Persistent Neck Pain and Headache: When to See a Neurologist?

Pain when turning the neck to the right + pain in the right occipital region?

A month ago, I experienced pain when turning my neck.
I have since sought treatment from a chiropractor, traditional Chinese medicine, and received muscle manipulation therapy, but there has been no improvement.
Two weeks ago, I visited a rehabilitation specialist who administered two injections of glucose and provided heat therapy and electrical stimulation.
While I felt better at that moment, the same symptoms have persisted (pain on the right side when turning my neck, and pain at the back of my head on the right side).
I have been undergoing rehabilitation for two weeks, and the treatment has shifted to neck traction, but my condition has not improved.
Should I consider seeing a neurologist for further evaluation?

Xiao Chen, 20~29 year old female. Ask Date: 2022/10/11

Dr. Wang Zhaomin reply Rehabilitation

Rehabilitation therapy usually requires a period of time to gradually show effects.
It is also important to pay attention to posture, keeping the head up, chest out, and chin tucked in, and to avoid prolonged bending or slouching.
If symptoms do not improve or worsen, you should consult a neurologist, orthopedic specialist, or rehabilitation physician.

Reply Date: 2022/10/11

More Info

When experiencing persistent neck pain and headaches, especially when conservative treatments such as chiropractic care, acupuncture, and physical therapy have not provided relief, it is advisable to consult a neurologist. Your symptoms, particularly the pain during neck movement and the associated headache in the right occipital region, could indicate underlying neurological issues that require further evaluation.

Neck pain can arise from various causes, including muscle strain, cervical spine disorders, or nerve compression. Given that you have already tried multiple treatment modalities without significant improvement, it is essential to consider the possibility of a more complex condition. For instance, cervical radiculopathy, which occurs when a nerve in the neck is compressed or irritated, can lead to pain that radiates to the head, shoulders, or arms. This condition can be caused by herniated discs, degenerative disc disease, or cervical spondylosis.

Additionally, your description of pain that persists despite treatment raises the concern for other potential causes, such as tension-type headaches or cervicogenic headaches, which originate from neck issues but manifest as headaches. These types of headaches can be challenging to diagnose and often require a comprehensive evaluation to determine the exact source of the pain.

A neurologist can perform a thorough examination, which may include a detailed medical history, physical examination, and possibly imaging studies such as MRI or CT scans to assess the cervical spine and rule out any structural abnormalities. These tests can help identify any nerve compression, disc herniation, or other neurological issues that may be contributing to your symptoms.

Moreover, if there are any signs of neurological deficits, such as weakness, numbness, or changes in reflexes, these warrant immediate attention. Such symptoms could indicate a more serious condition that may require urgent intervention.

In summary, given the persistence of your symptoms and the lack of improvement with conservative treatments, it is prudent to seek a consultation with a neurologist. They can provide a more specialized assessment and recommend appropriate diagnostic tests and treatment options tailored to your specific condition. Early intervention can lead to better outcomes and help alleviate your discomfort, allowing you to return to your daily activities without the burden of pain.

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