Suggest Remedy For Persistent Headache While Treating For A Neck Disc Protrusion

Posted on Wed, 21 Oct 2015

Question: I had an accident on holiday where I was sitting in an inflatable ring and was flipped upside down and landed on my neck. Xrays and MRI showed I had a significant compression at C5/C6 and a severe disc protrusion. My neurosurgeon put me on medication for six weeks and sent me to physio. The main symptom which is not responding to medication is tension headaches, although when I wear a neck brace these ease. Im being sent to another neurosurgeon for a second opinion before surgery. Is this the only option for me?

Answered by Dr. Dr. Erion Spaho (47 minutes later)

Brief Answer:
Surgery seems to be inevitable.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

I examinated the MRI view and report too.

Tension headaches in your case are more probably related to occipital nerves that supply back and top of the head, dysfunction, or compression.

At the moment, symptoms are not so severe as your cervical cord compression is.

There are still not developed symptoms such arms and legs pins and needles, spasticity, etc. because there is only compression on spinal cord without mielomalacia, or cord damage.

In other words, spinal cord is only compressed.

There are other options to treat tension headaches related to spine conditions, one possibility is epidural spinal injections.

Physical therapy should be continued also.

In my opinion, the best treatment way in your case is surgery ( minimally invasive anterior discectomy and fusion ) in order to decompress the spinal cord, create stability, relieve headaches and more important, to prevent mielomalacia and progression of symptoms.

You can wait also, and continue conservative treatment, but if mielomalacia symptoms become visible ( limbs pain and numbness, spasticity, difficulty controlling urination, confined walking etc.) you should be operated in no time.

Prolonged use of cervical collar isn't recommend because it may weaken cervical muscles and promote instability.

Hope you found the answer helpful.

Let me know if I can assist you further.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Erion Spaho (15 hours later)

Thank you. The tension headaches seem to ease with sleep ie lying down but get worse with activity such as walking..its almost if my suspension is gone and i can feel every step i take and every little bump. Also when turning my head i can hear crunching and grinding in my neck. If im still when watching tv and then turn my head i quite often hear and feel a loud click in my neck.

Answered by Dr. Dr. Erion Spaho (2 hours later)

Brief Answer:
Instability of the cervical spine show be assessed too.

Detailed Answer:
Welcome back.

MRI report didn't prescribed any fracture of cervical bones, but since MRI is done in laying position, it can't evaluate any instability of the spine with certainty.

To evaluate this possibility ( instability, listhesis ) x-rays of the cervical spine at neutral, flexed and extended position, should be done.

However, instability or not, you should consider having surgery about your condition.

Hope I helped you.

Best regards.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Dr. Erion Spaho (2 hours later)

Thank you. Xrays were done, show significant compression c5/c6 and some at c6/c7. Surgeon sugesting double disc excision and fusion pending second opinion in two weeks.

Answered by Dr. Dr. Erion Spaho (2 hours later)

Brief Answer:
I agree with that surgery plan.

Detailed Answer:
Okay then.

The decision is yours.

I wish you good health.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D