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What Causes Sharp Pain In The Left Side Of The Head?
Question: Hi,
I had two ruptured discs removed c4-5 and c6-7 with cervical fusion 6 years ago. Am having sharp pain shoot up back of head on the left side whenever i tilt head back or turn it to the right. Do you think this is muscle/nerve related and heat/ice/muscle relaxers should help (i have those) or could it be another disc issue?
in pain, so hate to sit at office or er if what I have at home and rest will help.
Thanks!!! XXXXXXX
I had two ruptured discs removed c4-5 and c6-7 with cervical fusion 6 years ago. Am having sharp pain shoot up back of head on the left side whenever i tilt head back or turn it to the right. Do you think this is muscle/nerve related and heat/ice/muscle relaxers should help (i have those) or could it be another disc issue?
in pain, so hate to sit at office or er if what I have at home and rest will help.
Thanks!!! XXXXXXX
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
The muscle/nerve issues are not necessarily separate from disc issues, it is often a disc issue leading to nerve compression and muscle spasms.
Judging from your description that type of pain sounds like occipital neuralgia. It is due to compression of the occipital nerve which exits the spine in the upper neck and supplies the back of the head. Such compression may come due to chronic arthritic changes like bony spurs or bulging discs. Having fusion at one (or 2) levels doesn't exclude having issues at other levels.
That is in first place because the degenerative changes at C4-5 C6-7 are rarely isolated, the spine in general is affected and furthermore the fusion by limiting mobility at that level adds the strain on other levels. So it can happen unfortunately.
In terms of what to do, the pain killers, heat and muscle relaxers are the correct first step. A soft cervical collar may be added for a few weeks as well. Hopefully with inflammation subsiding you will feel better. If that doesn't work medication for chronic and neuropathic pain like Gabapentin may be tried. If that doesn't work either local injections are the usual next step.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
The muscle/nerve issues are not necessarily separate from disc issues, it is often a disc issue leading to nerve compression and muscle spasms.
Judging from your description that type of pain sounds like occipital neuralgia. It is due to compression of the occipital nerve which exits the spine in the upper neck and supplies the back of the head. Such compression may come due to chronic arthritic changes like bony spurs or bulging discs. Having fusion at one (or 2) levels doesn't exclude having issues at other levels.
That is in first place because the degenerative changes at C4-5 C6-7 are rarely isolated, the spine in general is affected and furthermore the fusion by limiting mobility at that level adds the strain on other levels. So it can happen unfortunately.
In terms of what to do, the pain killers, heat and muscle relaxers are the correct first step. A soft cervical collar may be added for a few weeks as well. Hopefully with inflammation subsiding you will feel better. If that doesn't work medication for chronic and neuropathic pain like Gabapentin may be tried. If that doesn't work either local injections are the usual next step.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. I have a soft collar and also Gabapentin which was prescribed for migraine issues. If I continue the heat and muscle relaxers and add the Gabapentin (i have 100mg capsules) what dosage/frequency would you advise if adding that and how long would you advise I wait without improvement before I seek further treatment? I just don't want to do anything that could cause something more serious to come about? Anything I should watch for that would indicate something more damaging is happening?
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
Since you have 100 mg capsules I assume you take a low dose (there are 200 and 300 mg ones). Gabapentin dosage can go pretty high, but it should be gradual. It can go up to 1800 mg a day, even 3600, though I wouldn't recommend going over 900 mg a day (this being a virtual consult I would like to be prudent). So I would go up to 300 mg 3 times a day (again gradual, if you are under say 200-300 mg a day, increase by 300 mg every 2 days).
If symptoms persist for 3-4 weeks without improvement then imaging should be scheduled to consider other interventions.
You shouldn't be afraid of something more damaging happening, unlikely, but anyway symptoms which should worry you would be weakness of the limbs with gait difficulties which could indicate spinal cord compression.
Let me know if I can further assist you.
Read below
Detailed Answer:
Thank you for the additional information.
Since you have 100 mg capsules I assume you take a low dose (there are 200 and 300 mg ones). Gabapentin dosage can go pretty high, but it should be gradual. It can go up to 1800 mg a day, even 3600, though I wouldn't recommend going over 900 mg a day (this being a virtual consult I would like to be prudent). So I would go up to 300 mg 3 times a day (again gradual, if you are under say 200-300 mg a day, increase by 300 mg every 2 days).
If symptoms persist for 3-4 weeks without improvement then imaging should be scheduled to consider other interventions.
You shouldn't be afraid of something more damaging happening, unlikely, but anyway symptoms which should worry you would be weakness of the limbs with gait difficulties which could indicate spinal cord compression.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your assistance. I appreciate the advice and will follow your suggestions!
Brief Answer:
Thank you!
Detailed Answer:
Thank you for your appreciative words and you're welcome. I hope you feel better soon.
Thank you!
Detailed Answer:
Thank you for your appreciative words and you're welcome. I hope you feel better soon.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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