should also be considered.

Besides trauma, there could be an inflammation which is affecting the nerves. Meds for headaches are typically anti-inflammatory and so would also reduce the swelling affecting the nerve. The causes of inflammation are many but travel overseas is a flag to consider infections or toxins. Because the complaint has already spanned a month, although an infection could've been the trigger event, I kind of doubt it's still active. (I'm a bit curious about your first report of tingling in your foot; it was significant enough to concern you. Another point was if the neck tension was just "tight" or accompanied by pain, with or without head movement.)

 

[Cave Diver]

Any news on this?

Generally, headaches directly caused by a pinched nerve have an origin high in the neck; viz., the cervical vertebrae C2 and C3 which is roughly in the area behind the lower jaw. Pinched nerves lower in the neck can affect the neck, shoulders, upperback, and down various regions of the arm and hand. It's a bit unusual to get a pinched nerve so high in the neck without a previous noteworthy injurious event such as a blow to the area or a jolt such as whiplash from a car accident. A degenerative cause (a failing disc for example) should also be considered.

Besides trauma, there could be an inflammation which is affecting the nerves. Meds for headaches are typically anti-inflammatory and so would also reduce the swelling affecting the nerve. The causes of inflammation are many but travel overseas is a flag to consider infections or toxins. Because the complaint has already spanned a month, although an infection could've been the trigger event, I kind of doubt it's still active. (I'm a bit curious about your first report of tingling in your foot; it was significant enough to concern you.)

I have a friend experiencing similar problems (pain, headache) after having whiplash from a car accident. Work with a PT strengthening neck muscles has helped, but the problem still persists. I'd be interested in hearing any other treatments for this as well.

 

[cutlass]

I have a friend experiencing similar problems (pain, headache) after having whiplash from a car accident. Work with a PT strengthening neck muscles has helped, but the problem still persists. I'd be interested in hearing any other treatments for this as well.

Whiplash injury is variable, generally guided by the forces involved. Nerves in the high C2-C3 area are usually related to pain in fairly localizable areas of the head; e.g. the back areas for C2, more forward around the ears and cheeks for C3. *

Much more common is soft-tissue injury throughout the neck; stretched or compressed muscles, tendons, ligaments, discs, nerves, even blood vessels. Healing of these is variable (think "scars are replacements, no two scars are alike") and longterm residual pain from imperfect replacement is common, unfortunately. PT typically works toward relief by trying to optimize the structure of healing tissue and by strengthening supporting accessory structures. (Which is why you start PT asap and stay with it.) Pain has a psychogenic component and so some relief can come from that direction; i.e. building tolerance, good attitude, or placebo/self-hypnotic type treatments. As TS&M mentioned, alternative methods such as acupuncture may be tried. With these, the mechanisms are not understood and results inconsistent but, hey, if it's eligible for reimbursement, I'll give it a shot.

*As for actual fractures up this high (e.g. odontoid fracture), these call for a pretty forceful or focused whack; less, perhaps much less, in the presence of other diseases such as osteoporosis. Infants and young children have more relative head mass and smaller neck/shoulder structure than adults, making higher relative stresses for them.